wow-inequalities/02-data/intermediate/wos_sample/9b459725d4068cc566930d09f9d73c1b-balaji-madhumitha-a/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'Background: Care for schizophrenia in low and middle income countries is
predominantly facility based and led by specialists, with limited use of
non-pharmacological treatments. Although community based psychosocial
interventions are emphasised, there is little evidence about their
acceptability and feasibility. Furthermore, the shortage of skilled
manpower is a major barrier to improving access to these interventions.
Our study aimed to develop a lay health worker delivered community based
intervention in three sites in India. This paper describes how the
intervention was developed systematically, following the MRC framework
for the development of complex interventions.
Methods: We reviewed the lierature on the burden of schizophrenia and
the treatment gap in low and middle income countries and the evidence
for community based treatments, and identified intervention components.
We then evaluated the acceptability and feasibility of this package of
care through formative case studies with individuals with schizophrenia
and their primary caregivers and piloted its delivery with 30 families.
Results: Based on the reviews, our intervention comprised five
components (psycho-education; adherence management; rehabilitation;
referral to community agencies; and health promotion) to be delivered by
trained lay health workers supervised by specialists. The intervention
underwent a number of changes as a result of formative and pilot work.
While all the components were acceptable and most were feasible,
experiences of stigma and discrimination were inadequately addressed;
some participants feared that delivery of care at home would lead to
illness disclosure; some participants and providers did not understand
how the intervention related to usual care; some families were unwilling
to participate; and there were delivery problems, for example, in
meeting the targeted number of sessions. Participants found delivery by
health workers acceptable, and expected them to have knowledge about the
subject matter. Some had expectations regarding their demographic and
personal characteristics, for example, preferring only females or those
who are understanding/friendly. New components to address stigma were
then added to the intervention, the collaborative nature of service
provision was strengthened, a multi-level supervision system was
developed, and delivery of components was made more flexible. Criteria
were evolved for the selection and training of the health workers based
on participants'' expectations.
Conclusions: A multi-component community based intervention, targeting
multiple outcomes, and delivered by trained lay health workers,
supervised by mental health specialists, is an acceptable and feasible
intervention for treating schizophrenia in India.'
affiliation: 'Patel, V (Corresponding Author), Sangath Ctr, 841-1 Alto Porvorim, Bardez
403521, Goa, India.
Balaji, Madhumitha; Chatterjee, Sudipto; Kumar, Pratheesh; Patel, Vikram, Sangath
Ctr, Bardez 403521, Goa, India.
Koschorke, Mirja; Patel, Vikram, London Sch Hyg \& Trop Med, London WC1E 7HT, England.
Rangaswamy, Thara; Dakshin, Lilly; John, Sujit, Schizophrenia Res Fdn Ctr, Madras
600101, Tamil Nadu, India.
Chavan, Animish, Nirmitee, Sadar Bazar 415001, Satara, India.
Dabholkar, Hamid, Parivartan, Sadar Bazar 415001, Satara, India.
Thornicroft, Graham, Kings Coll London, Hlth Serv \& Populat Res Dept, Inst Psychiat,
London SE5 8AF, England.'
article-number: '42'
author: Balaji, Madhumitha and Chatterjee, Sudipto and Koschorke, Mirja and Rangaswamy,
Thara and Chavan, Animish and Dabholkar, Hamid and Dakshin, Lilly and Kumar, Pratheesh
and John, Sujit and Thornicroft, Graham and Patel, Vikram
author-email: vikram.patel@lshtm.ac.uk
author_list:
- family: Balaji
given: Madhumitha
- family: Chatterjee
given: Sudipto
- family: Koschorke
given: Mirja
- family: Rangaswamy
given: Thara
- family: Chavan
given: Animish
- family: Dabholkar
given: Hamid
- family: Dakshin
given: Lilly
- family: Kumar
given: Pratheesh
- family: John
given: Sujit
- family: Thornicroft
given: Graham
- family: Patel
given: Vikram
da: '2023-09-28'
doi: 10.1186/1472-6963-12-42
eissn: 1472-6963
files: []
journal: BMC HEALTH SERVICES RESEARCH
keywords: 'Low and middle income countries; India; Community care; Mental health;
Schizophrenia'
keywords-plus: 'SEVERE MENTAL-ILLNESS; PSYCHOEDUCATIONAL INTERVENTION; FAMILIES; CARE;
CHINA'
language: English
month: FEB 16
number-of-cited-references: '26'
orcid-numbers: 'Thornicroft, Graham/0000-0003-0662-0879
Balaji, Madhumitha/0000-0002-7399-8057
Patel, Vikram/0000-0003-1066-8584
John, Sujit/0000-0001-7157-3533'
papis_id: b07e927ea950a5e4287e95975283e00a
ref: Balaji2012developmentlay
researcherid-numbers: 'Thornicroft, Graham/B-4027-2010
'
times-cited: '89'
title: The development of a lay health worker delivered collaborative community based
intervention for people with schizophrenia in India
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000301930500001
usage-count-last-180-days: '0'
usage-count-since-2013: '26'
volume: '12'
web-of-science-categories: Health Care Sciences \& Services
year: '2012'