Atmiyata, A Community Led Psychosocial Intervention in Reducing Symptoms Associated with Common Mental Disorders: A Stepped Wedge Cluster Randomized Controlled Trial in Rural Gujarat, India

2020 ◽  
Author(s):  
Soumitra Pathare ◽  
Kaustubh Joag ◽  
Jasmine Kalha ◽  
Deepa Pandit ◽  
Sadhvi Krishnamoorthy ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Mental Disorders ◽  
Psychosocial Intervention ◽  
Common Mental Disorders ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Stepped Wedge ◽  
Randomized Controlled ◽  
Cluster Randomized

scholarly journals Atmiyata, a community led intervention to address common mental disorders: Study protocol for a stepped wedge cluster randomized controlled trial in rural Gujarat, India

2019 ◽  
Author(s):  
Kaustubh Joag ◽  
Jasmine Kalha ◽  
Deepa Pandit ◽  
Susmita Chatterjee ◽  
Sadhvi Krishnamoorthy ◽  
...  
Keyword(s):  
Mental Health ◽  
Randomized Controlled Trial ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Controlled Trial ◽  
Mixed Effects ◽  
Stepped Wedge ◽  
Linear Mixed Effects ◽  
Randomized Controlled ◽  
Cluster Randomized

Abstract Background: While lay-health worker models for mental health care have proven to be effective in controlled trials, there is limited evidence on the effectiveness and scalability of these models in rural communities in low- and middle-income countries (LMICs). Atmiyata is a rural community-led intervention using local community volunteers, called Champions, to identify and provide evidence-based counselling for persons with common mental disorders (CMD) as part of a package of community-based interventions for mental health. Methods: The impact of the Atmiyata intervention is evaluated through a stepped wedge cluster randomized controlled trial (SW-CRCT) with a nested economic evaluation. The trial spans across 10 sub-blocks (645 villages) in Mehsana district with 1.52 million rural adult population. There are 56 primary health centers (PHCs) in Mehsana district and villages covered under these PHCs are equally divided into four groups of clusters of 14 PHCs each, and the intervention is rolled out in a staggered manner in these groups of villages at an interval of 5 months. The primary outcome is symptomatic improvement measured through the GHQ-12 at 3-month follow-up. Secondary outcomes include: quality of life using the EURO-QoL (EQ- 5D), symptom improvement measured by the Self-Reporting Questionnaire-20 (SRQ-20), functioning using the World Health Organization’s Disability Assessment Scale (WHO-DAS-12), depression symptoms using the Patient Health Questionnaire, (PHQ-9), anxiety symptoms using Generalized Anxiety Disorder Questionnaire, (GAD-7) and social participation using the Social Participation Scale (SPS). Generalized linear mixed effects model are employed for binary outcomes and linear mixed effects models for continuous outcomes. A Return on Investment (ROI) analysis of the intervention will be conducted to understand whether the intervention generates any return on financial investments made into the project.

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