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- ItemSomente MetadadadosAttitudes and knowledge about obstructive sleep apnea among Latin American primary care physicians(Elsevier B.V., 2013-10-01) Ojeda, Ivan Cherrez; Jeffe, Donna B.; Guerrero, Thomas; Mantilla, Ronnie; Santoro, Ilka Lopes [UNIFESP]; Gabino, Gustavo; Calderon, Juan C.; Caballero, Fernan; Mori, Jose; Cherrez, Annia; Kennedy Hosp; Washington Univ; Brown Univ; Capital Hlth Reg Med Ctr; Universidade Federal de São Paulo (UNIFESP); Med Ctr La Trinidad; Clin San Borja; Heidelberg UnivObjectives: We aimed to evaluate Latin American primary care physicians' knowledge and attitudes about obstructive sleep apnea (OSA) using a Spanish-language version of the OSA Knowledge and Attitudes (OSAKA) questionnaire and to evaluate its psychometric properties.Methods: We used a cross-sectional survey of general practice physicians in Ecuador, Peru, and Venezuela who completed the Spanish-language version OSAKA questionnaire.Results: of 684 primary care physicians surveyed, 367 (65%) responded (mean age, 45 years; range, 21-75 years). Mean total knowledge (proportion of 18 items correctly answered) was 60% (range, 0-100%). Less than half of physicians correctly answered the questions about the association between OSA and hypertension. We found no significant differences in overall knowledge in gender or time since graduation (<= 5 years vs >5 years). Although 73.5% of the physicians felt confident in identifying patients at risk for OSA, only 35.4% felt confident in managing those patients and 22.1% felt confident in managing patients with continuous positive airway pressure (CPAP) therapy. the Spanish-language version of the OSAKA questionnaire had comparable psychometric properties to the English-language version.Conclusions: This Spanish-language version of the OSAKA yielded considerable variance in Spanish-speaking physicians' knowledge about OSA and confidence in identifying and managing patients with OSA. Focused OSA education for Latin American general physicians is needed. (C) 2013 Elsevier B. V. All rights reserved.
- ItemAcesso aberto (Open Access)Concepção dos médicos da atenção primária de Juazeiro do Norte sobre saúde do idoso(Universidade Federal de São Paulo (UNIFESP), 2010-02-24) Marques, Jaciara Bezerra [UNIFESP]; Villela, Wilza Vieira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Old age consists of one phase of life when there are several biological changes, psychological and social. Health professionals in primary care, including doctors, must be trained in the prevention and control of health hazards for the elderly. The multidimensional assessment of the elderly, which aims to make a comprehensive review with emphasis on functionality, constitutes a valuation model to be used in healthcare for the elderly. Juazeiro do Norte, a municipality in the interior of Ceará, with a population of 242 139 inhabitants and 21 714 elderly people, until December 2009, did not have the Reference Center on Elderly Care. In the public service there was no local geriatrician. Most elderly people of this city received medical care through the Family Health Strategy (FHS). This article focuses on the design of medical ESF of Juazeiro do Norte on healthcare for the elderly, and describe its activities within its team of FHS. For this qualitative study was conducted through interviews with ten doctors in the FHT. The theoretical framework was the Theory of Social Representations. The interviews were conducted by the researcher, who used a script with guiding questions. No one interviewed knew inform the number of elderly in the area attached to its FHS. Most denied collective activities with the elderly. All confirming perform home visits to elderly people. The memory most often cited when referring to actions of the ESF were elderly with medical appointments. When questioned about the main problems of the elderly in Juazeiro do Norte, stood out the memory of chronic diseases like hypertension and diabetes. Issues related to test ordering and medication were also highlighted. All respondents had some kind of critical to the health service in question, however, none showed dissatisfaction in serving the elderly. None of the respondents uses the multidimensional assessment of the elderly. The approach of care focused on disease and outpatient - focusing on chronic diseases common in old age - the failure to participate in activities with other health professionals, non-use of an overall assessment of the elderly, the low value placed on family aging process and a negative view of old age were the main characteristics of the conceptions of the doctors in this study.
