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Process evaluation of the systematic medical appraisal, referral and treatment (SMART) mental health project in rural India

Overview of attention for article published in BMC Psychiatry, December 2017
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Title
Process evaluation of the systematic medical appraisal, referral and treatment (SMART) mental health project in rural India
Published in
BMC Psychiatry, December 2017
DOI 10.1186/s12888-017-1525-6
Pubmed ID
Authors

Abha Tewari, Sudha Kallakuri, Siddhardha Devarapalli, Vivekanand Jha, Anushka Patel, Pallab K. Maulik

Abstract

Availability of basic mental health services is limited in rural areas of India. Health system and individual level factors such as lack of mental health professionals and infrastructure, poor awareness about mental health, stigma related to help seeking, are responsible for poor awareness and use of mental health services. We implemented a mental health services delivery model that leveraged technology and task sharing to facilitate identification and treatment of common mental disorders (CMDs) such as stress, depression, anxiety and suicide risk in rural areas of the state of Andhra Pradesh, India. The intervention was delivered by lay village health workers (Accredited Social Health Activists - ASHAs) and primary care doctors. An anti-stigma campaign was implemented prior to this activity. This paper reports the process evaluation of the intervention using mixed methods. A mixed methods pre-post evaluation assessed the intervention using quantitative service usage analytics from the server, and qualitative interviews with different stakeholders. Barriers and facilitators in implementing the intervention were identified. Health service use increased significantly at post-intervention, ASHAs could followup 78.6% of those who had screened positive, and 78.6% of the 1243 Interactive Voice Response System calls made, were successful. Most respondents were aware of the intervention. They indicated that knowledge received through the intervention empowered them to approach ASHAs and share their mental health symptoms. ASHAs and doctors opined that EDSS was useful and easy to use. Medical camps organized in villages to increase access to the doctor were received positively by all. However, some aspects or facilitators of the intervention need to be improved, including network connectivity, booster training, anti-stigma campaigns, quality of mental health services provided by doctors, provision of psychotropic medications at primary health centers and frequency of health camps. The respondents' views helped to understand the barriers and facilitators for improving the likely effectiveness of the intervention using Andersen's Modified Behavioral Model of Health Services Use, and identify the mechanisms by which those factors affected mental health services uptake in the community. The study is registered with Clinical Trials Registry India (Applied - 16/07/14-Ref2014/07/007256; registration received - 04/10/17-CTRI/2017/10/009992 ).

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 308 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 308 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 44 14%
Student > Ph. D. Student 39 13%
Researcher 37 12%
Student > Doctoral Student 24 8%
Student > Bachelor 23 7%
Other 45 15%
Unknown 96 31%
Readers by discipline Count As %
Psychology 53 17%
Medicine and Dentistry 51 17%
Nursing and Health Professions 30 10%
Social Sciences 20 6%
Computer Science 11 4%
Other 35 11%
Unknown 108 35%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 June 2018.
All research outputs
#20,453,782
of 23,009,818 outputs
Outputs from BMC Psychiatry
#4,264
of 4,746 outputs
Outputs of similar age
#374,467
of 439,388 outputs
Outputs of similar age from BMC Psychiatry
#68
of 75 outputs
Altmetric has tracked 23,009,818 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,746 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.9. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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We're also able to compare this research output to 75 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.