Addressing unmet needs: intervention approaches for mental health among people with tuberculosiss in Uganda

PROJECT SUMMARY Tuberculosis (TB) and common mental disorders (CMDs) are both leading causes of death and disability worldwide and are intertwined health states that often co-occur but are rarely addressed together. People with TB and diagnosis of at least one CMD have double the risk of loss to follow-up, treatment failure, or death

along with increased odds of non-adherence to TB treatment. Thus, there is an urgent need to identify and assess evidence-based interventions to address CMDs as part of routine TB care to improve wellbeing and TB treatment outcomes among people with TB. The overall objective of this application is to identify and adapt an intervention to address CMDs among people

being treated for TB. The central hypothesis is that an existing mental health intervention for CMDs is appropriate for and can be adapted and integrated into routine TB care. The central hypothesis will be tested by pursing three specific aims: 1) examine the relationship between CMDs and associated factors with TB

treatment adherence and treatment outcomes during the TB treatment period to identify the most critical timing and type of intervention needed, 2) adapt and explore barriers and facilitators for implementation of an evidence based CMD intervention for integration into routine TB treatment services, and 3) pilot an intervention

aimed at improving TB treatment outcomes among individuals with CMD symptoms. The results of this work will provide critical preliminary data for an NIH R01 application evaluating effectiveness of the adapted intervention among people with TB on treatment. Dr. West’s career goal is to become an independent investigator focused on improving TB treatment outcomes

in high-burden settings by addressing the mental health needs of people with TB. To support her path to independence, the proposed work will be paired with a dedicated, multidisciplinary mentorship team and training in longitudinal study design and conduct (Aim 1), implementation sciences (Aims 2 and 3), and

interventional research (Aim 3). UCSF is an outstanding environment that is committed to junior investigators with extensive resources for research and career development. Thus, the K01 award will provide Dr. West with the critical mentorship, training, resources and experience to become an international leader in mental health

research among people with TB.