Mutual capacity building model for adaptation (MCB-MA): a seven-step procedure bidirectional learning and support during intervention adaptation.

Global health reciprocal innovation emphasizes the movement of technologies or interventions between high- and low-income countries to address a shared public health problem, in contrast to unidirectional models of "development aid" or "reverse innovation". Evidence-based interventions are frequently adapted from the setting in which they were developed and applied in a new setting, presenting an opportunity for learning and partnership across high- and low-income contexts. However, few clear procedures exist to guide researchers and implementers on how to incorporate equitable and learning-oriented approaches into intervention adaptation across settings. We integrated theories from pedagogy, implementation science, and public health with examples from experience adapting behavioral health interventions across diverse settings to develop a procedure for a bidirectional, equitable process of intervention adaptation across high- and low-income contexts. The Mutual capacity building model for adaptation (MCB-MA) is made up of seven steps: 1) Exploring: A dialogue about the scope of the proposed adaptation and situational appraisal in the new setting; 2) Developing a shared vision: Agreeing on common goals for the adaptation; 3) Formalizing: Developing agreements around resource and data sharing; 4) Sharing complementary expertise: Group originating the intervention supporting the adapting group to learn about the intervention and develop adaptations, while gleaning new strategies for intervention implementation from the adapting group; 5) Reciprocal training: Originating and adapting groups collaborate to train the individuals who will be implementing the adapted intervention; 6) Mutual feedback: Originating and adapting groups share data and feedback on the outcomes of the adapted intervention and lessons learned; and 7) Consideration of next steps: Discuss future collaborations. This evidence-informed procedure may provide researchers with specific actions to approach the often ambiguous and challenging task of equitable partnership building. These steps can be used alongside existing intervention adaptation models, which guide the adaptation of the intervention itself.

The prevalence and associated characteristics of Bipolar Disorder diagnosis among admitted patients at three tertiary psychiatric hospitals in Zimbabwe: A cross sectional study.

BACKGROUND: Bipolar Affective Disorder (BD) is a serious condition that affects more than 1% of the world's population. If not treated can cause disability, yet its prevalence in Zimbabwe is not known. This study explores the burden of Bipolar Disorder and its associated factors in Zimbabwe. METHODS: A cross sectional study with a sample of 272 participants was carried out at three tertiary hospitals in Zimbabwe. Data was collected using an interviewer administered questionnaire and the Mini International Neuropsychiatric Interview (M.I.N.I). The study shows the prevalence and factors associated with Bipolar Disorder at tertiary psychiatric hospitals. Data analysis was done using STATA S/E 13.0 for data management. RESULTS: The prevalence of BD in the sample was 39.3%. Factors associated with BD were, being formally employed (AOR = 3.69, 95%CI: 1.55-8.79), a history of defaulting medications (AOR = 1.90, 95%CI: 1.02-3.57) and a reported previous diagnosis of BD (AOR = 5.66, 95%CI: 2.72-11.8). CONCLUSIONS: The prevalence of BD among admitted participants in tertiary psychiatric hospitals in Zimbabwe is high. It is comparable to that from African studies done in clinical settings. There is need for in-service training for clinicians to be more vigilant in diagnosing BD.

Cognitive performance in depression in low- and middle-income countries: A systematic review with meta-analytic components.

BACKGROUND: Depression is highly prevalent in low- and middle- income countries (LMIC) and associated with significant cognitive dysfunction across multiple domains. However, little is known about neurocognitive tests used in people with depression in LMIC. We aimed to investigate cognitive performance and cognitive tests in depression research in LMIC. METHODS: APA PsycInfo, Embase, Ovid MEDLINE, and Global Health were systematically searched for studies that implemented a cognitive performance test in a depressed, LMIC population. Tool quality was assessed using an adapted scale for quality of measures in cross-cultural settings. Data extracted included demographics, depression and cognitive performance measures, and cognitive performance comparisons between depression and control groups. RESULTS: 29 studies met eligibility criteria, involving a total of 19,100 participants from 11 LMIC. 93.1 % of studies were conducted in upper middle-income countries. 67 cognitive performance tools were implemented. Reliability was reported for 5.6 % of cognitive performance tests and validity was reported for 8.3 %. 36.1 % of tests used were culturally adapted. 75.9 % of included studies implemented at least one memory test. Cognitive deficits were observed in all depressed groups, especially in memory (Cohen's d = -1.60, 95 % CI -2.02 to -1.18). LIMITATIONS: Heterogeneity between studies; averaged results across memory subtypes; no assessment of depression severity and cognitive deficits associations; restrictive search terms. CONCLUSIONS: Cognitive impairments in depression, especially in memory, are prevalent in LMIC. This research has drawn attention to the burden of cognitive dysfunction in depression in LMIC, and to the disparate research gap in LMIC. PROSPERO registration CRD42022315397.