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Table 1 Recruitment and data collection method for the PRIME cohorts

From: Impact of district mental health care plans on symptom severity and functioning of patients with priority mental health conditions: the Programme for Improving Mental Health Care (PRIME) cohort protocol

  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
  1. aThe implementation area includes 10 of the 36 Village Development Committees in Chitwan District
  2. 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