Research
Implementation Science

A research hub dedicated to bridging scientific evidence with real-world healthcare, education, and public policy settings, transforming evidence-based interventions into practical, sustainable, and potentially scalable strategies for implementation within Sistema Único de Saúde (SUS) and other community-based settings.

Primeiros Laços

The Primeiros Laços project evaluates the effects of a nurse-led home-visiting program for adolescent mothers living in socially and economically vulnerable circumstances. The program aims to strengthen the mother–child bond, promote healthy child development, improve maternal health, and foster a supportive family environment.

The intervention is organized around five core domains:

• Health and Social Care – providing psychoeducation on maternal and child health;
• Environmental Health – helping participants identify resources that support safe and healthy living conditions;
• Life Course Development – supporting participants in setting and achieving goals related to education, employment, and family planning;
• Parenting Skills – offering psychoeducation on positive parenting practices and age-appropriate child development;
• Family and Social Support Networks – encouraging pregnant women and adolescent mothers to recognize and access family and community resources that support their children’s development.

The study is pioneering in combining an experimental design with longitudinal assessments spanning cognitive, emotional, and neurophysiological domains. Previous findings demonstrated significant positive effects on key aspects of child development, including expressive language and gross motor skills. These outcomes are further supported by neurobiological evidence, suggesting that the program can positively influence children’s developmental trajectories.

CONEMO

The CONEMO – CONtrole EMOcional project aims to implement a behavioral activation–based mobile application for people experiencing symptoms of depression and anxiety in primary healthcare units. The project seeks to improve access to mental health treatment while reducing the burden on primary healthcare services.

Symptoms of depression and anxiety are highly prevalent in Brazil and worldwide. In low- and middle-income countries, in particular, the shortage of specialized mental health professionals remains a major challenge. In this context, digital interventions have emerged as a promising solution, and the CONEMO app offers a scalable and accessible approach to expanding mental healthcare.

The project uses the implementation science model to evaluate the effectiveness of the intervention, with a primary focus on reducing symptoms of depression and anxiety, and to access the barriers and opportunities for implementation. Qualitative data are collected through interviews to identify barriers to and facilitators of implementation and improve the intervention according to local demands. The research team has extensive experience conducting similar implementation and digital mental health studies.

SAVE Study

The SAVE Study aims to evaluate the effectiveness of different approaches for preventing suicidal thoughts and behaviors among high-risk patients treated in emergency departments in the municipality of Indaiatuba, São Paulo, Brazil.

The research team will conduct a Phase IV randomized controlled clinical trial to compare the outcomes of three different interventions. One intervention involves the use of esketamine plus enhanced usual care, an anesthetic that has demonstrated rapid effects in reducing suicidal ideation, providing immediate relief for patients experiencing an acute suicidal crisis. A second intervention focuses on the Crisis Response Plan (CRP), an evidence-based, non-pharmacological safety intervention. The CRP, delivered alongside enhanced usual care, helps participants recognize warning signs, use internal and external coping strategies, and access professional support, thereby reducing the risk of suicide attempts.

The third study arm will receive enhanced usual care alone. The primary objective is to compare the effectiveness of esketamine and the CRP in reducing suicidal behaviors among high-risk patients. The findings are expected to provide evidence for accessible, cost-effective interventions that can be implemented within public healthcare systems to improve care and reduce the suffering of individuals at risk of suicide.

Intervenção Educativa em Saúde Mental

The Intervenção Educativa em Saúde Mental project was developed in response to a need identified by the Mental Health Coordination Office of the municipality of Jaguariúna, São Paulo, Brazil. Local health managers observed that Primary Health Care (PHC) services had limited capacity to manage common mental health conditions, resulting in a high number of referrals to specialized care.

A pilot implementation study was conducted to train PHC professionals in Jaguariúna. The intervention consisted of an online course comprising modules designed for healthcare professionals and managers. Delivered via Google Meet, the sessions lasted approximately 30 to 60 minutes and combined theoretical instruction, case discussions, and interactive exchanges between instructors and participants. As an outcome of the project, the team published the “Quick Guide to Assessing, Managing, and Referring 15 Mental Health Conditions in Primary Health Care.”

