# Integration of a collaborative care model for mental health services into HIV care for pregnant and postpartum women in Kenya (the Tunawiri Study)

> **NIH NIH R01** · UNIVERSITY OF COLORADO DENVER · 2024 · $532,540

## Abstract

Common mental disorders (CMD) of depression and anxiety are prevalent and largely untreated among Kenyan
pregnant and postpartum women living with HIV (PPWH). CMD lead to poor maternal and child health outcomes
and contribute to lack of HIV care engagement and virologic failure in PPWH. While efficacious treatments for
CMD exist, scaling treatment within routine health care in low- and middle-income (LMIC) settings will require
stakeholder engagement and both effectiveness and implementation data to inform scale up and sustainability.
Our team has integrated other efficacious interventions into antenatal (ANC) and HIV care in Kenya. We now
propose to integrate proven mental health services using a collaborative care model, combined with a low
intensity evidence-based intervention (problem solving therapy), while targeting known social determinants of
HIV-related health for PPWH (stigma and IPV). Building on the current multidisciplinary approach for HIV care
in Kenya, our proposed Collaborative Care Model (CCM) will utilize existing peer mentor mothers, non-specialist
behavioral care managers, and psychiatric nurses; and will incorporate a consultant psychiatrist into the
ANC/HIV care team. Guided by the EPIS (Exploration-Preparation-Implementation-Sustainment) framework, the
overall study goal is to integrate collaborative care for perinatal CMD within routine ANC/HIV services in
Kenya, assess the costs and cost-effectiveness of this approach, and work with policy and decision makers to
determine key considerations for scale-up. Specifically, in Aim 1, we will identify contextual barriers and
facilitators to refine an optimal integration model for delivering collaborative care model using multi-
method data collection (focus groups with providers, in-depth interviews with key informants, and a clinic
readiness checklist). A workshop with our Advisory Board comprising both county and national level stakeholders,
will allow us to translate findings into a locally relevant CCM. In Aim 2 we will test CCM
PPWH
health
during
depression
retention Aim 3, we will
refine CCM implementation strategies through cost-effectiveness and dissemination research. We will
carry out costing and cost-effectiveness analysis and invite policy and decision-makers to participate in a nominal
group technique process to elucidate factors for further scale up and sustainment of the CCM approach. Findings
from this study will developing a scalable model adaptable to other LMIC settings, contributing to global HIV and
maternal health goals while and addressing the burden of untreated CMD.
in antenatal care for
in a hybrid type 2 implementation-effectiveness trial using a stepped wedge design at 15 primary
 care facilities in southwestern Kenya . We will i ntroduce CCM care for PPWH diagnosed with CMD
 antenatal care. The co-primary health outcomes at 12 months postpartum will be (1) recovery from
or anxiety symptoms in PPWH, and (2) proportion PPWH with sustained viral suppre...

## Key facts

- **NIH application ID:** 10895530
- **Project number:** 5R01MH133260-02
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Lisa Lynn Abuogi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $532,540
- **Award type:** 5
- **Project period:** 2023-08-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10895530

## Citation

> US National Institutes of Health, RePORTER application 10895530, Integration of a collaborative care model for mental health services into HIV care for pregnant and postpartum women in Kenya (the Tunawiri Study) (5R01MH133260-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10895530. Licensed CC0.

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