| Autor: |
Saloni Dev, Tanvi Kankan, Drew Blasco, PhuongThao D. Le, Martin Agrest, Gabriella Dishy, Franco Mascayano, Sara Schilling, María José Jorquera, Catarina Dahl, Maria Tavares Cavalcanti, LeShawndra Price, Sarah Conover, Lawrence H. Yang, Rubén Alvarado, Ezra S. Susser |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
|
| Zdroj: |
Cambridge Prisms: Global Mental Health, Vol 8 (2021) |
| Druh dokumentu: |
article |
| ISSN: |
2054-4251 |
| DOI: |
10.1017/gmh.2021.10 |
| Popis: |
Abstract Background Few studies provide clear rationale for and the reception of adaptations of evidence-based interventions. To address this gap, we describe the context-dependent adaptations in critical time intervention-task shifting (CTI-TS), a manualized recovery program for individuals with psychosis in Rio de Janeiro, Brazil and Santiago, Chile. Implications of the adaptations – incorporating a task-shifting approach and modifying the mode of community-based service delivery – are examined from users' perspectives. Methods A secondary analysis of in-depth interviews with CTI-TS users (n = 9 in Brazil; n = 15 in Chile) was conducted. Using the framework method, we thematically compared how participants from each site perceived the main adapted components of CTI-TS. Results Users of both sites appreciated the task-shifting worker pair to provide personalized, flexible, and relatable support. They wanted CTI-TS to be longer and experienced difficulty maintaining intervention benefits in the long-term. In Chile, stigma and a perceived professional hierarchy toward the task-shifting providers were more profound than in Brazil. Engagement with community-based services delivery in homes and neighborhoods (Chile), and at community mental health centers (Brazil) were influenced by various personal, familial, financial, and social factors. Uniquely, community violence was a significant barrier to engagement in Brazil. Conclusion CTI-TS’ major adaptations were informed by the distinct mental health systems and social context of Santiago and Rio. Evaluation of user experiences with these adaptations provides insights into implementing and scaling-up task-shifting and community-oriented interventions in the region through the creation of specialized roles for the worker pair, targeting sustained intervention effects, and addressing socio-cultural barriers. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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