Implementation science communications · 2025
Stakeholder engagement to co-design implementation strategies for integrating depression management into HIV care services in Senegal.
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Bernard Charlotte, Mensah Keitly, Lovero Kathryn L, Lam Hawa Abou, Font Hélène, Tine Judicaël Malick, Ziadeh Salaheddine, Ndiaye Ibrahima, Diagne Awa, Ndiaye Maguatte, Tine Jean Augustin Diégane, Jaquet Antoine, Ngom Ndeye Fatou, Seydi Moussa, IeDEA West Africa Cohort Collaboration (Group)
Аннотация
BACKGROUND: Depression is highly prevalent in people living with HIV (PWH), affecting their daily life and HIV outcomes. Following a successful pilot study to treat depression in PWH with Group Interpersonal Therapy, we examined its implementation potential. Despite a strong willingness for its adoption routine practice, formal integration of mental health services into HIV care remained challenging. Using Implementation Mapping, we aimed to select and specify a set of implementation strategies to integrate depression services into Senegalese HIV care.
METHODS: For each step of depression services (i.e. screening, diagnostic confirmation/referral, and treatment), we selected potential implementation strategies using the Expert Recommendations for Implementing Change (ERIC). During a 3-day workshop, 14 different stakeholders, including doctors, social workers, community health workers, a psychiatrist, a socio-anthropologist and local health officials, reviewed and discussed strategies selected for each implementation step. Each participant also voted on the importance and feasibility of each strategy, using a Likert scale from 1 to 5 (5 = very high importance or feasibility). Scores were then plotted on a 'go-zone' graph. Details of strategies ranked as important and feasible were then specified by stakeholders.
RESULTS: Forty-eight strategies were identified. Among them, 62,5% were considered as highly important and feasible, 31,3% as important but with concerns about feasibility, 6,2% as not very important or feasible. A total of 46 distinct implementation strategies, derived from 21 ERIC strategies and corresponding to 8 ERIC thematic clusters, were selected for the final implementation plan. Materials needed to implement and monitor implementation (i.e. registers, decision tree, patient's record) were validated during the workshop. Finally, a summary of the implementation plan for integrating depression management into HIV care services in Senegal was elaborated.
CONCLUSIONS: A systematic approach was used to collaboratively develop an implementation plan to integrate depression management into HIV care in Senegal. Informed by various stakeholders, this work can facilitate a national dissemination of the integration program and may offer a useful reference for developing similar programs for PWH in other settings.
METHODS: For each step of depression services (i.e. screening, diagnostic confirmation/referral, and treatment), we selected potential implementation strategies using the Expert Recommendations for Implementing Change (ERIC). During a 3-day workshop, 14 different stakeholders, including doctors, social workers, community health workers, a psychiatrist, a socio-anthropologist and local health officials, reviewed and discussed strategies selected for each implementation step. Each participant also voted on the importance and feasibility of each strategy, using a Likert scale from 1 to 5 (5 = very high importance or feasibility). Scores were then plotted on a 'go-zone' graph. Details of strategies ranked as important and feasible were then specified by stakeholders.
RESULTS: Forty-eight strategies were identified. Among them, 62,5% were considered as highly important and feasible, 31,3% as important but with concerns about feasibility, 6,2% as not very important or feasible. A total of 46 distinct implementation strategies, derived from 21 ERIC strategies and corresponding to 8 ERIC thematic clusters, were selected for the final implementation plan. Materials needed to implement and monitor implementation (i.e. registers, decision tree, patient's record) were validated during the workshop. Finally, a summary of the implementation plan for integrating depression management into HIV care services in Senegal was elaborated.
CONCLUSIONS: A systematic approach was used to collaboratively develop an implementation plan to integrate depression management into HIV care in Senegal. Informed by various stakeholders, this work can facilitate a national dissemination of the integration program and may offer a useful reference for developing similar programs for PWH in other settings.