The intervention served as a practical example of co-creation between academia and public health management. By integrating a local needs assessment, workforce training, the development of technical resources, and implementation evaluation, the initiative strengthened the capacity of PHC services to address common mental health conditions while generating valuable insights for future workforce training and health system improvement initiatives.

Saúde Mental nas Escolas

The Saúde Mental nas Escolas project was designed to promote mental health literacy among teachers through distance-learning strategies. Developed in partnership with the Ame Sua Mente Institute, the initiative aimed to prevent and mitigate the impact of mental health disorders among students, promote mental well-being, and improve the early identification and referral of students experiencing mental health difficulties.

The training program also sought to reduce the stigma surrounding mental health and equip teachers with practical strategies for managing mental health issues in the classroom. With strong engagement from the local community, the project also evaluated the implementation of a comprehensive ecosystem of interventions. In addition to teacher training, this ecosystem included Bússola, a WhatsApp-based chatbot designed to support issues related to self-harm and suicide risk; a referral tool to facilitate connections between students and healthcare services; lesson plans; educational games; and a variety of digital resources to help educators address mental health topics in the classroom.

Throughout its implementation, the project achieved substantial scale in the municipalities of Indaiatuba and Jaguariúna, in the state of São Paulo, Brazil. It engaged school administrators and teachers across the municipal education systems, reaching 31 schools, covering approximately 64.5% of all elementary schools in the two municipalities, and awarding 421 certificates to participating educators. The project is still underway with the Ame Sua Mente Institute. Learn more.

e-Saúde Mental no SUS

The e-Saúde Mental no SUS project is a digital platform that leverages technology to strengthen mental healthcare through three integrated pillars:

• Users – supporting individuals in managing and monitoring their mental health;
• Primary Health Care – assisting healthcare professionals with assessment, diagnosis, and treatment;
• Health Managers – providing data and insights to support mental health planning and public policy decision-making.

The platform is grounded in scientific evidence and incorporates validated assessment tools to help healthcare professionals make faster and more accurate clinical decisions. It is designed to support the identification of the most appropriate interventions, ranging from psychological techniques to referrals for specialized mental health services.

The project aims to strengthen the Sistema Único de Saúde (SUS) by enabling the platform to be adopted as a public digital health service, expanding access to mental healthcare and improving case resolution. Designed to be simple, scalable, and universally accessible, the technology has the potential to reach underserved regions, benefit vulnerable populations, and reduce regional inequalities in access to mental health services.

The platform is the result of a collaborative effort involving universities, leading mental health researchers, SUS health managers, and a multidisciplinary team of psychiatrists, psychologists, and other healthcare professionals. The project has been approved and is currently awaiting funding for implementation.

Suicide Risk Assessment Protocol (S-RAP)

Suicide constitutes a serious global public health problem. Despite advances in evidence-based preventive strategies, many countries continue to show rising suicide rates, reinforcing the need for effective instruments capable of identifying risk factors such as suicidal ideation, planning, access to lethal means, and a history of self-harm.

In this context, the present study aims to implement and evaluate, within Primary Health Care, a digital tool called the Suicide Risk Assessment Protocol (S-RAP). This is a methodological study focused on investigating the processes of data collection, organization, and analysis, while also seeking to understand and overcome barriers such as professionals’ adherence and resistance to technological innovation, to effectively integrate the tool into clinical workflows.

The project is being conducted with approval from the Research Ethics Committee of the University of São Paulo Medical School (FMUSP), and the participation of health professionals was formalized through informed consent after training, ensuring autonomy and transparency. Preliminary results indicate the relevance of the digital tool for suicide risk assessment in Primary Health Care and also highlight the robustness of the platform’s security and privacy system, an essential element in mental health interventions.