Testing development, acceptability, feasibility and costing of MARBAR-Africa (a routine outcome interactive measurement dashboard) for improved psychotherapy outcomes in specialist public health care

Project Summary This is a pathfinder project that will begin by developing a prototype of a dashboard for routine outcomes monitoring in psychotherapy and mental health clinics in the two hospitals. The feasibility study will be carried out in Kisumu and Nairobi in public health clinics. Our specific aims include mapping of the effectiveness of psychotherapy as practiced in regular clinical practice at key sites in Kenya, in general and for specific diagnostic subgroups. This aim will be realized by implementing a Routine Outcome Monitoring system (ROM). Such systems have been used in other parts of the world, and are known to improve treatment effectiveness. Other sub-aims include: Aim 1 To adapt and extend the develop a contextualized prototype ofMarBar ROM system developed in Ecuador to Kisumu and Nairobi in Kenya Aim 2 To test feasibility, cost, efficacy and sustainability of the use of MarBar-Africa over 6 months pathfinder pilot in two clinics in Nairobi and Kisumu Aim 3 To carry out an exploratory analysis of the trajectories of distress, improvement of functioning and quality of life of study participants to identify characteristics of patients and treatments of those who are successfully remitted from those not. The information gained from the project will be used for optimizing treatment of mental disorders in Kenya and strengthen regional Kenyan public hospital partnerships. A long-term aim is to develop sustainable clinical excellence demonstration sites in Kenya and other neighboring East African countries, developing and testing methods that will be continually informed and refined by empirical data collected at these sites. Our group has previously done successful pilot research at two sites in Nairobi, Kenya, that has generated several publications in renowned international journals and useful information to clinics and patients. The feasibility of the project will be ensured by our group’s extensive and broad knowledge of psychotherapy research, clinical psychology, psychiatry, implementation science, and of local contexts in both counties. We believe the project has the potential of providing information that will be immediately useful to clinicians and patients at the studied sites, and in the long run to patients throughout the Sub- Saharan African continent.