Protocol for a multi-phase, mixed methods study to develop and evaluate culturally adapted CBT to improve community mental health services for Canadians of south Asian origin
Abstract Background Canadians of South Asian (SA) origin comprise the largest racialized group in Canada, representing 25.6% of what Statistics Canada terms “visible minority populations”. South Asian Canadians are disproportionately impacted by the social determinants of health, and this can result...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | Trials |
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| Online Access: | https://doi.org/10.1186/s13063-021-05547-4 |
| _version_ | 1819023588458496000 |
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| author | Farooq Naeem Andrew Tuck Baldev Mutta Puneet Dhillon Gary Thandi Azaad Kassam Nimo Farah Aamna Ashraf M. Ishrat Husain M. Omair Husain Helen-Maria Vasiliadis Marcos Sanches Tariq Munshi Maureen Abbott Nicholas Watters Sean A. Kidd Muhammad Ayub Kwame McKenzie |
| author_facet | Farooq Naeem Andrew Tuck Baldev Mutta Puneet Dhillon Gary Thandi Azaad Kassam Nimo Farah Aamna Ashraf M. Ishrat Husain M. Omair Husain Helen-Maria Vasiliadis Marcos Sanches Tariq Munshi Maureen Abbott Nicholas Watters Sean A. Kidd Muhammad Ayub Kwame McKenzie |
| author_sort | Farooq Naeem |
| collection | DOAJ |
| description | Abstract Background Canadians of South Asian (SA) origin comprise the largest racialized group in Canada, representing 25.6% of what Statistics Canada terms “visible minority populations”. South Asian Canadians are disproportionately impacted by the social determinants of health, and this can result in high rates of mood and anxiety disorders. These factors can negatively impact mental health and decrease access to care, thereby increasing mental health inequities. Cognitive Behavioural Therapy (CBT) in its current form is not suitable for persons from the non-western cultural backgrounds. Culturally adapted Cognitive Behavioural Therapy (CaCBT) is an evidence-based practice. CaCBT is more effective than standard CBT and can reduce dropouts from therapy compared with standard CBT. Thus, CaCBT can increase access to mental health services and improve outcomes for immigrant, refugee and ethno-cultural and racialized populations. Adapting CBT for growing SA populations in Canada will ensure equitable access to effective and culturally appropriate interventions. Methods The primary aim of the study is to develop and evaluate CaCBT for Canadian South Asian persons with depression and anxiety and to gather data from stakeholders to develop guidelines to culturally adapt CBT. This mixed methods study will use three phases: (1) cultural adaptation of CBT, (2) pilot feasibility of CaCBT and (3) implementation and evaluation of CaCBT. Phase 1 will use purposive sampling to recruit individuals from four different groups: (1) SA patients with depression and anxiety, (b) caregivers and family members of individuals affected by anxiety and depression, (c) mental health professionals and (d) SA community opinion leaders. Semi-structured interviews will be conducted virtually and analysis of interviews will be informed by an ethnographic approach. Phase 2 will pilot test the newly developed CaCBT for feasibility, acceptability and effectiveness via quantitative methodology and a randomized controlled trial, including an economic analysis. Phase 3 will recruit therapists to train and evaluate them in the new CaCBT. Discussion The outcome of this trial will benefit health services in Canada, in terms of helping to reduce the burden of depression and anxiety and provide better care for South Asians. We expect the results to help guide the development of better services and tailor existing services to the needs of other vulnerable groups. Trial registration ClinicalTrials.gov NCT04010890. Registered on July 8, 2019 |
| first_indexed | 2024-12-21T04:41:17Z |
| format | Article |
| id | doaj.art-c81622443767479e88b5854d4f739839 |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-12-21T04:41:17Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-c81622443767479e88b5854d4f7398392022-12-21T19:15:41ZengBMCTrials1745-62152021-09-012211910.1186/s13063-021-05547-4Protocol for a multi-phase, mixed methods study to develop and evaluate culturally adapted CBT to improve community mental health services for Canadians of south Asian originFarooq Naeem0Andrew Tuck1Baldev Mutta2Puneet Dhillon3Gary Thandi4Azaad Kassam5Nimo Farah6Aamna Ashraf7M. Ishrat Husain8M. Omair Husain9Helen-Maria Vasiliadis10Marcos Sanches11Tariq Munshi12Maureen Abbott13Nicholas Watters14Sean A. Kidd15Muhammad Ayub16Kwame McKenzie17Department of Psychiatry, University of TorontoCentre for Addiction and Mental HealthPunjabi Community Health ServicesPunjabi Community Health ServicesMoving Forward Family ServicesUniversity of OttawaSomerset West Community Health CentreCentre for Addiction and Mental HealthDepartment of Psychiatry, University of TorontoDepartment of Psychiatry, University