Scaling-up Stepped Care for Women’s Mental Health in Primary Care in an LMIC

Project Site Name:  Prisma Research Center
Project Site Location:  Dushanbe and Sughd, Tajikistan
UIC CGH Faculty Contact:  Stevan Weine, MD

Project/Activity Summary:

This project advances task sharing by testing the effectiveness and implementation of a stepped care model for LMICs. It uses nurses and mental health peers to treat depression and potential co-occurring anxiety among women in primary care. To improve implementation, this study examines the impact of clinic implementation teams in readying the clinics and service providers. The project assesses the effectiveness of the stepped care model with 420 women who have depression and potential co-occurring anxiety, recruited from 12 primary care clinics in Tajikistan, compared with standard of care plus provision of healthy lifestyle materials, with another 210 women recruited from 6 primary care clinics. The project also assesses whether a clinic implementation team moderates women’s reduction in depression post-intervention, as well as clinic-level and provider-level moderators. Finally, this project establishes a national mental health research network that focuses on improving the standard of mental health care and access to services by building mental health implementation research capacity. The knowledge produced through this study will inform stepped care models for mental health in LMICs such as Tajikistan and in low-resource settings in the United States. Project collaborators include the University of Illinois at Chicago (UIC), New York University, the University of Utah, and the Prisma Research Center of Tajikistan.