- ItemAcesso aberto (Open Access)Cuidando do cuidador: um espaço potencializador de educação permanente com equipes de estratégia de saúde da família(Universidade Federal de São Paulo, 2015-10-30) Alcântara, Débora Barbosa e [UNIFESP]; Liberman, Flávia [UNIFESP]; http://lattes.cnpq.br/8790313628912498; http://lattes.cnpq.br/8401729911075273; Universidade Federal de São Paulo (UNIFESP)With the elaboration of SUS, afther the Health Reform, new paradigms have become a part of the routine of health professionals in Brazil. the medical logic focused and the hospital-centric system, lose space out to the longitudinal follow-up, prevention and health promotion to people, regarding the health concept. The new reality makes the profile of the new working professionals adapt to new paradigms that are devoted to life production. Spaces, named by the Ministry of Health, such as Permanent Education ("Educação Permanente"), were created to facilitate this passage. The current study decided to discuss how this tool has been used, to propose a mechanism that in fact enhances the spaces of the Continuing Education in Primary Health Care ("Educação Permanente na Atenção Básica em Saúde"). It has been presented the possibility of eight meetings in the workshop format, intended to improve and facilitate the group processo of two teams of Family Health Strategy, so that they meet their potentials and difficulties regarding the learning needs, uniquely presented, and thus enabling their qualifications to act in this "new" SUS. The chosen method to experiencie this collective process and research was the mapping within the research-intervention, allowing that I could move between the intervention and the observation by lurking around. The meetings have provided delicate changes on the health work of these teams and the perceptions that these have on theis collective. To set these meetings through narratives, photograph and video records, brought an aesthetic perspective to the events, unraveling in the processes, the relevance of the reserach as being a space that has created a power to listen, recognize and investigate situations brought by workers and as an opportunity to "caring for the carers", in the daily work.
- ItemSomente MetadadadosGeoreferenced and secure mobile health system for large scale data collection in primary care(Elsevier Ireland Ltd, 2016) Sa, Joao Henrique Goncalves de [UNIFESP]; Rebelo, Marina S.; Brentani, Alexandra; Grisi, Sandra J. F. E.; Iwaya, Leonardo H.; Simplicio, Marcos A., Jr.; Carvalho, Tereza C. M. B.; Gutierrez, Marco Antonio [UNIFESP]Introduction: Mobile health consists in applying mobile devices and communication capabilities for expanding the coverage and improving the effectiveness of health care programs. The technology is particularly promising for developing countries, in which health authorities can take advantage of the flourishing mobile market to provide adequate health care to underprivileged communities, especially primary care. In Brazil, the Primary Care Information System (SIAB) receives primary health care data from all regions of the country, creating a rich database for health-related action planning. Family Health Teams (FHTs) collect this data in periodic visits to families enrolled in governmental programs, following an acquisition procedure that involves filling in paper forms. This procedure compromises the quality of the data provided to health care authorities and slows down the decision-making process. Objectives: To develop a mobile system (GeoHealth) that should address and overcome the aforementioned problems and deploy the proposed solution in a wide underprivileged metropolitan area of a major city in Brazil. Methods: The proposed solution comprises three main components: (a) an Application Server, with a database containing family health conditions
- ItemAcesso aberto (Open Access)Gestão da atenção básica por organizações de saúde no município de São Paulo : uma análise micropolítica(Universidade Federal de São Paulo (UNIFESP), 2017-06-26) Bragagnolo, Larissa Maria [UNIFESP]; Andreazza, Rosemarie [UNIFESP]; Reis, Ademar Arthur Chioro dos [UNIFESP]; http://lattes.cnpq.br/0107536337908259; http://lattes.cnpq.br/1447772258702244; http://lattes.cnpq.br/0600138582199721; Universidade Federal de São Paulo (UNIFESP)Introduction: This research focuses the work management in primary care in two basic healthcare units (UBS) done by two different Social Health Organizations (OSS). Objective: analyze the management of two UBS in the municipality of São Paulo managed by OSS. Method: qualitative research, multiple case study type, of a cartographic nature made through participant observation in two UBS in the municipality of São Paulo that resulted in a field journal composed by registers of scenes observed in everyday work. Two shared seminaries held with the subjects of the UBS that are the study object were also adopted. For the material analysis, it was used the “visibility plans” concept, which is something that becomes more prominent or visible/sayable from the scene connections of similar “nature” registered in the journals. The researchers’ estrangement from the team was used as an analyzer of team relations with OSS. Results: the professionals show a well-established relationship with OSS which starts from a big disturbance related the field researchers, and constantly worry about the possibility of the researchers to take part of a control and evaluation strategy. Those professionals are ignorant of the management strategies adopted by OSS, and managerialism is evident. An institutional malaise is exposed, even so professionals support this management model that is why are placed between fear and trust in the relationship with the company. Those professionals also point out that a pronounced rationalization of the practices places care as well as numbers and goals accomplishments in antagonistic positions. However, the professionals estimate the managerialism tools with the illusion they will get past structural issues of health work. This situation constantly places those professionals in a paradox between autonomy and goals. It was also possible to observe managers, the OSS’s spokespeople, having a discourse of valuing numbers and managing UBS based on productivity goals imposed by management instruments of the relationship between OSS and city council. Due to intense adoption of managerialism tools, work is like business logic so the spokespeople support a discourse which does not go beyond common sense about Sistema Único de Saúde (SUS) as well as certain externality. In addition to an identification and greater belonging with public entity they take a position and dispute the OSS management model. It was also possible to identify singularities and regularities among OSS because they are similar when it comes to managerial management and deepening of the entrepreneurship, however they differ in what they represent for their workers. Questionings about the legitimacy of that SUS produced in UBS managed by OSS and possible iniquities related to health from very complex organizational structures are now open.
