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Petagna M, Marley C, Guerra C, Calia C, Reid C. Mental Health Gap Action Programme intervention Guide (mhGAP-IG) for Child and Adolescent Mental Health in Low- and Middle-Income Countries (LMIC): A Systematic Review. Community Ment Health J 2023; 59:192-204. [PMID: 35579725 PMCID: PMC9813022 DOI: 10.1007/s10597-022-00981-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND The Mental Health Gap Action Programme (mhGAP) supports engagement of non-specialists in mental health services in Low- and Middle-Income countries. Given this aim, assessment of the effectiveness of approaches under its remit is warranted. AIMS We evaluated mhGAP approaches relating to child and adolescent mental health, focusing on provider / child outcomes, and barriers / facilitators of implementation. METHODS Thirteen databases were searched for reviews and primary research on mhGAP roll out for child and adolescent mental health. RESULTS Twelve studies were reviewed. Provider-level outcomes were restricted to knowledge gains, with limited evidence of other effects. Child-level outcomes included improved access to care, enhanced functioning and socio-emotional well-being. Organisational factors, clients and providers? attitudes and expectations, and transcultural considerations were barriers. CONCLUSIONS Further attention to the practical and methodological aspects of implementation of evaluation may improve the quality of evidence of the effectiveness of approaches under its remit.
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Affiliation(s)
- Marta Petagna
- School of Health in Social Sciences, The University of Edinburgh, Edinburgh, UK
| | - Charles Marley
- School of Allied Health Science and Practice, The University of Adelaide, Engineering & Mathematical Sciences Building, North Terrace, 5001, Adelaide, Australia.
| | | | - Clara Calia
- School of Health in Social Sciences, The University of Edinburgh, Edinburgh, UK
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Lenhard NK, An C, Jasthi D, Laurel-Vargas V, Weinstein I, Vargas JA, Jones K, Lam SK. Establishing a Virtual Global Health Education Partnership: The Cleveland-Cusco Connection. Med Sci Educ 2022; 32:1087-1094. [PMID: 36117947 PMCID: PMC9469813 DOI: 10.1007/s40670-022-01626-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The Cleveland-Cusco Connection (CCC) elective was created during the COVID-19 pandemic to continue global health (GH) education for Case Western Reserve University (CWRU) and Universidad Nacional de San Antonio Abad del Cusco (UNSAAC) medical students. The CCC elective was held over Zoom and aimed to promote international collaboration, knowledge about health systems, and perspectives in GH with synchronous and asynchronous learning. METHODS Peruvian and US medical students participated in six monthly sessions consisting of student presentations and large and small group discussions. The elective was led collaboratively by CWRU and UNSAAC students. We evaluated students' experience using pre- and post-course surveys. RESULTS Nineteen students (76%) completed the post-course survey. The median rating for meeting each course objective was "somewhat effective" on a 5-point scale ranging from "very ineffective" to "very effective." All respondents would recommend the course to a friend. Common barriers included language challenges, fatigue from other coursework, and technology issues. Seven students' pre- and post-course surveys could be linked. The number of students who agreed with the statements assessing course objectives increased for all questions between the pre- and post-test, with only the number agreeing that they understood the Peruvian healthcare system increasing significantly (p < 0.05). DISCUSSION The CCC elective provides a valuable GH educational opportunity via a virtual platform. Students reported that learning from their peers was effective and enjoyable. CONCLUSION Virtual GH electives like the CCC may offer benefits in terms of cost, equity, and flexibility and merit further investigation. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-022-01626-6.