of TorontoDepartment of Community Health Sciences, Faculty of Medicine and Health Science, Université de Sherbrooke, Research Center Charles-Le Moyne – Saguenay–Lac-Saint-Jean sur les innovations en santéDepartment of Psychiatry, University of TorontoDepartment of Psychiatry, University of TorontoMental Health Commission of CanadaMental Health Commission of CanadaDepartment of Psychiatry, University of TorontoQueen’s UniversityDepartment of Psychiatry, University of TorontoAbstract Background Canadians of South Asian (SA) origin comprise the largest racialized group in Canada, representing 25.6% of what Statistics Canada terms “visible minority populations”. South Asian Canadians are disproportionately impacted by the social determinants of health, and this can result in high rates of mood and anxiety disorders. These factors can negatively impact mental health and decrease access to care, thereby increasing mental health inequities. Cognitive Behavioural Therapy (CBT) in its current form is not suitable for persons from the non-western cultural backgrounds. Culturally adapted Cognitive Behavioural Therapy (CaCBT) is an evidence-based practice. CaCBT is more effective than standard CBT and can reduce dropouts from therapy compared with standard CBT. Thus, CaCBT can increase access to mental health services and improve outcomes for immigrant, refugee and ethno-cultural and racialized populations. Adapting CBT for growing SA populations in Canada will ensure equitable access to effective and culturally appropriate interventions. Methods The primary aim of the study is to develop and evaluate CaCBT for Canadian South Asian persons with depression and anxiety and to gather data from stakeholders to develop guidelines to culturally adapt CBT. This mixed methods study will use three phases: (1) cultural adaptation of CBT, (2) pilot feasibility of CaCBT and (3) implementation and evaluation of CaCBT. Phase 1 will use purposive sampling to recruit individuals from four different groups: (1) SA patients with depression and anxiety, (b) caregivers and family members of individuals affected by anxiety and depression, (c) mental health professionals and (d) SA community opinion leaders. Semi-structured interviews will be conducted virtually and analysis of interviews will be informed by an ethnographic approach. Phase 2 will pilot test the newly developed CaCBT for feasibility, acceptability and effectiveness via quantitative methodology and a randomized controlled trial, including an economic analysis. Phase 3 will recruit therapists to train and evaluate them in the new CaCBT. Discussion The outcome of this trial will benefit health services in Canada, in terms of helping to reduce the burden of depression and anxiety and provide better care for South Asians. We expect the results to help guide the development of better services and tailor existing services to the needs of other vulnerable groups. Trial registration ClinicalTrials.gov NCT04010890. Registered on July 8, 2019https://doi.org/10.1186/s13063-021-05547-4South AsianCulturally adapted cognitive Behavioural therapyCanadaDepressionAnxiety |
| spellingShingle | Farooq Naeem Andrew Tuck Baldev Mutta Puneet Dhillon Gary Thandi Azaad Kassam Nimo Farah Aamna Ashraf M. Ishrat Husain M. Omair Husain Helen-Maria Vasiliadis Marcos Sanches Tariq Munshi Maureen Abbott Nicholas Watters Sean A. Kidd Muhammad Ayub Kwame McKenzie Protocol for a multi-phase, mixed methods study to develop and evaluate culturally adapted CBT to improve community mental health services for Canadians of south Asian origin Trials South Asian Culturally adapted cognitive Behavioural therapy Canada Depression Anxiety |
| title | Protocol for a multi-phase, mixed methods study to develop and evaluate culturally adapted CBT to improve community mental health services for Canadians of south Asian origin |
| title_full | Protocol for a multi-phase, mixed methods study to develop and evaluate culturally adapted CBT to improve community mental health services for Canadians of south Asian origin |
| title_fullStr | Protocol for a multi-phase, mixed methods study to develop and evaluate culturally adapted CBT to improve community mental health services for Canadians of south Asian origin |
| title_full_unstemmed | Protocol for a multi-phase, mixed methods study to develop and evaluate culturally adapted CBT to improve community mental health services for Canadians of south Asian origin |
| title_short | Protocol for a multi-phase, mixed methods study to develop and evaluate culturally adapted CBT to improve community mental health services for Canadians of south Asian origin |
| title_sort | protocol for a multi phase mixed methods study to develop and evaluate culturally adapted cbt to improve community mental health services for canadians of south asian origin |
| topic | South Asian Culturally adapted cognitive Behavioural therapy Canada Depression Anxiety |
| url | https://doi.org/10.1186/s13063-021-05547-4 |
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