- ItemAcesso aberto (Open Access)Gravidez na adolescência: desafio da saúde pública em Cruzeiro do Sul-Acre(Universidade Federal de São Paulo (UNIFESP), 2014-12-17) Silva, Maria Susana Barboza da [UNIFESP]; Figueiredo, Elisabeth Niglio de [UNIFESP]; http://lattes.cnpq.br/5873289377529519; lattes.cnpq.br/5300242017136620; Universidade Federal de São Paulo (UNIFESP)Introdução: A gravidez na adolescência é considerada uma importante temática em saúde pública devido a sua alta prevalência e às inúmeras implicações materno fetais. Objetivo: Analisar os fatores associados à gestação na adolescência no Município de Cruzeiro do Sul, Acre. Método: Estudo analítico de corte transversal realizado com 58 gestantes primigestas: 29 adolescentes (10 a 19 anos) e 29 adultas (20 a 35 anos), que realizaram atendimento pré-natal nas Unidades de Saúde da Família (USF) em Cruzeiro do Sul-Acre. A coleta de dados foi realizada mediante aplicação de questionário, no período de agosto a dezembro de 2013. Os dados foram processados e analisados pelo software SPSS 16.0. Ao comparar as variáveis de acordo com grupo de gestante (adolescente ou adulta), aplicou-se o teste QuiQuadrado de Pearson ou teste exato de Fisher para associação entre variáveis qualitativas e o teste de Mann Whitney para as variáveis quantitativas. Utilizou-se um modelo de regressão logística para identificação dos fatores associados com o grupo. Resultados: A análise descritiva das adolescentes mostrou que a idade média foi de 17,2 anos, a maioria residia na área urbana de Cruzeiro do Sul, referiu ser de cor parda, ter religião, morar com o companheiro, não frequentar a escola, não ter atividade remunerada, com renda familiar menor que um salário mínimo. O uso de cigarro e bebida alcoólica pela família foi predominante nessa população. As mães das adolescentes não tinham completado o ensino fundamental e mais da metade delas engravidaram na adolescência. A média da idade na menarca foi de 13 anos, o primeiro namoro aos 15 anos e a primeira relação sexual aos 16 anos. A maioria referiu conhecimento sobre métodos contraceptivos, no entanto, somente (38%) fazia uso quando engravidou. A maioria teve acesso aos meios de prevenção e a escola foi a principal fonte de informação sobre relação sexual, gravidez e métodos contraceptivos. O não desejo de engravidar prevaleceu entre as adolescentes. Quanto à realização de consulta ginecológica antes da gravidez houve uma baixa procura (15,2%) pelo atendimento. História de aborto anterior foi referida por (7,6%) das adolescentes. O atendimento pré-natal foi considerado não adequado, uma vez que o número de consultas foi inferior ao recomendado pelo Ministério da Saúde. Verificou-se associação da gestação na adolescência com as seguintes variáveis: idade na 1ª relação sexual igual ou menor que 16 anos, não acesso aos métodos contraceptivos e não desejo de engravidar. Conclusão: A gravidez na adolescência tende a surgir na presença de vários fatores que expressam a vulnerabilidade do adolescente no contexto em que está inserido. Essas informações podem ser úteis para intervenções dirigidas a essa população com a perspectiva de reduzir a ocorrência de situações indesejáveis como a gravidez precoce, além de melhorar a qualidade no atendimento destas jovens.
