The overall goal of the proposed Partnership in Implementation Science for Geriatric Mental Health (PRISM) project is to establish a hub to integrate implementation research for scaling up sustainable, evidence-based mental health interventions with research capacity-building activities for East Asia. The proposed mental health implementation research hub, based in Thailand and including China, will focus on reducing the gap in treatment and support for community-residing older adults in general, and elders with Alzheimer's disease and related dementias (to be referred to as dementia in this proposal) in particular.
Specific aims are to: 1) empirically test a culturally adapted Getting-To-Outcomes (GTO) implementation support model aimed at enhancing the delivery of an evidence-based physical exercise intervention for narrowing the treatment gap for older persons with behavioral and psychological symptoms of dementia (BPSD) in Thailand (GTO-ThAI); 2) build individual and institutional capacity for the implementation of mental health intervention research in Thailand and China; 3) improve Thai and Chinese policy makers' capacity for using research for evidence informed decision making (EIDM); 4) develop a knowledge base for shared learning among stakeholders within each country and with other countries through NIMH and other regional NIMH hubs; and, 5) collaborate with NIMH program staff, through scientific and programmatic involvement, through a cooperative agreement for the implementation of all project activities. The focus on older adults was made as the Thai Ministry of Public Health has identified the reduction in the mental health treatment gap for older adults, specifically, for those with dementia and their family caregivers, as a key priority for the nation, due to the rising number of cases of dementia, concomitant with Thailand's rapidly growing aging population. The hub will bring together Thai and Chinese interdisciplinary researchers, policy-makers and NGO practitioners with US-based researchers who have a history of successful research collaborations with each other as well as with researchers and policy makers in the participating countries. Specific project aims will be implemented in three phases. The inception phase (study year 1) will involve: establishing the Administrative Core at BWH, Boston MA; developing a detailed research protocol for implementation at the research sites (Thailand); conducting an assessment of readiness for implementation of innovative mental health intervention solutions in both countries; and, making contacts and exploring possibilities for collaboration with other NIMH regional hubs. The implementation phase (study years 2-4) will involve piloting and conducting the implementation and scale up research activities (Thailand) and implementing the capacity-building plan (Thailand and China). The final stage (study years 4-5) will be devoted to evaluation, data sharing, and dissemination. 1
The proposed research partnerships for scaling-up mental health interventions for older adults with BPSD have the potential to make a major contribution to reducing the treatment gap and improving outcomes for older adults with mental health disorders in East Asia. The scale-up study will advance our knowledge of the extent to which systematic implementation support can be developed to ensure success in scaling-up evidence-based mental health services in LMICs. Capacity building activities will result in the development of a sustainable infrastructure of researchers to conduct implementation research, and of policy makers and health care leaders with the skills to conduct evidence-informed decision making for mental health policies and program development.