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.
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.
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DOI：
10.3390/ijerph17176368
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发表时间：
2020-09-01
影响因子：
--
通讯作者：
Naslund JA
中科院分区：
文献类型：
--
作者：
Muke SS;Tugnawat D;Joshi U;Anand A;Khan A;Shrivastava R;Singh A;Restivo JL;Bhan A;Patel V;Naslund JA
简介：任务共享有望在印度等国家扩大抑郁症护理规模，但需要培训大量非专业卫生工作者。该试点试验评估了培训非专业卫生工作者对抑郁症进行简短心理治疗的数字计划的可行性和可接受性。方法：参与者是从印度中央邦农村地区 Sehore 的初级保健机构招募的非专业卫生工作者。采用三组随机对照试验设计，将单独的数字化培训 (DGT) 与远程支持的数字化培训 (DGT+) 以及传统的面对面培训进行比较。主要成果是数字培训计划的可行性和可接受性。随着能力结果的变化，探索了初步有效性，并使用自我报告的措施进行评估，该措施涵盖了针对抑郁症进行简短心理治疗所需的具体知识和技能。在训练前和训练后收集结果。结果：在随机参加培训计划的 42 名非专业卫生工作者中，有 36 名开始接受培训，其中 10 名（72%）接受面对面培训，12 名（86%）参加 DGT，14 名（100%）参加 DGT+ 组。在这些参与者中，27 人（64%）完成了培训，其中 8 人（57%）为面对面培训，8 人（57%）为 DGT，11 人（79%）为 DGT+。增加远程电话支持似乎提高了 DGT+ 参与者的完成率。所有组的能力结果都有所提高，组间没有显着差异。然而，与单独 DGT 相比，面对面和 DGT+ 参与者表现出更大的进步。数字培训计划存在许多技术挑战，例如连接不良、智能手机应用程序无法加载以及难以导航课程内容，这些问题在与参与者的后续焦点小组讨论中得到了进一步强调。从参与者那里收集的反馈和建议为培训计划的进一步修改和完善提供了依据，为即将进行的大规模有效性试验做好准备。结论：这项研究进一步加强了旨在利用数字技术提高资源匮乏地区初级保健机构循证心理健康服务可用性的努力。
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—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.
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影响因子：
5.2
作者：
Cooper, Zafra;Doll, Helen;Fairburn, Christopher G.
通讯作者：
Fairburn, Christopher G.
DOI：
10.1007/s10488-017-0815-0
发表时间：
2018-03
期刊：
Administration and policy in mental health
影响因子：
--
作者：
Barnett ML;Gonzalez A;Miranda J;Chavira DA;Lau AS
通讯作者：
Lau AS
影响因子：
10.5
作者：
Jordans, Mark J. D.;Luitel, Nagendra P.;Patel, Vikram
通讯作者：
Patel, Vikram
影响因子：
4
作者：
Gale NK;Heath G;Cameron E;Rashid S;Redwood S
通讯作者：
Redwood S
DOI：
10.1146/annurev-clinpsy-050817084825
发表时间：
2018-01-01
期刊：
ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, VOL 14
影响因子：
--
作者：
Barnett, Miya L.;Lau, Anna S.;Miranda, Jeanne
通讯作者：
Miranda, Jeanne