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Affiliation(s)
- Nora K. Lenhard
- Case Western Reserve University School of Medicine, 9501 Euclid Avenue, 160F, Cleveland, OH USA
| | - Crystal An
- Case Western Reserve University School of Medicine, 9501 Euclid Avenue, 160F, Cleveland, OH USA
| | - Divya Jasthi
- Case Western Reserve University School of Medicine, 9501 Euclid Avenue, 160F, Cleveland, OH USA
| | | | - Ilon Weinstein
- Case Western Reserve University School of Medicine, 9501 Euclid Avenue, 160F, Cleveland, OH USA
| | | | - Katherine Jones
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University School of Medicine, Cleveland, OH 44106 USA
- Cleveland Clinic, Cleveland, OH 44106 USA
| | - Suet Kam Lam
- Case Western Reserve University School of Medicine, 9501 Euclid Avenue, 160F, Cleveland, OH USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University School of Medicine, Cleveland, OH 44106 USA
- Cleveland Clinic, Cleveland, OH 44106 USA
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Sormunen M, Heikkilä A, Salminen L, Vauhkonen A, Saaranen T. Learning Outcomes of Digital Learning Interventions in Higher Education: A Scoping Review. Comput Inform Nurs 2021; 40:154-164. [PMID: 34347644 DOI: 10.1097/cin.0000000000000797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Implementing digital technologies has become a policy priority worldwide among all types of education. The COVID-19 pandemic has further accelerated educational institutions' efforts to reorganize their teaching and introduce new digital learning technologies. Although using digital technologies in higher education, including nursing, is considered a modern and innovative way of teaching and learning, uncertainty exists concerning these technologies' actual usefulness in achieving positive learning outcomes. The aim of this scoping review was to examine the current evidence related to the effects of using digital technologies on learning outcomes in higher education. The authors searched five electronic databases for relevant studies and used a scoping review method to analyze and synthesize the evidence. Eighty-six articles from six disciplines met the selection criteria. As a key finding, the outcomes of the interventions were mainly positive. Increased professional knowledge, skills, and attitudes reflect the advancement of professional competence. Academic, collaborative, and study skills, in turn, contribute to general competence development. Our findings suggest that digital technology has the potential to improve learning in various disciplines.
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Affiliation(s)
- Marjorita Sormunen
- Author Affiliations: Faculty of Health Sciences, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio (Dr Sormunen); Faculty of Medicine, Department of Nursing Science, University of Turku, and Director of Nursing Excellence, Hospital District of Southwest Finland, Turku (Dr Heikkilä); Faculty of Medicine, Department of Nursing Science, University of Turku, Turku University Hospital, Turku (Dr Salminen); and Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Kuopio (Drs Vauhkonen and Saaranen)
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Sormunen M, Saaranen T, Heikkilä A, Sjögren T, Koskinen C, Mikkonen K, Kääriäinen M, Koivula M, Salminen L. Digital Learning Interventions in Higher Education: A Scoping Review. Comput Inform Nurs 2021; 38:613-624. [PMID: 32520782 DOI: 10.1097/cin.0000000000000645] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This scoping review was undertaken to synthesize and describe research related to digital learning interventions in higher education, focusing on technological outcomes. Five electronic databases were searched, and 86 articles were included in the review. The data related to positive and negative technological outcomes and authors' suggestions were analyzed using inductive content analysis. The articles represented six disciplines across six continents and included quantitative (n = 65), qualitative (n = 3), and mixed-methods (n = 18) intervention studies. For positive technological outcomes, digital formats of learning were considered effective and participatory forms of learning in a majority of the articles. The students appreciated individualized and self-paced learning, and the digital form increased their motivation to learn. Automatized technical solutions that enabled learning and teaching had several advantages, and digital learning was believed to save the resources of students, teachers, and organizations. For negative technological outcomes, the technical difficulties in using the digital devices or platforms were described the most, and a need for resources was identified. Feedback from teachers was considered important from positive and negative viewpoints. Authors' suggestions for future digital teaching and learning as well as related interventions consisted of various activities, resources, environments, and methods.
