Table 1.
Recruitment and data collection method for the PRIME cohorts
| Sodo district, Ethiopia | Sehore district, India | Chitwan districta, Nepal | Dr Kenneth Kaunda, SA | Kamuli district, Uganda | |
|---|---|---|---|---|---|
| District population | 143,507 (total) [70] | 318,314 (total) [71] | 579,984 [72] | 695,933 [73] | 490,255 (total) [74] |
| Number of clinics involved in recruitment | 9 facilities (8 health centres, 1 hospital) | 3 community health centres | 10 clinics | 4 clinics | 13 facilities (12 health centres, 1 hospital) |
| Recruitment period | |||||
| Depression | Feb 2015 – Dec 2015 | Nov 2014 – July 2015 | Aug 2014 – Sept 2015 | Aug 2014 – July 2015 | Jan 2015 - Sept 2015 |
| AUD | Aug 2015 – Nov 2015 | Nov 2014 – Aug 2015 | Aug 2014 – Sept 2015 | – | – |
| Psychosis | Dec 2014 – Jul 2015 | Nov 2014 – Aug 2015 | Aug 2014 – Sept 2015 | Aug 2014 – Sept 2014 Aug 2015 – Sept 2015 |
Jan 2015 - Sept 2015 |
| Epilepsy | Dec 2014 – March 2015 | – | Aug 2014 – Sept 2015 | – | Jan 2015 - Sept 2015 |
| Step 1 of recruitment – Detection of individuals with priority mental disorder | |||||
| Depression | 1. Diagnosis by mhGAP-trained nurse or health officer at clinic (MHCP) | 1. mhGAP master chart checklist (MHCP) at community or clinic 2. PHQ-9 & AUDIT by case manager (MHCP), or else researcher, at clinic 3. Consultation with medical officer (MO) at clinic (MHCP) |
1. Community informant detection tool (CIDT), at community (MHCP) 2. PHQ-9 & AUDIT by researcher, at clinic 3. Consultation with PHC worker or medical officer (MO), at clinic (MHCP) |
1. Consultation with PC101 trained nurse or doctor, at clinic (MHCP) 2. PHQ-9 & AUDIT by researcher, at clinic |
1. Consultation with mhGAP trained nurse or medical clinical officer, at clinic (MHCP) |
| AUD | 1. Single-question alcohol screening test by mhGAP-trained nurse or health officer at clinic (MHCP) 2. AUDIT by mhGAP-trained nurse or health officer at clinic (MHCP) |
– | |||
| Psychosis | 1. Identification of probable cases by HEWS and community key informant at community level (MHCP) 2. mhGAP master chart checklist by mhGAP-trained nurse or health officer used to identify psychosis or bipolar disorder (MHCP) 3. Confirmatory clinician interview (OPCRIT) by psychiatric nurse (MHCP) |
1. mhGAP master chart checklist, at community or clinic (MHCP) 2. Consultation with MO, at clinic (MHCP) |
1. Community information detection tool (CIDT), at community (MHCP) 2. Consultation with PHC worker or MO, at clinic (MHCP) |
1.Identified from patient registry | |
| Epilepsy | 1. Identification of probable cases by HEWS and community key informant at community level (MHCP) 2. mhGAP master chart checklist by mhGAP-trained nurse or health officer (MHCP) used to identify epilepsy 3. Diagnostic accuracy checked by neurologist in sub-sample of 25. |
– | – | ||
| Step 2 of recruitment – recruitment and group allocation | |||||
| Depression | Recruitment done by PRIME researcher; Group allocation: • Diagnosis made by nurse or health officer: diagnosed cohort • No diagnosis but screen positive on PHQ-9: comparison cohort |
Recruitment done by PRIME researcher; Group allocation: • Diagnosis made by MO: diagnosed cohort • No diagnosis but screen positive on PHQ-9 or AUDIT: depression or AUD comparison cohorts |
Recruitment done by PRIME researcher; Group allocation: • Diagnosis made by PHC worker: diagnosed cohort • No diagnosis but screen positive on PHQ-9 or AUDIT: depression or AUD comparison cohorts |
Recruitment done by PRIME researcher; Group allocation: • Diagnosis made by nurse or doctor: diagnosed cohort • No diagnosis but screen positive on PHQ-9: comparison cohort |
Recruitment done by PRIME researcher; • Group allocation: Diagnosis made by nurse: diagnosed cohort • No participants recruited in the comparison cohort |
| AUD | Diagnosis and recruitment done by PRIME researcher; • Screen positive on AUDIT: diagnosed cohort • No participants recruited in a comparison cohort |
n/a | n/a | ||
| Psychosis | Diagnosis and recruitment done by psychiatric nurse; Diagnosed patient recruited, together with caregiver |
Recruitment done by PRIME researcher; Diagnosis made by MO: diagnosed patient or caregiver recruited |
Recruitment done by PRIME researcher; Diagnosis made by trained PHC worker or MO: caregivers of diagnosed patients recruited |
Recruitment done by PRIME researcher: patient recruited; where possible, caregiver also recruited |
Recruitment done by PRIME researcher; Diagnosis made by nurse: diagnosed patient recruited, together with caregiver |
| Epilepsy | Diagnosis and recruitment done by nurse or health officer; Diagnosed patient recruited, together with caregiver |
n/a | Diagnosis given by PHC worker or MO: diagnosed patient recruited | n/a | |
| Assessments | |||||
| Location and timing of baseline assessment | All cohorts: Facility-based; if participants too unwell to leave their home, completed at home | All cohorts: Initiated at facility, finalised at home | All cohorts: Initiated at facility, finalised at home | All cohorts: Facility-based | Depression: Facility or home-based (depending on participant availability). Psychosis and epilepsy: Facility-based for participant, home-based for caregiver, or vice versa. |
| Location and timing of midline assessment | • Facility-based - if participants too unwell to leave their home, completed at home • Depression, psychosis and epilepsy: 6 months post-baseline • AUD: 3 months post-baseline |
• Home-based • Depression and AUD: 3 months post-baseline • Psychosis: 6 month post-baseline |
• Home-based • Depression and AUD: 3 months post-baseline • Psychosis and epilepsy: 6 month post-baseline |
• Facility/Home-based • Depression: 3 months post-baseline • Psychosis: no midline |
• Home-based • Depression: 3 months post-baseline • Psychosis and epilepsy: 6 month post-baseline |
| Location and timing of endline assessment | • Facility-based - if participants too unwell to leave their home, completed at home; • 12 months post-baseline |
Home-based; 12 months post-baseline | • Facility/Home based; 12 months post-partum | Home-based; 12 months post-baseline | |
aThe implementation area includes 10 of the 36 Village Development Committees in Chitwan District
PHC=Primary health care; PHQ-9 = Patient Health Questionnaire – 9 item; AUDIT = Alcohol Use Disorder Identification Test; OCPRIT = Operational Criteria Checklist for Psychotic Illness and Affective Illness; BRPSE = The Brief Psychiatric Rating Scale expanded version