TY - JOUR
T1 - Implementing the protocol of a pilot randomized controlled trial for the recovery-oriented intervention to people with psychoses in two Latin American cities
AU - Mascayano, Franco
AU - Alvarado, Ruben
AU - Andrews, Howard F.
AU - Jorquera, Maria Jose
AU - Lovisi, Giovanni Marcos
AU - De Souza, Flavia Mitkiewicz
AU - Pratt, Charissa
AU - Rojas, Graciela
AU - Restrepo-Toro, Maria E.
AU - Fader, Kim
AU - Gorroochurn, Prakash
AU - Galea, Sandro
AU - Dahl, Catarina Magalhães
AU - Cintra, Jacqueline
AU - Conover, Sarah
AU - Burrone, Maria Soledad
AU - Baumgartner, Joy Noel
AU - Rosenheck, Robert
AU - Schilling, Sara
AU - Sarução, Keli Rodrigues
AU - Stastny, Peter
AU - Tapia, Eric
AU - Cavalcanti, Maria Tavares
AU - Valencia, Eliecer
AU - Yang, Lawrence H.
AU - Susser, Ezra
N1 - Funding Information:
The RCT was conducted under the auspices of RedeAmericas, a regional network for mental health research in the Americas (NIMH U19MH095718). RedeAmericas is one of five such “collaborative hubs” funded by the United States National Institute of Mental Health (NIMH) in Latin America, Africa, and South Asia. A key feature of all hubs was the inclusion of a task-shifting component, in which non-professionals would be involved in the delivery of mental health services.
Funding Information:
Research in this publication was supported by the United States National Institute of Mental Health under award U19MH095718. Content is the sole responsibility of the authors and does not necessarily represent the official views of the United States National Institute of Health.
Publisher Copyright:
© 2019 Fundacao Oswaldo Cruz. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Several Latin American countries have made remarkable strides towards offering community mental health care for people with psychoses. Nonetheless, mental health clinics generally have a very limited outreach in the community, tending to have weaker links to primary health care; rarely engaging patients in providing care; and usually not providing recovery-oriented services. This paper describes a pilot randomized controlled trial (RCT) of Critical Time Intervention-Task Shifting (CTI-TS) aimed at addressing such limitations. The pilot RCT was conducted in Santiago (Chile) and Rio de Janeiro (Brazil). We included 110 people with psychosis in the study, who were recruited at the time of entry into community mental health clinics. Trial participants were randomly divided into CTI-TS intervention and usual care. Those allocated to the intervention group received usual care and, in addition, CTI-TS services over a 9-month period. Primary outcomes include quality of life (WHO Quality of Life Scale - Brief Version) and unmet needs (Camberwell Assessment of Needs) at the 18-month follow-up. Primary outcomes at 18 months will be analyzed by Generalized Estimating Equations (GEE), with observations clustered within sites. We will use three-level multilevel models to examine time trends on the primary outcomes. Similar procedures will be used for analyzing secondary outcomes. Our hope is that this trial provides a foundation for planning a large-scale multi-site RCT to establish the efficacy of recovery-oriented interventions such as CTI-TS in Latin America.
AB - Several Latin American countries have made remarkable strides towards offering community mental health care for people with psychoses. Nonetheless, mental health clinics generally have a very limited outreach in the community, tending to have weaker links to primary health care; rarely engaging patients in providing care; and usually not providing recovery-oriented services. This paper describes a pilot randomized controlled trial (RCT) of Critical Time Intervention-Task Shifting (CTI-TS) aimed at addressing such limitations. The pilot RCT was conducted in Santiago (Chile) and Rio de Janeiro (Brazil). We included 110 people with psychosis in the study, who were recruited at the time of entry into community mental health clinics. Trial participants were randomly divided into CTI-TS intervention and usual care. Those allocated to the intervention group received usual care and, in addition, CTI-TS services over a 9-month period. Primary outcomes include quality of life (WHO Quality of Life Scale - Brief Version) and unmet needs (Camberwell Assessment of Needs) at the 18-month follow-up. Primary outcomes at 18 months will be analyzed by Generalized Estimating Equations (GEE), with observations clustered within sites. We will use three-level multilevel models to examine time trends on the primary outcomes. Similar procedures will be used for analyzing secondary outcomes. Our hope is that this trial provides a foundation for planning a large-scale multi-site RCT to establish the efficacy of recovery-oriented interventions such as CTI-TS in Latin America.
KW - Community Mental Health Services
KW - Global Health
KW - Psychotic Disorders
KW - Randomized Controlled Trial
UR - http://www.scopus.com/inward/record.url?scp=85065788171&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85065788171&partnerID=8YFLogxK
U2 - 10.1590/0102-311X00108018
DO - 10.1590/0102-311X00108018
M3 - Article
C2 - 31066775
AN - SCOPUS:85065788171
SN - 0102-311X
VL - 35
JO - Cadernos de Saude Publica
JF - Cadernos de Saude Publica
IS - 4
M1 - e00108018
ER -