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Affiliation(s)
- Marjorita Sormunen
- Author Affiliations: Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio (Drs Sormunen and Saaranen); Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio (Dr Sormunen); Department of Nursing Science, Faculty of Medicine, University of Turku (Drs Heikkilä and Salminen); Faculty of Sport and Health Sciences, University of Jyväskylä (Dr Sjögren); University of Stavanger, Faculty of Health Science, Department of Caring and Ethics and Åbo Akademi, Faculty of Pedagogy and Welfare Studies, Department of Caring Science, Turku (Dr Koskinen); Research Unit of Nursing Science and Health Management, University of Oulu (Drs Mikkonen and Kääriäinen); Medical Research Center Oulu, Oulu University Hospital and University of Oulu, and The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki (Dr Kääriäinen); and Faculty of Social Sciences, University of Tampere (Dr Koivula), Finland
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Rajabzadeh V, Burn E, Sajun SZ, Suzuki M, Bird VJ, Priebe S. Understanding global mental health: a conceptual review. BMJ Glob Health 2021; 6:bmjgh-2020-004631. [PMID: 33758013 PMCID: PMC7993328 DOI: 10.1136/bmjgh-2020-004631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 11/14/2022] Open
Abstract
Background Mental health disorders are viewed as a global concern requiring globally led approaches to address them. Since the publication of the 2007 Lancet series on global mental health (GMH), the term has become widespread. Over the last two decades, GMH has become increasingly affiliated with policy reform, academic courses, funding bodies and research. However, it is not always obvious how those working in the field of GMH are using the term, resulting in a lack of clarity. Therefore, work is needed to synthesise the current understanding(s) of GMH to help characterise its meaning. Aim To synthesise the literature and identify the different ways GMH is understood. Method A conceptual review, using a systematic search and a content analysis, was conducted to develop a conceptual framework of the different conceptual understandings of GMH. Results We developed a conceptual framework of four understandings of GMH. These understandings of GMH are as follows: an area of research generating findings to establish a GMH evidence-base; implementation of research into practice; improving the mental health environment; learning from and supporting low-and-middle-income countries (LMICs). Conclusion Our review proposes a simple framework, clarifying the key characteristics of the GMH landscape. The findings highlight the diversity of usage of the term in the literature, as well as present the wide scope that comprises the field of GMH. Referring to this framework may help those engaged with GMH to be more specific with which aspect of the field they are concerned with.
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Affiliation(s)
- Vian Rajabzadeh
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Erin Burn
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Sana Z Sajun
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Mimi Suzuki
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Victoria Jane Bird
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
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Sapag JC, Álvarez Huenchulaf C, Campos Á, Corona F, Pereira M, Véliz V, Soto-Brandt G, Irarrazaval M, Gómez M, Abaakouk Z. [Mental Health Global Action Programme (mhGAP) in Chile: Lessons Learned and Challenges for Latin America and the CaribbeanPrograma de ação mundial para reduzir as lacunas em saúde mental (mhGAP) no Chile: aprendizados e desafios para América Latina e Caribe]. Rev Panam Salud Publica 2021; 45:e32. [PMID: 33833786 PMCID: PMC8021207 DOI: 10.26633/rpsp.2021.32] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/21/2020] [Indexed: 11/25/2022] Open
Abstract
Objetivos. Presentar la metodología de evaluación integral de la implementación del Programa de Acción Mundial para Superar las Brechas en Salud Mental (mhGAP) en Chile y exponer sus resultados. Métodos. Estudio evaluativo de corte transversal basado en una encuesta a referentes clave del programa, desplegados en los 29 servicios públicos de salud del país, y entrevistas individuales y grupos focales con actores clave y expertos. El foco de la evaluación estuvo en la relevancia e impacto del mhGAP en la prestación de servicios de salud mental y en la implementación del programa. Resultados. Los participantes evaluaron positivamente la implementación progresiva del mhGAP en Chile, en particular: 1) manifestaron contar con mejores herramientas de detección, diagnóstico y tratamiento de trastornos frecuentes, y estrategias eficientes de derivación; 2) calificaron todos los módulos como importantes; los más relevantes fueron autolesión/suicidio (x¯ = 4,77) y trastornos mentales y conductuales del niño y el adolescente (x¯ = 4,58); 3) evaluaron favorablemente las Jornadas Nacionales y sus réplicas y su contribución al éxito de la implementación del mhGAP; 4) coincidieron en la necesidad de incorporar nuevos actores, fortalecer algunos aspectos y ampliar la información sobre el programa. Conclusiones. La implementación del mhGAP en Chile constituye un caso emblemático de aprendizaje, apoyado por el desarrollo de la salud mental comunitaria y la salud familiar, entre otros factores. Lo logrado abre una oportunidad única para continuar avanzando en la implementación de este programa en el país y transmitir esta experiencia a otros contextos de América Latina y el Caribe.
