This proposal aims to establish a regional hub for mental health research and training addressing the comorbidity between mental and chronic diseases, aiming to decrease the treatment gap for mental disorders among people with physical disorders in LA &C.
These aims will be achieved through: 1. Development of a research agenda focused on developing an intervention for the identification and treatment of depression among people attending programs for chronic diseases. This intervention will involve two key elements: a) improved recognition and b) improved psycho-social management of depression in diverse health care settings in LA &C. It will be mostly delivered through the use of mobile phones, with minimal assistance from primary care auxiliary nurses, with substantial task-shifting. The main emphasis is on patients helping themselves through using resources that are currently delivered on a one-to-one basis by specialized human resources. The intervention will be tested in primary care clinics in Sao Paulo, Brazil, and in secondary care clinics in Lima, Peru. Pilot studies will take place in Guatemala, Colombia and Ecuador. 2. To build increased mental health research capacity in the region through a research training program delivered by a network involving the University of Sao Paulo in Brazil, the Latin American network for the Global Alliance for Chronic Disease, and Universities of Washington and Bristol. The strategy will include: 1) greater prominence to South-South collaboration;2) focus on a multiplying strategy starting with the strengthening of a solid research hub and gradual expansion to other sub-centers in a large mutually supportive research network;and 3) more efficient methods of delivering training with improved accessibility. The capacity building component prioritizes training in research methodologies that can generate sound evidence on the best strategies to reduce this gap, allowing 'hands-on'training for researchers. In both components due importance is given to issues related to scaling up and policy making, including the creation of a highly qualified advisory board and consultation with a range of stakeholders throughout the life of the project.

Public Health Relevance

Depression is highly prevalent in LA &C and is now considered the second most important contributor to the global health burden in the region. Only small proportions of those depressed are recognized and receive treatment in LA &C. There is substantial co-morbidity between depression and chronic physical conditions, and outcome of both conditions is impaired when there is co-morbidity. Evidence on efficient, low-cost interventions is urgently needed to guide policy.to reduce the mental health treatment gap.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Program--Cooperative Agreements (U19)
Project #
1U19MH098780-01
Application #
8412798
Study Section
Special Emphasis Panel (ZMH1-ERB-B (04))
Program Officer
Pringle, Beverly
Project Start
2013-09-26
Project End
2014-08-31
Budget Start
2013-09-26
Budget End
2014-08-31
Support Year
1
Fiscal Year
2013
Total Cost
$344,314
Indirect Cost
$25,016
Name
Fundacao Faculdade de Medicina
Department
Type
DUNS #
902096528
City
Sao Paulo
State
Country
Brazil
Zip Code
05401--000
Miranda, J Jaime; Bernabé-Ortiz, Antonio; Diez-Canseco, Francisco et al. (2016) Towards sustainable partnerships in global health: the case of the CRONICAS Centre of Excellence in Chronic Diseases in Peru. Global Health 12:29
Miranda, J Jaime; Taype-Rondan, Alvaro; Tapia, Jose Carlos et al. (2016) Hair follicle characteristics as early marker of Type 2 Diabetes. Med Hypotheses 95:39-44
Lazo-Porras, Maria; Bernabe-Ortiz, Antonio; Sacksteder, Katherine A et al. (2016) Implementation of foot thermometry plus mHealth to prevent diabetic foot ulcers: study protocol for a randomized controlled trial. Trials 17:206
Bernabe-Ortiz, Antonio; Smeeth, Liam; Gilman, Robert H et al. (2016) Development and Validation of a Simple Risk Score for Undiagnosed Type 2 Diabetes in a Resource-Constrained Setting. J Diabetes Res 2016:8790235
Pilowsky, Daniel J; Rojas, Graciela; Price, LeShawndra N et al. (2016) Building Research Capacity Across and Within Low- and Middle-Income Countries: The Collaborative Hubs for International Research on Mental Health. Acad Psychiatry 40:686-91
Quispe, Renato; Benziger, Catherine P; Bazo-Alvarez, Juan Carlos et al. (2016) The Relationship Between Socioeconomic Status and CV Risk Factors: The CRONICAS Cohort Study of Peruvian Adults. Glob Heart 11:121-130.e2
Miranda, J Jaime; Bernabé-Ortiz, Antonio; Diez-Canseco, Francisco et al. (2015) Building a platform for translational research in chronic noncommunicable diseases to address population health: lessons from NHLBI supported CRONICAS in Peru. Glob Heart 10:13-9
Pesantes, M Amalia; Lazo-Porras, María; Abu Dabrh, Abd Moain et al. (2015) Resilience in Vulnerable Populations With Type 2 Diabetes Mellitus and Hypertension: A Systematic Review and Meta-analysis. Can J Cardiol 31:1180-8