Just published: PIECEs Health Economics Analysis Plan
We are pleased to share the updated document with our Health Economics Analysis Plan. We’ll be using this methodology to measure cost-effectiveness of our DIALOG+ trial. The economic analysis will be led by our Co-I, Dr Ashar Malik (Aga Khan University).
You can read our plan here.
Join Us on World Schizophrenia Day: A Day in the Life of “Dastan”
On World Schizophrenia Day, we invite you to step into the world of “Dastan” – a user-led theatre team in Karachi, Pakistan that is breaking the stigma surrounding psychosis. Through powerful storytelling, Dastan has been reshaping perceptions and challenging misconceptions about mental illness.
Watch here:
The Power of Waiting Room Theatre
In the vibrant waiting room of the Schizophrenia Research Foundation (Scarf) in Chennai, India, a transformative initiative unfolds as patients and caregivers take the stage in impromptu theatre performances. Through collaborative dialogue and creative expression, this initiative not only challenges stigma but also fosters understanding and compassion within the community. Read more about how SCARF’s waiting room theatre serves as a catalyst for meaningful conversations on mental health:
Namma Area: Celebrating Two Years of Empowerment and Community Engagement
On May 24, 2024, our team in India, SCARF, celebrated the second anniversary of Namma Area, an extraordinary event led and organized by individuals with lived experience of psychoses.
For those unfamiliar with this concept, “Namma” is a Tamil word for “Our,” and Namma Area means “Our Space.” This innovative space for individuals with psychoses or any mental health issues embodies autonomy, freedom, ownership, and responsibility. It promotes socialization and recreation through activities like games, movies, reading, and visits to places such as museums or parks. Initiated two years ago under the aegis of the PIECEs project, supported by an NIHR grant, Namma Area has served as a vital platform for engaging communities. The anniversary event, held at Vani Mahal in the heart of Chennai, showcased the remarkable talents of the service users in theatrics, dance, and a dramatic depiction of the space, with the highlight being a powerful panel discussion. The panel featured individuals with lived experience who shared how being part of Namma Area had significantly impacted their lives
The panel featured individuals with lived experience who shared how being part of the Namma Area had significantly impacted their lives. One poignant moment came when a young woman, responding to a question about whether her symptoms interfered with stage performance, said, “New learning pushes back any symptom that I would experience – that is the power of this space.” Answering a family member requesting transport to Namma Area, another panellist was quick to respond, “It is our desire to open more spaces in several parts of the city – this will allow lots of people to be part of the space”
These heartfelt exchanges highlighted the immense value of lived experience in shaping effective mental health initiatives. The director of Scarf mentioned that, as mental health professionals, we have much to learn from those with firsthand knowledge. The day is not far when individuals with psychoses will advocate for what they want and how they want it, paving the way for more inclusive and supportive community spaces.
Namma Area’s second anniversary was a celebration as well as a testament to the power of collective community efforts in fostering mental well-being.
Scaling up DIALOG+in Karachi, Pakistan
In a concerted effort to improve mental healthcare in Karachi, three Dialog+ sessions were recently held across Karachi’s prominent hospitals, conducted by the IRD Team. Commencing on March 8 at the Karachi Psychiatric Hospital, the initiative brought together mental health professionals to engage in conversations about using DIALOG+. Subsequent sessions were held at Lady Dufferin Hospital on April 19 and Jinnah Postgraduate Medical Centre on April 27th to offer individuals a safe platform to learn about DIALOG+.
Community Engagement Initiative: Forum Theatre at MMM Nursing College, Chennai
Our community engagement initiative, conducted by the mixed arts group at SCARFindia, involved delivering forum theatre performances and workshops at the MMM Nursing College in Chennai. This initiative provided an excellent platform for students to engage in discussions regarding challenges in mental healthcare. Additionally, students had the opportunity to interact with service users and members after the session, fostering a deeper understanding of mental health issues within the community.
