Digital training for non-specialist health workers to deliver a brief psychological treatment for depression in India: Protocol for a three-arm randomized controlled trial
Digital training for non-specialist health workers to deliver a brief psychological treatment for depression in India: Protocol for a three-arm randomized controlled trial
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DOI：
10.1016/j.cct.2021.106267
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发表时间：
2021-01-21
影响因子：
2.2
通讯作者：
Patel, Vikram
中科院分区：
文献类型：
--
作者：
Naslund, John A.;Tugnawat, Deepak;Patel, Vikram
背景：大规模培训非专业卫生工作者 (NSHW) 是提高印度抑郁症护理覆盖率的主要障碍。该试验将测试两种形式的数字培训与传统的面对面培训相比，在改变 NSHW 为抑郁症提供简短的循证心理治疗的能力方面的有效性。方法：本方案适用于一项三臂、平行组随机对照试验，比较了培训 NSHW 在初级保健中提供健康活动计划 (HAP)（一种针对抑郁症的简短手动心理治疗）的三种方法。这些武器是：数字培训（DGT）；数字化培训与个性化辅导支持相结合（DGT+）；和传统的面对面培训（F2F）。目标样本包括印度中央邦 N = 336 个政府签约的 NSHW。主要成果是交付 HAP 的能力发生变化；次要成果包括培训计划的成本效益、参与者的变化？心理健康知识、态度和行为以及对培训的满意度。对参与者分配状态不知情的评估者将收集训练前（基线）和训练后（终点）的结果，以确定各组之间结果的差异。将收集培训计划成本，以计算与面对面培训计划相比，在数字化能力衡量中增加一单元的增量成本。卫生工作者的积极性、工作满意度和倦怠将被收集为探索性结果变量。讨论：该试验将确定数字培训是否是一种有效、具有成本效益且可扩展的方法，用于培养劳动力能力，为资源匮乏的初级保健机构提供简短的循证心理治疗抑郁症。试验注册：ClinicalTrials.gov 标识符：NCT04157816
Background: Training non-specialist health workers (NSHWs) at scale is a major barrier to increasing the coverage of depression care in India. This trial will test the effectiveness of two forms of digital training compared to conventional face-to-face training in changing the competence of NSHWs to deliver a brief evidence-based psychological treatment for depression. Methods: This protocol is for a three-arm, parallel group randomized controlled trial comparing three ways of training NSHWs to deliver the Healthy Activity Program (HAP), a brief manualized psychotherapy for depression, in primary care. The arms are: digital training (DGT); digital training combined with individualized coaching support (DGT+); and conventional face-to-face training (F2F). The target sample comprises N = 336 government contracted NSHWs in Madhya Pradesh, India. The primary outcome is change of competence to deliver HAP; secondary outcomes include cost-effectiveness of the training programs, change in participants? mental health knowledge, attitudes and behavior, and satisfaction with the training. Assessors blind to participant allocation status will collect outcomes pre- (baseline) and post- (endpoint) training to ascertain differences in outcomes between arms. Training program costs will be collected to calculate incremental costs of achieving one additional unit on the competency measure in the digital compared to face-to-face training programs. Health worker motivation, job satisfaction, and burnout will be collected as exploratory outcome variables.Discussion: This trial will determine whether digital training is an effective, cost-effective, and scalable approach for building workforce capacity to deliver a brief evidence-based psychological treatment for depression in primary care in a low-resource setting. Trial Registration: ClinicalTrials.gov Identifier: NCT04157816