Addressing the global mental health (MH) treatment and research gaps requires scaling up efficacious treatments using feasible, sustainable venues that leverage existing platforms supported by sustaining policies. The PRIDE: sub Saharan Africa MH Hub established a collaborative network of researchers, community- advocates, service providers and policy makers across Sub-Saharan Africa to build capacity and conduct implementation research to sustainably scale-up MH services. This hub may generate templates for other LMICs as well. In the parent grant, the Scale Up Research evaluates strategies and costs of scaling up an innovative, sustainable MH integrated stepped-care community approach for mental and substance use disorders in Mozambique. We leverage Mozambique?s task-shifting strategy which trained psychiatric technicians (PsyTs) to provide MH care throughout the country. Our partnership between researchers, providers, and community and policy stakeholders will scale-up a cost-effective and sustainable program and inform policy applicable to other LMICs. PRIDE is optimally poised to respond to the RFA in ways that could be transformative to the diagnosis and treatment of age-related neurocognitive disorders ranging from mild cognitive impairment (MCI) to Alzheimer?s Disease in LMICs, offering a cost-effective scalable tool to the field. Identifying elderly at risk for dementing illnesses is particularly challenging in LMICs. Even where professionals are available, traditional neuropsychological batteries for evaluating dementia or MCI require hours to administer and scoring and interpretation by highly trained personnel. The University of Pennsylvania (Penn) computerized neurocognitive battery (PennCNB) offers an alternative approach optimally suitable for LMICs. PennCNB is a compilation of neuroscience-based tests that have been validated with functional neuroimaging and in clinical settings and takes less than an hour to administer. It has an established factorial structure and is sensitive to sex differences, age effects, and the presence of neurocognitive deficits across the lifespan. The Penn group will leverage on a current R01 (MH117014; PI: Gur, RC; ?Creating an adaptive screening tool for detecting neurocognitive deficits and psychopathology across the lifespan?, 5/1/19-2/28/23) and deploy a computer adaptive testing (CAT) version of the PennCNB (PennCNB-CAT). PennCNB-CAT uses innovative methods that incorporate item response theory to substantially cut administration time to about 30-35 minutes, without loss of information or reliability. We will deploy the PennCNB-CAT in a sample of 500 patients and healthy controls from the Mozambique sites of the PRIDE, of whom 200 will be recruited from clinics for the elderly. This pilot study will allow establishing the feasibility of administration and the ability of the battery to detect age associated cognitive decline as well as MCI, AD and other dementing disorders. If successful, this project will provide a crucial tool that can be used in Mozambique and other LMICs globally to identify and chart the course of cognitive deficits in the elderly and evaluate efforts toward prevention and intervention.
NIH ExPorter
NIH ExPorter