Using participatory action research to pilot a model of service user and caregiver involvement in mental health system strengthening in Ethiopian primary healthcare: a case study.
Participatory action research
Service-user involvement
Sub-Saharan Africa
Theory of change
Journal
International journal of mental health systems
ISSN: 1752-4458
Titre abrégé: Int J Ment Health Syst
Pays: England
ID NLM: 101294224
Informations de publication
Date de publication:
11 Jul 2022
11 Jul 2022
Historique:
received:
15
04
2022
accepted:
22
06
2022
entrez:
11
7
2022
pubmed:
12
7
2022
medline:
12
7
2022
Statut:
epublish
Résumé
Little is known about actual involvement or how to achieve service user and caregiver in mental health systems strengthening in low-and middle-income countries. This study describes the processes and explores involvement experiences of participants in a pilot study of a new model of service user involvement in mental health system strengthening in a rural district in southern Ethiopia. We applied a case study design using participatory action research (PAR). The PAR process comprised of three stages, each with iterative activities of plan, act, observe and reflect. Two stakeholder groups, a Research Advisory Group (RAG) and Research Participant Group (RPG), were established and collaborated in the PAR process. Data collection involved process documentation of meetings and activities: attendances, workshop minutes, discussion outputs, reflective notes, participatory observation of sessions, and in-depth interviews with 12 RPG members. We analyzed the process data descriptively. Thematic analysis was used for qualitative data. Triangulation and synthesis of findings was carried out to develop the case study. The stakeholder groups identified their top research priorities, developed an intervention and action plan and made a public presentation of preliminary findings. Key mechanisms used for inclusive participation included capacity building and bringing together diverse stakeholders, anchoring the study in established strong community involvement structures, and making use of participatory strategies and activities during the PAR process. Four themes were developed about experiences of involvement in PAR: (i) expectations and motivation, (ii) experiences of the dynamics of the PAR process, (iii) perceived impacts of involvement in the PAR process, and (iv) implementation challenges and future directions. This case study demonstrated the feasibility and acceptability of implementing a complex model of service-user involvement in mental health system strengthening in a resource constrained setting. More needs to be done to embed service-user involvement into routines of the primary healthcare system, alongside sustained support and strengthening multi-stakeholder collaboration at multiple levels.
Sections du résumé
BACKGROUND
BACKGROUND
Little is known about actual involvement or how to achieve service user and caregiver in mental health systems strengthening in low-and middle-income countries. This study describes the processes and explores involvement experiences of participants in a pilot study of a new model of service user involvement in mental health system strengthening in a rural district in southern Ethiopia.
METHODS
METHODS
We applied a case study design using participatory action research (PAR). The PAR process comprised of three stages, each with iterative activities of plan, act, observe and reflect. Two stakeholder groups, a Research Advisory Group (RAG) and Research Participant Group (RPG), were established and collaborated in the PAR process. Data collection involved process documentation of meetings and activities: attendances, workshop minutes, discussion outputs, reflective notes, participatory observation of sessions, and in-depth interviews with 12 RPG members. We analyzed the process data descriptively. Thematic analysis was used for qualitative data. Triangulation and synthesis of findings was carried out to develop the case study.
RESULTS
RESULTS
The stakeholder groups identified their top research priorities, developed an intervention and action plan and made a public presentation of preliminary findings. Key mechanisms used for inclusive participation included capacity building and bringing together diverse stakeholders, anchoring the study in established strong community involvement structures, and making use of participatory strategies and activities during the PAR process. Four themes were developed about experiences of involvement in PAR: (i) expectations and motivation, (ii) experiences of the dynamics of the PAR process, (iii) perceived impacts of involvement in the PAR process, and (iv) implementation challenges and future directions.
CONCLUSIONS
CONCLUSIONS
This case study demonstrated the feasibility and acceptability of implementing a complex model of service-user involvement in mental health system strengthening in a resource constrained setting. More needs to be done to embed service-user involvement into routines of the primary healthcare system, alongside sustained support and strengthening multi-stakeholder collaboration at multiple levels.
Identifiants
pubmed: 35818056
doi: 10.1186/s13033-022-00545-8
pii: 10.1186/s13033-022-00545-8
pmc: PMC9275138
doi:
Types de publication
Journal Article
Langues
eng
Pagination
33Subventions
Organisme : NIMH NIH HHS
ID : R01 MH120649
Pays : United States
Organisme : NIMH NIH HHS
ID : R21 MH111280
Pays : United States
Informations de copyright
© 2022. The Author(s).
Références
Afr J Psychiatry (Johannesbg). 2013 May;16(3):187-95
pubmed: 23739821
BMC Public Health. 2015 Jul 30;15:725
pubmed: 26223523
BMC Med. 2020 Nov 10;18(1):301
pubmed: 33167974
Soc Sci Med. 2020 Feb 15;250:112852
pubmed: 32135459
PLoS Med. 2012;9(12):e1001359
pubmed: 23300387
Soc Sci Med. 2020 Jul;257:112153
pubmed: 30857750
Health Expect. 2018 Feb;21(1):159-170
pubmed: 28841753
PLoS One. 2014 Feb 18;9(2):e88437
pubmed: 24558389
Soc Psychiatry Psychiatr Epidemiol. 2015 Jun;50(6):867-77
pubmed: 25515608
BJPsych Int. 2019 May;16(2):37-40
pubmed: 31144679
Int J Soc Psychiatry. 2016 May;62(3):281-91
pubmed: 26831826
Epidemiol Psychiatr Sci. 2018 Feb;27(1):29-39
pubmed: 29113598
Lancet. 2011 Nov 5;378(9803):1664-75
pubmed: 22008426
Nurse Res. 2013 Nov;21(2):14-7
pubmed: 24171632
Int J Qual Stud Health Well-being. 2014 May 07;9:23606
pubmed: 24809980
Scand J Public Health. 2020 Aug;48(6):617-628
pubmed: 31319762
Br J Psychiatry. 2016 Jan;208 Suppl 56:s4-12
pubmed: 26447174
Curr Opin Psychiatry. 2019 Jul;32(4):355-360
pubmed: 30870258
BMC Health Serv Res. 2016 Mar 01;16:79
pubmed: 26931580
BMC Psychiatry. 2017 May 18;17(1):187
pubmed: 28521749
Transcult Psychiatry. 2012 Jul;49(3-4):418-37
pubmed: 23008351
Int J Ment Health Syst. 2020 Mar 10;14:17
pubmed: 32175004
Clin Psychol Rev. 2019 Aug;72:101749
pubmed: 31254936
BJPsych Open. 2019 Aug 06;5(5):e66
pubmed: 31685066
BMC Health Serv Res. 2016 Nov 15;16(Suppl 7):623
pubmed: 28185589
BMJ Qual Saf. 2011 Apr;20 Suppl 1:i30-5
pubmed: 21450767
Int J Ment Health Syst. 2020 Jul 23;14:51
pubmed: 32760440
Res Involv Engagem. 2020 Jan 08;6:2
pubmed: 31934350
Health Expect. 2019 Jun;22(3):307-316
pubmed: 30761699
Int J Ment Health Nurs. 2019 Aug;28(4):798-815
pubmed: 30938019
PLoS One. 2015 May 11;10(5):e0126666
pubmed: 25962075
Int J Ment Health Syst. 2018 Jul 24;12:41
pubmed: 30061922