2023-09-28 14:46:10 +00:00
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abstract: 'BackgroundIntegrating evidence-based mental health services into primary
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care has been identified as one strategy for overcoming the treatment
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gap in low and middle-income countries, yet their uptake into standard
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practice remains poor. The purpose of this study was to understand
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stakeholder perspectives regarding barriers and facilitators to
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integration of mental health services into primary care settings in
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Northern Iraq.MethodsUsing a convergent mixed methods study design,
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quantitative and qualitative questionnaires assessed respondent
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perceptions of implementation factors under the domains of Autonomy,
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Acceptability, Appropriateness, Feasibility, Penetration/Accessibility,
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Sustainability, and Organizational Climate. We interviewed four types of
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stakeholders: clients, providers of mental health services, non-mental
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health (MH) staff working at the centers, and center directors.
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Interviews were conducted with clients at the completion of services,
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and with all other stakeholder groups in the latter half of the first
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year of program implementation, by Kurdish-speaking interviewer pairs.
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Qualitative and quantitative data were analyzed separately and merged
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using qualitative data transformation to quantify frequency of theme and
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integrate with quantitative findings through woven narrative.Results123
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clients, 26 providers, 40 non-MH staff, and 12 directors provided data.
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Positive perceptions of the program''s acceptability, appropriateness,
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feasibility, and positive impacts were reported across all stakeholder
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levels. Providers reported that the program length (8-12 sessions) was a
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challenge. Clients described logistical challenges (e.g.:
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transportation, childcare, home duties); support from family and friends
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appeared to be critical. Lack of private space, insufficient staffing,
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and need for greater government support were also important
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issues.ConclusionsThis mixed methods study is unique in its inclusion of
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non-MH staff and director perspectives on integration of mental health
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services in primary care clinics. Their inclusion proved vital since
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they included critical human resource barriers to feasibility. Providers
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reported generally positive integration experiences but that some
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colleagues (clinic staff not involved in mental health services) were
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unsupportive. Most non-MH staff were supportive, but some did report
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negative impacts on their working environment. Future studies of
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integration of mental health services into other service platforms
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should include the perspectives of stakeholders not involved in
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provision of mental health services.'
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affiliation: 'Nguyen, AJ (Corresponding Author), Univ Virginia, Curry Sch Educ \&
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Human Dev, Dept Human Serv, Charlottesville, VA 22904 USA.
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Nguyen, Amanda J., Univ Virginia, Curry Sch Educ \& Human Dev, Dept Human Serv,
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Charlottesville, VA 22904 USA.
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Rykiel, Natalie, Johns Hopkins Univ, Sch Med, Div Pulm \& Crit Care, Baltimore,
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MD 21205 USA.
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Murray, Laura; Haroz, Emily, Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mental
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Hlth, Baltimore, MD 21205 USA.
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Amin, Ahmed, Wchan Org Victims Human Rights Violat, Sulaymaniyah, Iraq.
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Amin, Ahmed, Sulaimani Polytech Univ, Tech Coll Hlth, Sulaymaniyah, Iraq.
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Lee, Catherine; Bolton, Paul, Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth,
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Baltimore, MD 21205 USA.'
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author: Nguyen, Amanda J. and Rykiel, Natalie and Murray, Laura and Amin, Ahmed and
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Haroz, Emily and Lee, Catherine and Bolton, Paul
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author-email: ajnguyen@virginia.edu
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author_list:
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- family: Nguyen
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given: Amanda J.
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- family: Rykiel
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given: Natalie
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- family: Murray
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given: Laura
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- family: Amin
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given: Ahmed
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- family: Haroz
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given: Emily
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- family: Lee
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given: Catherine
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- family: Bolton
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given: Paul
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da: '2023-09-28'
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doi: 10.1186/s13033-019-0330-7
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files: []
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issn: 1752-4458
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journal: INTERNATIONAL JOURNAL OF MENTAL HEALTH SYSTEMS
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keywords: Mental health; Implementation; Iraq; Primary care
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keywords-plus: 'INCOME; ACCEPTABILITY; INTERVENTIONS; FEASIBILITY; DEPRESSION;
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KURDISTAN; ISSUES; IMPACT'
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language: English
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month: DEC 28
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number: '1'
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number-of-cited-references: '52'
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papis_id: 7b842faee3eb84516f7f57539c107768
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ref: Nguyen2019stakeholderperspecti
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times-cited: '5'
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title: 'Stakeholder perspectives on integration of mental health services into primary
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care: a mixed methods study in Northern Iraq'
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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:000513509700001
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usage-count-last-180-days: '1'
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usage-count-since-2013: '3'
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volume: '13'
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web-of-science-categories: Psychiatry
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year: '2019'
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