Strengthening the understanding of south partnerships and rigor in addressing social determinants of child and adolescent mental health

The Journal of Adolescent Health\u27s current supplement presents the work of a highly active team of researchers who are focusing on developing a strong body of evidence around child and adolescent mental health in Sub-Saharan Africa. The supplement lays out scholarship generated through years of partnership between researchers based in the United States—some of whom are from Sub-Saharan context, specifically Uganda—in connecting applied social work, community mental health for children and adolescents, and family development. The work comprises a series of articles embedded within several National Institutes of Health–funded grants by authors based in the United States in partnership with various academic and nongovernmental organizations in Uganda and Ghana

Championing Equity, Empowerment, and Transformational Leadership in (Mental Health) Research Partnerships: Aligning Collaborative Work With the Global Development Agenda

Through a narrative synthesis of existing literature on research partnerships, the paper underscores four core values championed in public policy and practice: equity, empowerment, transformational leadership, and treating mental health research as a cooperative inquiry. Building on these values, the author maps the challenges before mental health researchers in forging resilient, egalitarian, and committed Global North-South partnerships within the context of current global development agenda. Reports appraising the UN Millennium Development Goals lament how the goal of developing global partnerships to combat health, gender, and economic inequities has remained under-realized. Emphasis has been placed on the great need to augment Sustainable Development Goals (SDG) in ways where partnership processes would drive development and human rights agenda for the most afflicted, under-resourced, and marginalized in the world. Global North-South partnerships result in fewer lasting benefits to Global South-a regressive trend that is critically analyzed. The need for Global North to adopt ethical and responsible stances while creating/curating new knowledge is discussed. Being responsible is not only imperative for Global North researchers; it is imperative for both North and South researchers to adopt a dialogical approach in clarifying and sharing roles, responsibilities, access, and leadership in developing scholarship and praxis in mental health. The importance of de-centering hierarchies, valuing reciprocity in one another, improving communication, demonstrating empathy, and sharing resources and benefits are found to be key components in the narrative synthesis towards achieving greater empowerment and equity. The paper reflects on the potential problems in engagement and development of de-centered and transformational leadership in partnerships and implications for research ethics in the context of lower-and-middle-income countries. Lastly, the author in a bid to encourage global partnerships suggests that engaging in transparent and bi-directional conversations regarding these issues and realigning research priorities along the four core values will contribute to greater success in research collaborations (across cultural contexts) and more so in the global mental health field

Use of multidimensional item response theory methods for dementia prevalence prediction: an example using the Health and Retirement Survey and the Aging, Demographics, and Memory Study

Abstract: Background: Data sparsity is a major limitation to estimating national and global dementia burden. Surveys with full diagnostic evaluations of dementia prevalence are prohibitively resource-intensive in many settings. However, validation samples from nationally representative surveys allow for the development of algorithms for the prediction of dementia prevalence nationally. Methods: Using cognitive testing data and data on functional limitations from Wave A (2001–2003) of the ADAMS study (n=744) and the 2000 wave of the HRS study (n=6358) we estimated a two-dimensional item response theory model to calculate cognition and function scores for all individuals over 70. Based on diagnostic information from the formal clinical adjudication in ADAMS, we ft a logistic regression model for the classifcation of dementia status using cognition and function scores and applied this algorithm to the full HRS sample to calculate dementia prevalence by age and sex. Results: Our algorithm had a cross-validated predictive accuracy of 88% (86–90), and an area under the curve of 0.97 (0.97–0.98) in ADAMS. Prevalence was higher in females than males and increased over age, with a prevalence of 4% (3–4) in individuals 70–79, 11% (9–12) in individuals 80–89 years old, and 28% (22–35) in those 90 and older. Conclusions: Our model had similar or better accuracy as compared to previously reviewed algorithms for the prediction of dementia prevalence in HRS, while utilizing more fexible methods. These methods could be more easily generalized and utilized to estimate dementia prevalence in other national surveys

Mental health service preferences of patients and providers: a scoping review of conjoint analysis and discrete choice experiments from global public health literature over the last 20 years (1999–2019)

Abstract: Background: In designing, adapting, and integrating mental health interventions, it is pertinent to understand patients’ needs and their own perceptions and values in receiving care. Conjoint analysis (CA) and discrete choice experiments (DCEs) are survey-based preference-elicitation approaches that, when applied to healthcare settings, offer opportunities to quantify and rank the healthcare-related choices of patients, providers, and other stakeholders. However, a knowledge gap exists in characterizing the extent to which DCEs/CA have been used in designing mental health services for patients and providers. Methods: We performed a scoping review from the past 20 years (2009–2019) to identify and describe applications of conjoint analysis and discrete choice experiments. We searched the following electronic databases: Pubmed, CINAHL, PsychInfo, Embase, Cochrane, and Web of Science to identify stakehold,er preferences for mental health services using Mesh terms. Studies were categorized according to pertaining to patients, providers and parents or caregivers. Results: Among the 30 studies we reviewed, most were published after 2010 (24/30, 80%), the majority were conducted in the United States (11/30, 37%) or Canada (10/30, 33%), and all were conducted in high-income settings. Studies more frequently elicited preferences from patients or potential patients (21/30, 70%) as opposed to providers. About half of the studies used CA while the others utilized DCEs. Nearly half of the studies sought preferences for mental health services in general (14/30, 47%) while a quarter specifically evaluated preferences for unipolar depression services (8/30, 27%). Most of the studies sought stakeholder preferences for attributes of mental health care and treatment services (17/30, 57%)

Awareness regarding emergency contraception among married women attending urban health centre, Berhampur, Odisha, India

Background: In India unplanned pregnancy and illegal abortions still remains a problem. Unintended early pregnancy and frequent childbearing contribute to high pregnancy related morbidity and mortality which can be prevented by use of suitable contraceptives. In circumstances where women are unable to exercise sexual and reproductive decision making, introduction of emergency contraceptive pills may provide important back up option to enable women to control their fertility.Methods: A cross-sectional study was conducted between August- October 2016 among 215 married women of reproductive age group attending the Urban Health Center, Berhampur, to study the awareness about most common methods of contraception, decision-making regarding contraceptive and knowledge and practice of emergency contraceptive pills.Results: This study concludes that most commonly used method was Oral contraceptive pills (28.3%) and major source of information regarding different methods of contraception were through friends and relatives (44.6%). Awareness about emergency contraception mostly came through television. Of those aware of ECPs (14.4%) only 16.1% had used it in their lifetime.Conclusions: Although there is awareness about contraceptives methods, knowledge and practice of emergency contraception is low