Implementation of a Depression Screening Intervention at a Transgender Health Clinic in Thailand

Study Overview
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Brief Summary
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The study aims to develop and implement a depression screening intervention into routine HIV and sexual health service provision at a transgender health clinic in Thailand, and to explore the facilitators, barriers, feasibility and acceptability of the screening implementation.

Detailed Description
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The study will follow a mixed-methods approach that will incorporate quantitative and qualitative components. Aim 1 will involve the development and implementation of depression screening intervention at Tangerine Clinic. Aim 2 will involve semi-structured interviews with a purposive subset of participants who received the intervention and healthcare providers to explore the multilevel facilitators, barriers, feasibility and acceptability of the screening implementation. Aim 3 will evaluate the proportion of participants who are offered, accept, and receive the peer-led depression screening intervention, and the proportion who screen positive.

Official Title
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Implementation of a Depression Screening Intervention at a Transgender Health Clinic in Thailand

Conditions
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Depressive Symptoms

Intervention / Treatment
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* Behavioral: Depression Screening Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Thai nationality Transgender women ≥18 years Attending the Tangerine Clinic for routine care visits during the intervention period. Can be a new or returning clients. Exclusion Criteria: 1. Transgender women currently receiving care for a mental health diagnosis will be excluded from participating in this study. Inclusion Criteria for healthcare providers: Currently working at the Tangerine Clinic Can be medical doctors, nurses, peer counselors and other members of the clinic management team involved in the routine delivery of HIV and health services to Transgender women. Exclusion criteria for healthcare providers 1. Not willing to participate in this study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Depression Screening Intervention<br>All eligible participants will be screened using the Patient Health Questionnaire-2 (PHQ-2) for depression. If screened positive, participants will be further screened with Patient Health Questionnaire-9 (PHQ-9). | Behavioral: Depression Screening Intervention<br>* All participants will be screened for depression using PHQ-2 and PHQ-9. Those screened positive for PHQ-2 but decline further screening with PHQ-9 will be assisted for further assessment or care. Those with mild to severe symptoms (score of 7 or higher on PHQ-9) will be assisted for further assessment or care with a psychiatrist.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intervention Acceptability: Number of participants who accepted intervention | Acceptability will be measured by the number of clients who were offered and accepted the intervention. | Day 1 | 
| Intervention Acceptability: Participants' perspective of the intervention through in-depth interviews | Acceptability will be assessed qualitatively through post-intervention in-depth interviews. | Day 1 | 
| Intervention Acceptability: Participants' perspective of the intervention through focus group discussion | Acceptability will be assessed qualitatively through post-intervention focus group discussion. | Day 1 | 
| Intervention Feasibility: Number of intervention completed | Feasibility will be measured by number of intervention completed. Point estimates of >50% of participants completed is considered as the minimum criteria for feasibility. | Day 1 | 
| Intervention Feasibility: Participants' perspective of the intervention through in-depth interviews | Feasibility will be assessed qualitatively through post-intervention in-depth interviews. | Day 1 | 
| Intervention Feasibility: Participants' perspective of the intervention through focus group discussion. | Feasibility will be assessed qualitatively through post-intervention focus group discussion. | Day 1 | 
| Number of participants screening positive for depression | Screening positive is defined as scoring 7 or greater on PHQ-9. The total possible score for PHQ-9 is 27, with 0-6 being minimum and indicating no depressive symptoms, 7-12 mild depression, 13-18 moderate depression, and 19-27 severe depression. | Day 1 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Depression, Transgender women