The goal of SHARE-THPP, Thinking Health Programme-Peer delivery, is to develop an innovative, effective and sustainable approach for the delivery of an established psychological treatment that reduces the burden of depression in mothers in South Asia.
We aim to address a key barrier to the scaling up of mental health interventions in LMIC, the lack of trained human resources, by adapting an existing evidence-based intervention so that it can be delivered by peer counsellors - experienced women living in the same community - in partnership with established community health workers (CHWs). The SHARE-THPP intervention will be developed through extensive formative research and piloting the intervention with peer counselors to evaluate the feasibility and acceptability of the the implementation of the intervention. The effectiveness of the resulting intervention will then be evaluated through randomised controlled trials in three diverse settings in South Asia: a) Through a cluster randomised trial in Rawalpindi, Pakistan (rural setting) involving 40 CHW supervisory zones and 444 mothers, with trained peer-counsellors delivering the intervention in group format in the 20 intervention zones b) Through an individual randomised trial in Goa, India (urban setting), involving 328 women randomised into intervention and control arms, with peer-counsellors delivering the intervention in individual format to the mothers randomised to the intervention arm. c) Through an exploratory randomised trial in Swat, Pakistan (disaster-affected setting) involving 60 women randomised into intervention and control arms, with peer-counsellors delivering the intervention in individual format to the mothers randomised to the intervention arm. The primary outcome is maternal depression evaluated at six months, and secondary outcomes include maternal disability and child health. All analyses will be intention to treat. The programme will include detailed process evaluation and qualitative interviews with a sub-sample of participants.

Public Health Relevance

; SHARE-THPP has the potential to make a major contribution to reducing the treatment gap and improving outcomes for mothers and their infants by improving access to psychological treatments for depressed mothers. It will also advance our knowledge of the extent to which task-shifting can be implemented through lay persons, offering a potential opportunity to access a vast untapped human resource for mental health.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Program--Cooperative Agreements (U19)
Project #
4U19MH095687-03
Application #
8546248
Study Section
Special Emphasis Panel (ZMH1-ERB-B)
Project Start
Project End
Budget Start
2013-09-01
Budget End
2014-08-31
Support Year
3
Fiscal Year
2013
Total Cost
$281,635
Indirect Cost
$20,863
Name
London School/Hygiene & Tropical Medicine
Department
Type
DUNS #
424403046
City
London
State
Country
United Kingdom
Zip Code
Turner, Elizabeth L; Sikander, Siham; Bangash, Omer et al. (2016) The effectiveness of the peer-delivered Thinking Healthy PLUS (THPP+) Program for maternal depression and child socioemotional development in Pakistan: study protocol for a randomized controlled trial. Trials 17:442
Siriwardhana, Chesmal; Adikari, Anushka; Jayaweera, Kaushalya et al. (2016) Integrating mental health into primary care for post-conflict populations: a pilot study. Int J Ment Health Syst 10:12
Griffith, James L; Kohrt, Brandon A (2016) Managing Stigma Effectively: What Social Psychology and Social Neuroscience Can Teach Us. Acad Psychiatry 40:339-47
Atif, Najia; Lovell, Karina; Husain, Nusrat et al. (2016) Barefoot therapists: barriers and facilitators to delivering maternal mental health care through peer volunteers in Pakistan: a qualitative study. Int J Ment Health Syst 10:24
Sikander, Siham; Lazarus, Anisha; Bangash, Omer et al. (2015) The effectiveness and cost-effectiveness of the peer-delivered Thinking Healthy Programme for perinatal depression in Pakistan and India: the SHARE study protocol for randomised controlled trials. Trials 16:534
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Chowdhary, Neerja; Sikander, Siham; Atif, Najia et al. (2014) The content and delivery of psychological interventions for perinatal depression by non-specialist health workers in low and middle income countries: a systematic review. Best Pract Res Clin Obstet Gynaecol 28:113-33
Kohrt, Brandon A; Upadhaya, Nawaraj; Luitel, Nagendra P et al. (2014) Authorship in global mental health research: recommendations for collaborative approaches to writing and publishing. Ann Glob Health 80:134-42

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