- ItemAcesso aberto (Open Access)Impacto do estigma no manejo clinico dos transtornos mentais na atenção primária(Universidade Federal de São Paulo (UNIFESP), 2018-02-08) Rojas Vistorte, Angel Olider [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; http://lattes.cnpq.br/5783141369706484; http://lattes.cnpq.br/0507476619809231; Universidade Federal de São Paulo (UNIFESP)Introdução: O tratamento de transtornos mentais comuns em unidades da atenção primária tem sido sugerido como estratégia prioritária para garantir que todos os portadores de transtornos mentais tenham acesso à abordagem terapêutica que necessitam. Porém, médicos da atenção primária enfrentam importantes obstáculos para o diagnóstico e tratamento de transtornos mentais, por não estarem capacitados para fazê-lo, ou por apresentarem atitudes estigmatizantes em relação a eles. Objetivo: Avaliar como o estigma relacionado aos transtornos mentais pode afetar os cuidados oferecidos aos pacientes com transtornos mentais comuns na atenção primária. Método: No primeiro artigo foi realizada uma revisão sistemática da literatura das atitudes estigmatizantes que apresentam os médicos da atenção primária com respeito às pessoas com transtornos mentais. No segundo artigo foi realizado o processo de tradução, adaptação e validação de um instrumento que avalia os níveis do estigma nos médicos da atenção primária. E no terceiro artigo foi realizado análises da associação entre as condutas clínicas e os níveis de estigma, assim como a identificação de potenciais fatores associados às atitudes estigmatizantes. Os artigos 2 e 3 foram baseados em uma amostra de médicos que trabalham em unidades de atenção primária no Brasil, Bolívia, Chile. Participaram 550 profissionais dos quatro países. As condutas clínicas dos médicos em relação aos transtornos mentais comuns foram investigadas por meio de vinhetas clínicas. As atitudes estigmatizantes foram avaliadas por meio do questionário Mental Illenss: Clinicians’ Attitudes Scale (MICA v4). Resultados: Após aplicar critérios de elegibilidade, onze artigos foram incluídos na revisão. Os médicos de atenção primária apresentaram atitudes estigmatizantes com respeito às pessoas com transtornos mentais, e mostraram atitudes mais negativas em relação aos pacientes com esquizofrenia do que com pessoas com depressão. Os dois modelos na validação do MICA v4 demonstraram uma boa confiabilidade e ajuste para as amostras em Espanhol e Português (Português: CFI=0.927; TLI=0.913; RMSEA= 0.066; Spanish: CFI=0.945; TLI=0.935; RMSEA= 0.068). 70% dos médicos que atuam na atenção primária reconhecem a presença de um transtorno mental nas vinhetas apresentadas, e 80.9% se sentem capacitados para diagnosticar e tratar pessoas com transtornos mentais comuns. Mais de 90% dos médicos da Bolívia, Cuba e Chile concordaram em tratar os pacientes apresentados nas três vinhetas. Não encontramos diferenças significativas entre os quatro países nas pontuações dos níveis de estigma no MICA v4 (M=36.1, SD=8.3). O gênero (p = .672), a idade (p = .171), os anos de experiência (p = 0,28) e treinamento (p = .673) não estão relacionados ao estigma. Aqueles médicos que não se sentem preparados para o diagnóstico e tratamento de transtornos mentais apresentam maiores níveis do estigma (t(385)=2.5, p<0.01). Médicos com níveis mais baixos de estigma apresentaram maior probabilidade de não encaminhar para um psiquiatra os pacientes com sintomas de depressão e somatoformes. Conclusões: As versões do MICA v4 em espanhol e português possuem boas propriedades psicométricas, boa consistência interna e são aplicáveis e aceitáveis para o contexto latino-americano. Há uma correlação entre níveis de estigma e habilidade do médico para cuidar adequadamente dos transtornos mentais na atenção primária. Atitudes estigmatizantes podem atuar como uma barreira importante para que os pacientes recebam o tratamento que eles precisam.
