Perinatal depression (PD) is more prevalent among adolescents than older perinatal women. In LMIC, Maternal and Child Health (MCHC) services are provided mainly by non-specialist clinicians in primary care due to insufficient human resources. However, despite availability of effective treatment in primary care, a combination of self stigma and perceived stigma from health care workers exacerbate feelings of ostracization in adolescent mothers and limit their use of available services. ubiquitous and can be leveraged as therapeutic tools in a blended approach Mobile technologies are with face to face care to increase patients' contact with care. In Nigeria there is high usage of mobile phones even among adolescents. Given the common observation that young people are often attached to their mobile phones, mobile technologies provide a practical medium for the delivery of health care to this population. The goal of this proposed Emerging Global Health Leader K43 Award is to develop Dr Lola Kola's expertise in the development and use of mHealth tools to scale up evidence based psychosocial interventions for mental disorders within routine care in LMIC. Through research, coursework, and structured mentorship activities, the candidate will acquire new competency in (1) Mobile Technology Methods in Mental Heath research, (2) Implementation research methodologies, (3) Advanced Analytic and Statistical methods and (4) Professional development to lead Large-scale research projects independently in LMIC settings. Drs Dror Ben Zeev, Oye Gureje, David Atkins and Crick Lund will mentor her. The mentored research will build on past scale up efforts in Nigeria, specifically a recently concluded study, Expanding care for perinatal women with depression (EXPONATE) in primary care, where results showed that adolescent mothers were less likely to attend treatment sessions, and their children had poorer outcomes despite availability of effective treatment. The treatment guide for the EXPONATE study which utilises mhGAP guidelines, will be adapted for mHealth use. Candidate will utilise a User-Centered approach to design, develop, and refined the mHealth system for the treatment of Adolescent Perinatal Depression (APD) within routine care, and develop a roadmap to scaleability in an R01 application using implementation research principles. The research advances FIC's mission (GOAL 2) to stimulate innovation through technologies to address global health problems and contributes to NIMH Strategic Plan Objective 4 to strengthen Public Health Impact of supported Research. It advances Grand Challenges in Global Mental Health to improve and increase access to evidence based care (Goal C and F). Integration of mental health into primary care and improved access to care are also goals of the WHO Action Plan 2013-2020. Data from the mentored study will provide unique information on mHealth use in the treatment of APD in LMIC. At the end of the training, candidate will have acquired strong foundational skills for mHealth use in mental health research
This project uses a User-Centered approach to design, develop, and test a mHealth system for the treatment of adolescent perinatal depression within routine primary care in Nigeria. It also utilises implementation research strategies to develops a roadmap to promote the scalability of its use. Thus it has the potential of scaling-up care for adolescent perinatal mental health in Nigeria and other LMIC contexts.
