Evidence map›Paper›PMID 40336135›Full record

ArticleImplementation science communications2025

Multi-sector determinants of implementation and sustainment for non-specialist treatment of depression and post-traumatic stress disorder in Kenya: a concept mapping study.

Erika L Crable, Susan M Meffert, Ryan G Kenneally, Linnet Ongeri, David Bukusi, Rachel L Burger, Grace Rota, Ammon Otieno, Raymond Rotai, Muthoni Mathai and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Implementation science communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Erika L CrableDepartment of Psychiatry, University of California San Diego, La Jolla, CA, USA. ecrable@health.ucsd.edu.
Susan M MeffertDepartment of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
Ryan G KenneallyDepartment of Psychiatry, University of California San Diego, La Jolla, CA, USA.
Linnet OngeriCentre for Clinical Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
David BukusiDepartment of Psychiatry, University of Nairobi, Nairobi, Kenya.
Rachel L BurgerDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
Grace RotaUniversity of Nairobi, Nairobi, Kenya.
Ammon OtienoUniversity of Nairobi, Nairobi, Kenya.
Raymond RotaiUniversity of Nairobi, Nairobi, Kenya.
Muthoni MathaiUniversity of Nairobi, Nairobi, Kenya.
Gregory A AaronsDepartment of Psychiatry, University of California San Diego, La Jolla, CA, USA.

Funding

The SMART-DAPPER study: Implementation research on Tele-mental health care in the COVID19 eraR01MH113722 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MEFFERT, SUSAN M. · 2019 to 2023
$3.6M
Depression And Primary-care Partnership for Effectiveness-implementation Research (DAPPER)R01MH115512 · NIMH · UNIVERSITY OF NAIROBI · PI MATHAI, MUTHONI MUTHONI, MEFFERT, SUSAN M. · 2018 to 2022
$3.1M
Policy Dissemination Strategies to Improve the Use of Research Evidence in Medicaid Benefits for Opioid Use Disorder TreatmentK01DA056838 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Erika Lynn Crable · 2022 to 2026
$914k
NIDA NIH HHS K01 DA056838NIDA NIH HHS K01DA056838NIDA NIH HHS L60 DA056946NIMH NIH HHS R01 MH113722NIMH NIH HHS R01MH113722NIMH NIH HHS R01 MH115512NIMH NIH HHS R01MH115512
6 · The paper itself

Abstract

backgroundThe global shortage of trained mental health workers disproportionately impacts mental health care access in low- and middle-income countries. In Kenya, effective strategies are needed to scale-up the workforce to meet the demand for depression and post-traumatic stress disorder treatment. Task-shifting - delegating specific tasks to non-specialist workers - is one workforce expansion approach. However, non-specialist workers remain underutilized in Kenya due to a paucity of research on how to scale-up and sustain such service models.

methodsPurposive sampling was used to recruit experts from policy, healthcare practice, research, and mental health advocacy roles in Kenya (N = 30). Participants completed concept mapping activities to explore factors likely to facilitate or hinder a collaborative Ministry of Health-researcher training of the mental health non-specialist workforce. Participants brainstormed 71 statements describing determinants and implementation strategies, sorted and rated the importance and changeability of each. Multidimensional scaling and hierarchical cluster analysis quantified relationships between statements. The Exploration, Preparation, Implementation, and Sustainment (EPIS) framework guided cluster interpretation activities.

resultsTwelve determinant clusters were identified: 1) Current workforce characteristics, 2) Exploration considerations, 3) Preparation considerations, 4) Sustainment considerations, 5) Inner context implementation processes and tools, 6) Local capacity and partnerships, 7) Financing for community health teams, 8) Outer context resource allocation/policy into action, 9) Workforce characteristics to enhance during implementation, 10) Workforce implementation strategies, 11) Cross-level workforce strategies, and 12) Training and education recommendations. Cluster 8 was rated the most important and changeable.

conclusionConcept mapping offers a rapid, community-engaged approach for identifying determinants and implementation strategies to address workforce shortages. Organizing results by EPIS phases can help prioritize strategy deployment to achieve implementation goals. Scale-up and sustainment of the non-specialist workforce in Kenya requires formal partnerships between the Ministry of Health and community health worker teams to distribute financial resources and collaboratively standardize training curriculum.

Indexed as

Concept mappingEPIS FrameworkImplementation scienceMental healthNon-specialist workforcePolicy

Identifiers

PMID40336135
PMCPMC12056999

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.