Adapting Friendship Bench, a lay-delivered, problem-solving mental health intervention, for women who use methamphetamine in Vietnam - Mental illness is common among women who use methamphetamine (WWUM). We propose to evaluate the potential of Friendship Bench, a lay-delivered mental health intervention based on problem-solving therapy – an intervention approach that trains participants in a set of skills to manage their stressors – for WWUM in Vietnam. Specific aims: (1) assess the mental health needs of WWUM in Haiphong, (2) adapt Friendship Bench to the specific needs of Vietnamese WWUM and (3) assess the feasibility, fidelity, and acceptability of the adapted Friendship Bench among WWUM and preliminary indicators of its impact in improving their mental health and methamphetamine use in a randomized trial versus usual psychiatric care. The foreign component is essential: Vietnam provides a unique and policy-relevant context to study WWUM, a population that remains highly stigmatized and difficult to engage in care—challenges that are also increasingly observed in the U.S. The rising prevalence of methamphetamine use among women in the U.S., particularly in rural and other low-resourced communities, is accompanied by similar patterns of comorbid mental health conditions, limited access to behavioral health services, and barriers related to stigma and system fragmentation. Findings from this research will generate critical insights into (1) culturally responsive adaptation of task-shifting interventions, (2) strategies to engage marginalized WWUM, and (3) implementation approaches that can be translated to resource-limited or rural settings in the U.S. The research will support the candidate, Dr. Nguyen Thu Trang (Hanoi Medical University), to achieve her career goal to ensure more humane and effective treatment of drug-related issues in Vietnam and globally. She will work under the mentorship of Drs. Bradley N. Gaynes (Psychiatry/Epidemiology, University of North Carolina, Chapel Hill), Le Minh Giang (Epidemiology, HMU), Vivian Go (Health Behavior, UNC) and William C. Miller (Epidemiology, UNC), towards four training objectives: (1) acquire necessary knowledge in mental health interventions and research, including the identification and management of common mental disorders and the applicability of the Friendship Bench model; (2) develop key skills in conducting research with people who use drugs including theoretically driven, evidence-based systematic recruitment approaches to hidden populations, community engagement, and the associated concerns related to research in vulnerable populations; (3) acquire the skills needed to design and implement randomized controlled trials for both effectiveness and implementation science research and (4) develop key skills needed for a successful research career.