- ItemAcesso aberto (Open Access)Matriciamento na atenção básica: estudo de equipes ESF e NASF atuando na região da Capela do Socorro-SP(Universidade Federal de São Paulo (UNIFESP), 2015-11-30) Santos, Rosimeire Aparecida Bezerra de Gois dos [UNIFESP]; Lima, Laura Camara [UNIFESP]; Uchôa-Figueiredo, Lúcia da Rocha [UNIFESP]; http://lattes.cnpq.br/3179063226554474; http://lattes.cnpq.br/6277780648747957; http://lattes.cnpq.br/1414454195907488; Universidade Federal de São Paulo (UNIFESP)In early 1970, the Brazilian Government reformed the basic attention to health (ABS). The outpatient model, centered in the medical professional, it moved to a strategy or the family health program (PSF), with new principles as: health promotion, health responsibility for a territory. In January 2008, the core of support for family health (NASF) was created for the expansion, increased resolution and completeness in health care. The NASF was thought of as a specialized rear toward the clinical and educational action in support of teams, using technologies such as: Matrix Support, Expanded Clinic, Unique Therapeutic Project (PTS), Health project in the territory (PST) and continuing education (EP). The research presented here aims to investigate the General theoretical knowledge and practices that the ESF professionals and the NASF associated with the Matrix-based. The specific objectives are: to investigate how the Matrix-based into the daily routine of the professionals and shared construction; besides enabling scientific return for public authorities and contribute to effective public policy. It is descriptive and exploratory study, quantitative approach, with qualitative refinement. Were invited to join the PSF doctors and nurses and all the professionals of the NASF linked the five basic health units (UBS) of the region of Capela do Socorro of Sao Paulo. Data collection took place by questionnaire; It took five dates of 30 minutes each, in five UBS, to perform it. 78:44 professionals participated in the PSF and 34 of the NASF. Descriptive statistics and inferenciais were carried out. The results reveal that 80 of surveyed have graduate degrees, but only 35 are post-graduates in family health, indicating lack of theoretical training. The answers regarding the everyday actions of Matrix-based, indicate the existence of differences between PSF teams and NASF, in particular three concepts: intersectoral approach (32.6 of the PSF against 76.5 of the NASF), Permanent Education (51 of the PSF against 85 of the NASF) and Expanded Clinic (48.8 of the PSF and 79 of the NASF). The differences are smaller with regard to the practice of PTS and discussion of Case, respectively: 76.7 of the PSF and 100 of NASF and 85 of the PSF and 100 of the NASF. There is more consensus when it comes to work. The analysis of qualitative issues have enabled a refinement, giving access to freely meanings assigned to the Matrix-based by groups of subjects and the set of parsed data indicates that the PSF teams tend to organize from a model of ambulatory assistance doctor-centric, while the teams of the NASF are more open to other sectors, knowledge and trading spaces. It was noticed that the Matrix-based can be a good strategy, but still need to make adjustments to make it more compatible with the work of the two teams, for example making the ESF professional agendas, as well as raise the awareness of managers and trainers of universities of the need to expand the vision that they have of the possibilities of sharing knowledge and experiences.
- ItemSomente MetadadadosQualidade de vida em pacientes da atenção primária do Rio de Janeiro e São Paulo, Brasil: associações com eventos de vida produtores de estresse e saúde mental(Abrasco, 2016) Portugal, Flavia Batista; Campos, Monica Rodrigues; Goncalves, Daniel Almeida [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; Fortes, Sandra Lucia Correia LimaQuality of life (QoL) is a subjective construct, which can be negatively associated with factors such as mental disorders and stressful life events (SLEs). This article seeks to identify the association between socioeconomic and demographic variables, common mental disorders, symptoms suggestive of depression and anxiety, SLEs with QoL in patients attended in Primary Care (PC). It is a transversal study, conducted with 1,466 patients attended in PC centers in the cities of Sao Paulo and Rio de Janeiro in 2009 and 2010. Bivariate analysis was performed using the T-test and four multiple linear regressions for each QoL domain. The scores for the physical, psychological, social relations and environment domains were, respectively, 64.7; 64.2; 68.5 and 49.1. By means of multivariate analysis, associations of the physical domain were found with health problems and discrimination; of the psychological domain with discrimination; of social relations with financial/structural problems; of external causes and health problems; and of the environment with financial/structural problems, external causes and discrimination. Mental health variables, health problems and financial/structural problems were the factors negatively associated with QoL.
