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.

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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Price, LeShawndra N (2018) Building global mental health research capacity: the collaborative hubs for international research on mental health. Glob Ment Health (Camb) 5:e34
Adhikari, Ramesh P; Upadhaya, Nawaraj; Satinsky, Emily N et al. (2018) Feasibility study of a family- and school-based intervention for child behavior problems in Nepal. Child Adolesc Psychiatry Ment Health 12:20
Maselko, Joanna; Bates, Lisa; Bhalotra, Sonia et al. (2018) Socioeconomic status indicators and common mental disorders: Evidence from a study of prenatal depression in Pakistan. SSM Popul Health 4:1-9
Atif, Najia; Krishna, Revathi N; Sikander, Siham et al. (2017) Mother-to-mother therapy in India and Pakistan: adaptation and feasibility evaluation of the peer-delivered Thinking Healthy Programme. BMC Psychiatry 17:79
Sharma, M; Razzaque, B (2017) Research capacity strengthening in South Asia: based on the experience of South Asian Hub for Advocacy, Research and Education on Mental Health (SHARE). Glob Ment Health (Camb) 4:e9
Singla, Daisy R; Kohrt, Brandon A; Murray, Laura K et al. (2017) Psychological Treatments for the World: Lessons from Low- and Middle-Income Countries. Annu Rev Clin Psychol 13:149-181
Burkey, Matthew D; Ghimire, Lajina; Adhikari, Ramesh P et al. (2016) Development process of an assessment tool for disruptive behavior problems in cross-cultural settings: the Disruptive Behavior International Scale - Nepal version (DBIS-N). Int J Cult Ment Health 9:387-398
Turner, Elizabeth L; Sikander, Siham; Bangash, Omer et al. (2016) The effectiveness of the peer delivered Thinking Healthy Plus (THPP+) Programme for maternal depression and child socio-emotional development in Pakistan: study protocol for a three-year cluster randomized controlled trial. Trials 17:442
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
Griffith, James L; Kohrt, Brandon A (2016) Managing Stigma Effectively: What Social Psychology and Social Neuroscience Can Teach Us. Acad Psychiatry 40:339-47

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