2023-09-28 14:46:10 +00:00
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abstract: 'BackgroundPrimary care physicians (PCPs) working in mental health care
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in Tunisia often lack knowledge and skills needed to adequately address
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mental health-related issues. To address these lacunas, a training based
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on the Mental Health Gap Action Programme (mhGAP) Intervention Guide
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(IG) was offered to PCPs working in the Greater Tunis area between
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February and April 2016. While the mhGAP-IG has been used extensively in
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low- and middle-income countries (LMICs) to help build non-specialists''
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mental health capacity, little research has focused on how contextual
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factors interact with the implemented training program to influence its
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expected outcomes. This paper''s objective is to fill that lack.MethodsWe
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conducted a case study with a purposeful sample of 18 trained PCPs. Data
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was collected by semi-structured interviews between March and April
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2016. Qualitative data was analyzed using thematic
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analysis.ResultsParticipants identified more barriers than facilitators
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when describing contextual factors influencing the mhGAP-based
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training''s expected outcomes. Barriers were regrouped into five
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categories: structural factors (e.g., policies, social context, local
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workforce development, and physical aspects of the environment),
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organizational factors (e.g., logistical issues for the provision of
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care and collaboration within and across healthcare organizations),
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provider factors (e.g., previous mental health experience and personal
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characteristics), patient factors (e.g., beliefs about the health system
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and healthcare professionals, and motivation to seek care), and
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innovation factors (e.g., training characteristics). These contextual
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factors interacted with the implemented training to influence knowledge
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about pharmacological treatments and symptoms of mental illness,
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confidence in providing treatment, negative beliefs about certain mental
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health conditions, and the understanding of the role of PCPs in mental
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health care delivery. In addition, post-training, participants still
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felt uncomfortable with certain aspects of treatment and the management
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of some mental health conditions.ConclusionsFindings highlight the
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complexity of implementing a mhGAP-based training given its interaction
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with contextual factors to influence the attainment of expected
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outcomes. Results may be used to tailor structural, organizational,
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provider, patient, and innovation factors prior to future
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implementations of the mhGAP-based training in Tunisia. Findings may
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also be used by decision-makers interested in implementing the mhGAP-IG
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training in other LMICs.'
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affiliation: 'Spagnolo, J (Corresponding Author), Univ Montreal, IRSPUM, Sch Publ
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Hlth, Montreal, PQ H3N 1X9, Canada.
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Spagnolo, Jessica; Champagne, Francois, Univ Montreal, IRSPUM, Sch Publ Hlth, Montreal,
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PQ H3N 1X9, Canada.
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Leduc, Nicole, Univ Montreal, Sch Publ Hlth, Montreal, PQ, Canada.
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Melki, Wahid; Bram, Nesrine, Univ Tunis El Manar, Razi Hosp, Tunis, Tunisia.
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Piat, Myra, McGill Univ, Douglas Mental Hlth Univ Inst, Montreal, PQ, Canada.
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Laporta, Marc, McGill Univ, Montreal WHO PAHO Collaborating Ctr Res \& Trainin,
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Montreal, PQ, Canada.
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Guesmi, Imen, Ctr Sch \& Univ Med Manouba, Manouba, Tunisia.
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Charfi, Fatma, Univ Tunis El Manar, Mongi Slim Hosp, Tunis, Tunisia.'
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article-number: '1398'
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author: Spagnolo, Jessica and Champagne, Francois and Leduc, Nicole and Melki, Wahid
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and Piat, Myra and Laporta, Marc and Bram, Nesrine and Guesmi, Imen and Charfi,
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Fatma
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author-email: jessica.maria-violanda.spagnolo@umontreal.ca
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author_list:
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- family: Spagnolo
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given: Jessica
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- family: Champagne
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given: Francois
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- family: Leduc
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given: Nicole
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- family: Melki
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given: Wahid
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- family: Piat
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given: Myra
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- family: Laporta
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given: Marc
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- family: Bram
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given: Nesrine
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- family: Guesmi
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given: Imen
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- family: Charfi
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given: Fatma
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da: '2023-09-28'
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doi: 10.1186/s12889-018-6261-4
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eissn: 1471-2458
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files: []
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journal: BMC PUBLIC HEALTH
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keywords: 'Implementation; mhGAP; Training; Mental health; Primary care;
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Physicians; Case study; Tunisia'
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keywords-plus: MIDDLE-INCOME COUNTRIES; DISORDERS; GAP
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language: English
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month: DEC 20
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number-of-cited-references: '71'
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orcid-numbers: 'Spagnolo, Jessica/0000-0002-1125-3121
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Charfi, Fatma/0000-0002-5171-2767'
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papis_id: ade6f79cd987993f3a7cfad6a4cf0abc
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ref: Spagnolo2018wefind
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researcherid-numbers: 'Charfi, Fatma/AAZ-8912-2020
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'
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times-cited: '12'
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title: '``We find what we look for, and we look for what we know″: factors interacting
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with a mental health training program to influence its expected outcomes in Tunisia'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000454103900006
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usage-count-last-180-days: '1'
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usage-count-since-2013: '5'
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volume: '18'
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web-of-science-categories: Public, Environmental \& Occupational Health
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year: '2018'
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