The aim of the shared research project is to develop an innovative and effective mobile phone based application to aid non-specialist health workers in the detection and management of depression (Mobile Health for non-specialists health WorKers - MOHAWK) with the ultimate goal of reducing the treatment gap for depression by improving the fidelity with which mhGAP guidelines are delivered. The specific objectives of the shared research component are: 1. To carry out the technical development of MOHAWK in collaboration with our technology partners. 2. To evaluate the acceptability and feasibility of MOHAWK and to provide preliminary evidence of its impact in settings in each of the Hubs. 3. To refine and finalise the MOHAWK application based on these lessons in preparation for future formal evaluation in an RCT and scaling up. MOHAWK is built on scalable, cost-effective mobile health technology which can be used in any resource poor area, has a rapidly increasing coverage in LMIC, has growing applicability and acceptability in health care applications, and can be extended to several other MNS disorders. It is designed to be used by any cadre of non-specialist health worker from primary care physicians and CHWs to lay health workers. It has the potential to make a major contribution to reducing the treatment gap and improving outcomes for people suffering from depression by enabling task-shifting to improve the screening and diagnosis, initiation of evidence based treatments derived from mhGAP, and follow-up of patients with depression to achieve optimal clinical outcomes. MOHAWK will achieve its objectives through a three year collaborative programme of work in three sites (one from each Hub) in two phases: (1) the development of MOHAWK core capabilities and formative research to ensure effective implementation of MOHAWK to each of the three Hub sites;and (2) the evaluation of MOHAWK in exploratory trials in these three sites including process evaluation and formative research to inform the scale up of MOHAWK.

Public Health Relevance

MOHAWK has the potential to make a major contribution to reducing the treatment gap for people suffering from depression through task-shifting by providing a mechanism whereby international guidelines for the diagnosis and treatment of MNS disorders developed by mhGAP are implemented at scale, in a contextually appropriate form in all regions of the world and using a widely accessed, low cost technology.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Program--Cooperative Agreements (U19)
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Special Emphasis Panel (ZMH1-ERB-B)
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London School/Hygiene & Tropical Medicine
United Kingdom
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