TY - JOUR
KW - collaborative stepped care
KW - Nigeria
KW - Depression
KW - feasibility
KW - primary care
AU - A. O. Adewuya
AU - T. Adewumi
AU - O. Momodu
AU - O. Olibamoyo
AU - O. Adesoji
AU - A. Adegbokun
AU - S. Adeyemo
AU - O. Manuwa
AU - D. Adegbaju
A1 - 
AB - BACKGROUND: This study aimed to develop and test the feasibility of a primary care worker-led psychological intervention as the main feature of a collaborative stepped care for depression that is effective, affordable, culturally acceptable, tailored to patients' clinical condition and easily integrate-able into the primary care schedule in Nigeria. METHODS: Using the Medical Research Council framework, in the first stage (modelling/theoretical development), experts reviewed and distilled evidence from literature to form the intervention components. In the second (formative) stage, local stakeholders were consulted on the practical application and feasibility of the proposed intervention. The third (piloting) stage involved testing for the clinical efficacy and acceptability of the components of the draft intervention. RESULTS: The final intervention components included a 2-stage screening (red-flagging and further evaluation), psychoeducation, low-intensity psychological therapy (problem-solving therapy for primary care), antidepressant prescription, proactive mobile telephony adherence support and referral to the mental health specialist if needed. At 3 months, 71.6% of depressed patients on the intervention improved. The intervention was perceived to be acceptable and useful by over 70% of health workers and clients and had high ratings (>70% score) by expert panels on intervention simplicity, facilitation strategies, and quality of delivery. CONCLUSIONS: The development and feasibility testing of our integrated intervention encompassed review of current literature, expert opinions and consultation with local stakeholders and end users. Our intervention package was largely deemed acceptable, relevant, useful, and feasible. Important lessons learnt with this process will help in future intervention developments.
AD - Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria.; Centre for Mental Health Research and Initiative, Lagos, Nigeria.; Centre for Mental Health Research and Initiative, Lagos, Nigeria.; Centre for Mental Health Research and Initiative, Lagos, Nigeria.; Lagos State Health Services Commission, Lagos, Nigeria.; Department of Psychiatry, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.; Lagos State Health Services Commission, Lagos, Nigeria.; Lagos State Health Services Commission, Lagos, Nigeria.; Lagos State Health Services Commission, Lagos, Nigeria.; Lagos State Health Services Commission, Lagos, Nigeria.; Federal Neuropsychiatric Hospital, Yaba, Lagos, Nigeria.
BT - Psychological medicine
C5 - General Literature
CP - 13
CY - England
DO - 10.1017/S0033291718002970
IS - 13
JF - Psychological medicine
M1 - Journal Article
N2 - BACKGROUND: This study aimed to develop and test the feasibility of a primary care worker-led psychological intervention as the main feature of a collaborative stepped care for depression that is effective, affordable, culturally acceptable, tailored to patients' clinical condition and easily integrate-able into the primary care schedule in Nigeria. METHODS: Using the Medical Research Council framework, in the first stage (modelling/theoretical development), experts reviewed and distilled evidence from literature to form the intervention components. In the second (formative) stage, local stakeholders were consulted on the practical application and feasibility of the proposed intervention. The third (piloting) stage involved testing for the clinical efficacy and acceptability of the components of the draft intervention. RESULTS: The final intervention components included a 2-stage screening (red-flagging and further evaluation), psychoeducation, low-intensity psychological therapy (problem-solving therapy for primary care), antidepressant prescription, proactive mobile telephony adherence support and referral to the mental health specialist if needed. At 3 months, 71.6% of depressed patients on the intervention improved. The intervention was perceived to be acceptable and useful by over 70% of health workers and clients and had high ratings (>70% score) by expert panels on intervention simplicity, facilitation strategies, and quality of delivery. CONCLUSIONS: The development and feasibility testing of our integrated intervention encompassed review of current literature, expert opinions and consultation with local stakeholders and end users. Our intervention package was largely deemed acceptable, relevant, useful, and feasible. Important lessons learnt with this process will help in future intervention developments.
PP - England
PY - 2019
SN - 1469-8978; 0033-2917
SP - 2149
EP - 2157
EP - 
T1 - Development and feasibility assessment of a collaborative stepped care intervention for management of depression in the mental health in primary care (MeHPriC) project, Lagos, Nigeria
T2 - Psychological medicine
TI - Development and feasibility assessment of a collaborative stepped care intervention for management of depression in the mental health in primary care (MeHPriC) project, Lagos, Nigeria
U1 - General Literature
U2 - 30326980
U3 - 10.1017/S0033291718002970
VL - 49
VO - 1469-8978; 0033-2917
Y1 - 2019
Y2 - Oct
ER -