# Prism Scale Up Study

> **NIH NIH U19** · BRIGHAM AND WOMEN'S HOSPITAL · 2021 · $456,663

## Abstract

Abstract: The Scale-Up Component of the Partnership in Implementation Science for Geriatric Mental Health
(PRISM) project proposes an evidence-based physical exercise intervention for older adults who exhibit
behavioral and psychological symptoms of dementia (BPSD). The intervention will be delivered in Thai
communities through an evidence-based implementation strategy of “task sharing” among community health
workers (CHWs), nurses, primary care physicians, and mental health specialists. In response to the common
problem of technical and cultural compatibility between evidence-based interventions and local implementation
contexts as well as the uneven local political will for implementing mental health service initiatives, we propose
to develop and test an innovative implementation support strategy (i.e., the GTO-ThAI model), based on the
evidence-based Getting-to-Outcome model, which will be adapted to Thai settings, to ensure the success of
implementation and scaling up of the mental health service for older adults in Thailand. To our knowledge, no
previous study has examined the effectiveness of a GTO-ThAI implementation support strategy for delivering
clinical interventions for older adults with BPSD in Asia.
 The proposed evaluation study will conduct a randomized controlled trial with a Hyprid Type 3 design to
compare the intervention arm that implements the culturally-adapted GTO model (GTO-ThAI) to deliver
implementation support, with a control arm, which receives usual top-down administrative instruction for
implementing a policy initiative. Our specific scale-up study aims are to: 1) tailor an evidence-based physical
exercise intervention (EBPEI) to fit with Thai local social, cultural, and policy context (Yr 1); 2) develop
culturally-informed tools to assess readiness for implementing EBPEI to improve mental health of older adults
in local provinces of Thailand (Yr 1); 3) develop the GTO-ThAI implementation support model through a pre-
implementation case study and formative evaluation (Yr 2); 4) evaluate implementation strategies and clinical
outcomes through a hybrid Type 3 randomized trial to test effectiveness of the GTO-ThAI implementation
support strategy for the delivery of EBPEI, compared with the existing standard administrative procedures for
delivering the same EBPEI (Yrs 3-4); 5) develop policy recommendations with tools and performance
indicators (Yr 5). The proposed scale-up study is expected to generate knowledge and tools essential for
further scale-up of mental health services in Thailand, and will contribute significantly to knowledge
development within other NIMH program HUBs on going to scale with mental health innovations in LMICs.

## Key facts

- **NIH application ID:** 10198666
- **Project number:** 5U19MH113201-05
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Hongtu Chen
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $456,663
- **Award type:** 5
- **Project period:** 2017-08-10 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10198666

## Citation

> US National Institutes of Health, RePORTER application 10198666, Prism Scale Up Study (5U19MH113201-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10198666. Licensed CC0.

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