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Integration of a Technology-Based Mental Health Screening Program Into Routine Practices of Primary Health Care Services in Peru (The Allillanchu Project): Development and Implementation

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dc.contributor.author Diez-Canseco Montero, Francisco
dc.contributor.author Toyama, Mauricio
dc.contributor.author Ipince, Alessandra
dc.contributor.author Pérez León Quinoso, Silvana Patricia
dc.contributor.author Cavero, Victoria
dc.contributor.author Araya, Ricardo
dc.contributor.author Miranda, J. Jaime
dc.date.accessioned 2018-11-30T17:17:14Z
dc.date.available 2018-11-30T17:17:14Z
dc.date.issued 2018
dc.identifier.uri https://hdl.handle.net/20.500.12866/4102
dc.description.abstract BACKGROUND: Despite their high prevalence and significant burden, mental disorders such as depression remain largely underdiagnosed and undertreated. OBJECTIVE: The aim of the Allillanchu Project was to design, develop, and test an intervention to promote early detection, opportune referral, and access to treatment of patients with mental disorders attending public primary health care (PHC) services in Lima, Peru. METHODS: The project had a multiphase design: formative study, development of intervention components, and implementation. The intervention combined three strategies: training of PHC providers (PHCPs), task shifting the detection and referral of mental disorders, and a mobile health (mHealth) component comprising a screening app followed by motivational and reminder short message service (SMS) to identify at-risk patients. The intervention was implemented by 22 PHCPs from five health centers, working in antenatal care, tuberculosis, chronic diseases, and HIV or AIDS services. RESULTS: Over a period of 9 weeks, from September 2015 to November 2015, 733 patients were screened by the 22 PHCPs during routine consultations, and 762 screening were completed in total. The chronic diseases (49.9%, 380/762) and antenatal care services (36.7%, 380/762) had the higher number of screenings. Time constraints and workload were the main barriers to implementing the screening, whereas the use of technology, training, and supervision of the PHCPs by the research team were identified as facilitators. Of the 733 patients, 21.7% (159/733) screened positively and were advised to seek specialized care. Out of the 159 patients with a positive screening result, 127 had a follow-up interview, 72.4% (92/127) reported seeking specialized care, and 55.1% (70/127) stated seeing a specialist. Both patients and PHCPs recognized the utility of the screening and identified some key challenges to its wider implementation. CONCLUSIONS: The use of a screening app supported by training and supervision is feasible and uncovers a high prevalence of unidentified psychological symptoms in primary care. To increase its sustainability and utility, this procedure can be incorporated into the routine practices of existing health care services, following tailoring to the resources and features of each service. The early detection of psychological symptoms by a PHCP within a regular consultation, followed by adequate advice and support, can lead to a significant percentage of patients accessing specialized care and reducing the treatment gap of mental disorders. en_US
dc.language.iso eng
dc.publisher JMIR Publications
dc.relation.ispartofseries JMIR. Journal of Medical Internet Research
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject mHealth en_US
dc.subject SMS en_US
dc.subject health services research en_US
dc.subject mental health en_US
dc.subject mobile health en_US
dc.subject screening en_US
dc.subject textmessaging en_US
dc.title Integration of a Technology-Based Mental Health Screening Program Into Routine Practices of Primary Health Care Services in Peru (The Allillanchu Project): Development and Implementation en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.2196/jmir.9208
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#1.02.03
dc.relation.issn 1438-8871


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