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Affiliation(s)
- Jaime C Sapag
- Departamentos de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile Santiago Chile Departamentos de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cinthia Álvarez Huenchulaf
- Departamentos de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile Santiago Chile Departamentos de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Álvaro Campos
- Departamento de Gestión del Cuidado, División de Atención Primaria, Subsecretaría de Redes Asistenciales, Ministerio de Salud Santiago Chile Departamento de Gestión del Cuidado, División de Atención Primaria, Subsecretaría de Redes Asistenciales, Ministerio de Salud, Santiago, Chile
| | - Francisca Corona
- Representación de la Organización Panamericana de la Salud / Organización Mundial de la Salud Santiago Chile Representación de la Organización Panamericana de la Salud / Organización Mundial de la Salud, Santiago, Chile
| | - Milena Pereira
- Departamento de Gestión del Cuidado, División de Atención Primaria, Subsecretaría de Redes Asistenciales, Ministerio de Salud Santiago Chile Departamento de Gestión del Cuidado, División de Atención Primaria, Subsecretaría de Redes Asistenciales, Ministerio de Salud, Santiago, Chile
| | - Verónica Véliz
- Departamento de Gestión del Cuidado, División de Atención Primaria, Subsecretaría de Redes Asistenciales, Ministerio de Salud Santiago Chile Departamento de Gestión del Cuidado, División de Atención Primaria, Subsecretaría de Redes Asistenciales, Ministerio de Salud, Santiago, Chile
| | - Gonzalo Soto-Brandt
- Departamento de Gestión del Cuidado, División de Atención Primaria, Subsecretaría de Redes Asistenciales, Ministerio de Salud Santiago Chile Departamento de Gestión del Cuidado, División de Atención Primaria, Subsecretaría de Redes Asistenciales, Ministerio de Salud, Santiago, Chile
| | - Matias Irarrazaval
- Departamento de Salud Mental, Subsecretaría de Salud Pública, Ministerio de Salud Santiago Chile Departamento de Salud Mental, Subsecretaría de Salud Pública, Ministerio de Salud, Santiago, Chile
| | - Mauricio Gómez
- Departamento de Salud Mental, Subsecretaría de Salud Pública, Ministerio de Salud Santiago Chile Departamento de Salud Mental, Subsecretaría de Salud Pública, Ministerio de Salud, Santiago, Chile
| | - Zohra Abaakouk
- Representación de la Organización Panamericana de la Salud / Organización Mundial de la Salud Santiago Chile Representación de la Organización Panamericana de la Salud / Organización Mundial de la Salud, Santiago, Chile
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Prosser M, Stephenson T, Mathur J, Enayati H, Kadie A, Abdi MM, Handuleh JIM, Keynejad RC. Reflective practice and transcultural psychiatry peer e-learning between Somaliland and the UK: a qualitative evaluation. BMC Med Educ 2021; 21:58. [PMID: 33451314 PMCID: PMC7811254 DOI: 10.1186/s12909-020-02465-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Reflective practice is a key skill for healthcare professionals. E-learning programmes have the potential to develop reflective practice in remote settings and low- and middle-income countries (LMICs), where access to in-person reflective groups may be reduced. 'Aqoon' is a global mental health peer-to-peer e-learning programme between Somaliland and UK medical students. We aimed to explore participants' experiences of participating in the Aqoon programme, including their experiences of reflective practice. METHODS Thirty-three medical students (22 Somaliland, 11 UK) enrolled in Aqoon. We matched volunteer learners in trios, to meet online to discuss anonymised clinical cases relevant to chapters of the World Health Organization's mental health gap action programme (mhGAP) intervention guide. We conducted thematic analysis of learners' reflective writing and post-programme focus group transcripts. RESULTS Twenty-four students (73%) attended at least three online discussions (14 Somaliland, 10 UK). Somaliland and UK students described improved reflective skills and greater recognition of stigma towards mental ill-health. Themes included gaining memorable insights from peer discussions which would impact their medical education. UK students emphasised improved cultural understanding of common psychiatric presentations whilst Somaliland students reflected on increased clinical confidence. DISCUSSION Integrating reflective practice into Aqoon showed the potential for low-cost e-learning interventions to develop cross-cultural reflective practice among medical students in diverse settings.
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Affiliation(s)
| | - Thomas Stephenson
- South London and Maudsley NHS Foundation Trust Maudsley Hospital, Denmark Hill, London, Greater London, SE5 8AZ, UK
| | - Jai Mathur
- St George's, University of London, London, UK
| | | | - Abdirasak Kadie
- Buhoodle District Hospital, IOM Mida Finnsom Health Project, Bohotle, Somaliland
| | - Manal Mohamed Abdi
- College of Medicine and Health Science, University of Hargeisa, Hargeisa, Somalia
| | - Jibril I M Handuleh
- College of Health Sciences, Amoud University, Borama, Somaliland.
- Department of Psychiatry, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
| | - Roxanne C Keynejad
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
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