Empowering Healthcare Professionals: Scaling Up DIALOG+
In the fast-paced world of healthcare, innovation is key to improving patient care and outcomes. One such innovation making waves is DIALOG+, a platform designed to enhance communication and collaboration among healthcare professionals. As we approach the end of the trial phase, our teams are ramping up efforts to scale up the use of DIALOG+, empowering clinicians through comprehensive training sessions. Recently, the Interactive Development and Research Team in Pakistan took strides in this endeavour by conducting training sessions at Karwan-e-hayat and Karachi Psychiatric Hospital. These sessions were about fostering a deep understanding of its potential and integrating it seamlessly into routine practices.
At the heart of these sessions were meaningful discussions about the continued utilization of DIALOG+ in everyday clinical workflows. The aim was to equip healthcare professionals with the skills and knowledge needed to leverage this platform effectively. Through interactive sessions, clinicians explored the various features of DIALOG+ and learned how it could streamline communication, enhance collaboration, and ultimately improve patient care. By streamlining communication processes and reducing administrative burdens, clinicians will devote more time to patient care, enhancing patient and provider satisfaction.
As we continue scaling up DIALOG+, our commitment remains unwavering: to empower healthcare professionals with the tools they need to deliver quality mental healthcare. Through ongoing training and support, we are not just transforming workflows; we are revolutionizing the way healthcare is delivered, one interaction at a time.
Statistical Analysis Plan (SAP) for PIECEs
As we approach the end of this trial, the teams have worked to develop a statistical analysis plan to measure the impact of PIECEs. Read here: Statistical Analysis Plan for PIECEs
Capacity Building for Early Career Researchers: Insights from the Mixed Methods Research Training for PIECES Small Scale Research Grant Awardees
Written by: Swaleha Khowaja, Sr. Research Coordinator – Mental Health, IRD Pakistan.
From November 20-24, 2023, a cohort of dedicated researchers participated in an immersive 5-day Small Scale Research Grant (SSRG) Capacity Building Session. This blog post summarises the practical insights gained during this week-long program, with a particular focus on fortifying research capabilities for the PIECES Small Scale Research Grant awardees. The initiative is part of the larger NIHR UK-funded ‘Improving outcomes for people with psychosis in Pakistan and India – enhancing the Effectiveness of Community-based care (PIECES)’ project, spearheaded by the Queen Mary University of London and implemented by Interactive Research and Development, Pakistan (IRD) and Schizophrenia Research Foundation, Chennai, India. (SCARF) along with a host of local and international partners. The SSRG initiative aimed to enhance local endeavours in mental health, arts, community engagement, and mental health evaluation, and build the research capacity of early career researchers, students, clinicians, and academics in the public health field. The selection process for five finalists involved evaluating project proposals based on innovation, feasibility, and potential impact in the specified areas.
The sessions were facilitated by a range of experts including Junaid Siddiqui (Research and evaluation Consultant), Onaiza Qureshi (Senior Program Manager, IRD Pakistan), Aneeta Pasha (Country Director, IRD Pakistan), Maria Baig (Clinical Psychologist) and Dr. Kausar S. Khan (Senior Consultant, Community Engagement), Attendees included clinicians from PIECEs’ implementation partners Karwan-e-Hayat (KeH) and Jinnah Postgraduate Medical Center (JPMC), early career researchers from IRD and the selected SSRG project representatives.
Day 1: Laying Foundations and Unveiling Project Stories
The journey commenced with introductions facilitated by Dr. Kausar S. Khan, and the PIECES team. Brief yet impactful poster presentations from five SSRG projects provided a glimpse into diverse research endeavours on the progress updates and next steps for their research projects. The day unfolded with discussions on ethical considerations and the fundamental types and designs of research.
Day 2: Navigating Contexts and Demystifying Psychometrics
Day two immersed participants in understanding the contexts of their studies through research frameworks and the intricacies of psychometric analysis.
