Digital Training for Non-Specialist Health Workers to Deliver a Brief Psychological Treatment for Depression in Primary Care in India: Findings from a Randomized Pilot Study
Autor: | Anant Bhan, Abhishek Singh, Aditya Anand, Vikram Patel, Ritu Shrivastava, Azaz Khan, Shital Muke, Deepak Tugnawat, John A. Naslund, Udita Joshi, Juliana L. Restivo |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Health Toxicology and Mutagenesis Health Personnel education lcsh:Medicine Poison control India Pilot Projects Suicide prevention Article Occupational safety and health law.invention 03 medical and health sciences primary care 0302 clinical medicine Randomized controlled trial law Injury prevention Medicine Humans 030212 general & internal medicine Health Workforce non-specialist health worker training Primary Health Care business.industry lcsh:R pilot study Public Health Environmental and Occupational Health Human factors and ergonomics psychological treatment Focus group Mental health task sharing Telemedicine 030227 psychiatry Family medicine depression Female digital technology business mental health |
Zdroj: | International Journal of Environmental Research and Public Health Volume 17 Issue 17 International Journal of Environmental Research and Public Health, Vol 17, Iss 6368, p 6368 (2020) |
ISSN: | 1660-4601 |
DOI: | 10.3390/ijerph17176368 |
Popis: | Introduction: Task sharing holds promise for scaling up depression care in countries such as India, yet requires training large numbers of non-specialist health workers. This pilot trial evaluated the feasibility and acceptability of a digital program for training non-specialist health workers to deliver a brief psychological treatment for depression. Methods: Participants were non-specialist health workers recruited from primary care facilities in Sehore, a rural district in Madhya Pradesh, India. A three-arm randomized controlled trial design was used, comparing digital training alone (DGT) to digital training with remote support (DGT+), and conventional face-to-face training. The primary outcome was the feasibility and acceptability of digital training programs. Preliminary effectiveness was explored as changes in competency outcomes, assessed using a self-reported measure covering the specific knowledge and skills required to deliver the brief psychological treatment for depression. Outcomes were collected at pre-training and post-training. Results: Of 42 non-specialist health workers randomized to the training programs, 36 including 10 (72%) in face-to-face, 12 (86%) in DGT, and 14 (100%) in DGT+ arms started the training. Among these participants, 27 (64%) completed the training, with 8 (57%) in face-to-face, 8 (57%) in DGT, and 11 (79%) in DGT+. The addition of remote telephone support appeared to improve completion rates for DGT+ participants. The competency outcome improved across all groups, with no significant between-group differences. However, face-to-face and DGT+ participants showed greater improvement compared to DGT alone. There were numerous technical challenges with the digital training program such as poor connectivity, smartphone app not loading, and difficulty navigating the course content&mdash issues that were further emphasized in follow-up focus group discussions with participants. Feedback and recommendations collected from participants informed further modifications and refinements to the training programs in preparation for a forthcoming large-scale effectiveness trial. Conclusions: This study adds to mounting efforts aimed at leveraging digital technology to increase the availability of evidence-based mental health services in primary care settings in low-resource settings. |
Databáze: | OpenAIRE |
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