- ItemAcesso aberto (Open Access)Qualidade de vida em pacientes da atenção primária do Rio de Janeiro e São Paulo, Brasil: associações com eventos de vida produtores de estresse e saúde mental(Abrasco, 2016) Portugal, Flavia Batista; Campos, Monica Rodrigues; Goncalves, Daniel Almeida [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; Fortes, Sandra Lucia Correia LimaQuality of life (QoL) is a subjective construct, which can be negatively associated with factors such as mental disorders and stressful life events (SLEs). This article seeks to identify the association between socioeconomic and demographic variables, common mental disorders, symptoms suggestive of depression and anxiety, SLEs with QoL in patients attended in Primary Care (PC). It is a transversal study, conducted with 1,466 patients attended in PC centers in the cities of Sao Paulo and Rio de Janeiro in 2009 and 2010. Bivariate analysis was performed using the T-test and four multiple linear regressions for each QoL domain. The scores for the physical, psychological, social relations and environment domains were, respectively, 64.7; 64.2; 68.5 and 49.1. By means of multivariate analysis, associations of the physical domain were found with health problems and discrimination; of the psychological domain with discrimination; of social relations with financial/structural problems; of external causes and health problems; and of the environment with financial/structural problems, external causes and discrimination. Mental health variables, health problems and financial/structural problems were the factors negatively associated with QoL.
- ItemAcesso aberto (Open Access)Sistema para coleta, registro e análise de dados georreferenciados na atenção primária baseado em dispositivos móveis(Universidade Federal de São Paulo (UNIFESP), 2016-11-30) Sá, João Henrique Gonçalves de [UNIFESP]; Gutierrez, Marco Antonio [UNIFESP]; http://lattes.cnpq.br/4428534123137232; http://lattes.cnpq.br/1897087795965443; Universidade Federal de São Paulo (UNIFESP)Objective: To develop a system to collect, register and analysis geo-referenced data in primary care based on mobile device, which should be capable to export data to SIAB, to retrieve data from SIGA Saúde, and make a web interface available to territory epidemiologic follow up. Methods: There are 2 components, GeoHealth-Mobile and GeoHealth-Web. 1) GeoHealth-Mobile is used by health community worker HCW to data gathering of families during their home visits. 2) GeoHealth-Web is used by nurses, physicians and health providers to monitor the community data via web, extracting analytic, synthetic and cartographic reports. The software has been developed in 2 phases, designed in Java 1.7, Android 4, Tomcat 7.0, MySQL 5.5 and the security framework, SecourHealth. At last, a survey to measure the user satisfaction has been sent to 39(19%) HCWs. The survey instrument has 20 questions / 11 categories. Results and Conclusion: The modules GeoHealth-Mobile and GeoHealth-Web has been developed, the first one being able to capture the GPS coordinates to geo-reference the data. The HCW can query in SIGA Saúde system the number of CNS (Health National Card). Security features have been developed: User authentication: User authentication, Data Confidentiality, Data Authentication, Privacy-preserving device sharing and communication safety. Due to the success of the two first phases, the system was deployed in production environment, currently, there are 94.5 thousand inhabitants / 35.8 thousand families in database and all data can be export to SIAB periodically. The survey results show that 77% of users prefer the system over the paper, and 90% of HCWs think the system is easier to plan activities when compared to the older system
- ItemAcesso aberto (Open Access)Task shifting interpersonal counseling for depression: a pragmatic randomized controlled trial in primary care(Biomed Central Ltd, 2017) Matsuzaka, Camila T. [UNIFESP]; Wainberg, Milton; Pala, Andrea Norcini; Hoffmann, Elis V. [UNIFESP]; Coimbra, Bruno M. [UNIFESP]; Braga, Rosaly F. [UNIFESP]; Sweetland, Annika C.; Mello, Marcelo F. [UNIFESP]Background: Task shifting approaches (rational redistribution of tasks among health workforce teams) to train lay professionals to assist with integrating mental health treatment in primary care has been recommended to close the mental health treatment gap for depression in low-and middle-income countries. This study aims to examine the a new model for depression care in a low-resource environment compared to enhanced treatment at usual (E-TAU). Methods: We trained non-specialist community health workers (local lay employees of the public health system) to provide Interpersonal Counseling (IPC) to treat depressive symptoms in the Brazilian, Sao Paulo city, family health strategy (FHS). We conducted a randomized controlled trial involving 86 patients with a current major depressive disorder or dysthymia (based on DSM-IV) recruited from an FHS clinic. Participants were randomized to IPC intervention (n = 43) or E-TAU (n = 43). Participants allocated to IPC received 3-4 sessions provided by community health workers