Day 3: Immersing in Qualitative Research Realities
The third day was a hands-on exploration of qualitative research—coding assignments, thematic development, and synthesising findings. Facilitators held engaging sessions, allowing participants to connect with the human side of data analysis.
Day 4: Crafting Research Narratives and Seeking Support for Grants
On day 4, the group dove headfirst into practical insights into grant writing and donor mapping, offering tangible tips for securing support. The afternoon delved into manuscript writing and a hands-on proposal development session using the PRECEDE-PROCEDE framework.
Day 5: Wrapping Up and Project Presentations
The final day started with a recap and lively Q&A session, followed by hands-on training on Zotero (reference management), project presentations from each SSRG project based on a culmination of the week’s lessons on strengthening methodology and proposal development, along with a closing note, distribution of certificates, and a group picture, marked the successful conclusion of this impactful capacity building session.
The SSRG Capacity Building Session, tailored for the PIECES Small Scale Research Grant awardees, was essential in exploring research components to strengthen research being undertaken by the SSRG grantees. This initiative, integral to the PIECES program, signifies a commitment to enhancing research capacity in Early Career Researchers from LMICs for better outcomes in psychosis care. As participants move forward, the focus will be on applying these insights to their work, contributing meaningfully to the broader objectives of the PIECES program.
Looking Forward to the Future
We are thrilled to announce that the PIECEs project will be entering its final year, marking a significant chapter in our journey towards enhancing mental healthcare for people with psychosis in India and Pakistan.
As we approach the final year, let’s delve into the exciting developments that lie ahead:
RCT Activities: Valuable Insights and Outcomes
Our dedicated teams are diligently working on completing participants’ sixth and twelfth-month follow-up assessments. Through in-depth interviews, we aim to understand the unique experiences of individuals who have received the intervention. We will also be finalizing our economic evaluation which will provide valuable insights to decision-makers in India and Pakistan. By highlighting the incremental cost and associated health outcomes of implementing DIALOG+ in routine psychosis management, it will offer a comprehensive perspective from the healthcare system’s point.
Implementation and Scaling up DIALOG+: Transformative Workshops on the Horizon
Anticipation fills the air as our teams gear up to conduct quality improvement and Support, appreciate, listen team approach (SALT) workshops in the coming year. These workshops represent a pivotal aspect of our scale-up activities, initiating the training of clinicians on DIALOG+. By integrating quality improvement methodologies and SALT principles, we aim to ensure a seamless and effective implementation of this innovative intervention.
Small-Scale Research Grants: Nurturing Early Career Researchers
Our team of early career researchers from India and Pakistan is set to complete their projects in the upcoming year. We eagerly look forward to their showcase presentations, where the fruits of a year-long capacity-building journey will be on display. These early career researchers have been pivotal in advancing our understanding of mental health, and their contributions promise to make a lasting impact.
Community Engagement Initiatives: Amplifying Impact through Arts-Based Methodologies
Teams in India and Pakistan continue to foster community engagement through theatre-of-the-art performances. In an exciting development, they are actively crafting an evaluation framework to assess the impact of community-based initiatives. Simultaneously, efforts are underway to develop a comprehensive community engagement toolkit, setting the stage for a more profound and sustainable impact on mental health at the grassroots level.
Dissemination: Sharing Insights and Shaping Futures
Our journey wouldn’t be complete without sharing our learnings and experiences. To facilitate this, we plan to host dissemination and knowledge exchange events, bringing together a diverse array of stakeholders. Academics, clinicians, policy-makers, service managers, patients, carers, and the local community will converge to engage in a dialogue that transcends boundaries. As our team diligently works on crafting a three-year project report, we aim to highlight our journey – from setting up the trial and initiating community engagement initiatives to fostering the growth of early career researchers.
Join us in marking the meaningful conclusion of the PIECEs project in the next year!