Applying Human-Centered Design in Global Mental Health to Improve Reach Among Underserved Populations in the United States and India.
Applying Human-Centered Design in Global Mental Health to Improve Reach Among Underserved Populations in the United States and India.
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DOI：
10.9745/ghsp-d-22-00312
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发表时间：
2023-02-28
期刊：
影响因子：
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通讯作者：
Betancourt TS
中科院分区：
文献类型：
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作者：
Black CJ;Berent JM;Joshi U;Khan A;Chamlagai L;Shrivastava R;Gautam B;Negeye A;Iftin AN;Ali H;Desrosiers A;Bhan A;Bhattacharya S;Naslund JA;Betancourt TS
我们展示了两个全球精神卫生研究项目如何让最终用户参与设计定制的、文化上知情的数字化工具，用于支持提供基于证据的干预措施。让最终用户参与开发心理健康干预提供工具，确保了设计功能反映了使用者的观点和需求。技术可以扩大心理健康干预措施的覆盖面，并提供若干潜在的好处，包括支持低资源环境中的能力建设;改善服务不足社区的技术扫盲;以及实现困难的扩大进程。在为服务不足的人群或技术素养较低的人群开发移动健康工具时，研究人员和从业人员应在开发过程中建立支持机制，以帮助用户参与每个产品功能的设计和评估。政策制定者、国家利益相关者、研究人员和从业人员可以通过使用任务分担模式招募和培训非专业卫生工作者来缩小心理健康治疗差距。以人为本的设计（HCD）是指一套多样化的交互式过程，使最终用户参与开发所需的结果。我们展示了两个全球心理健康研究团队如何应用HCD开发移动的健康工具，每个工具都旨在减少服务不足人群的治疗差距。难民面临更高的心理健康问题风险，但这些社区面临结构和文化障碍，减少了获得和使用服务的机会。为了应对这些挑战，波士顿大学社会工作学院的儿童与逆境研究项目与美国东北部的重新安置难民社区合作，使用共同设计方法来数字化地调整难民家庭加强干预措施的交付，该计划旨在改善重新安置家庭的心理健康和家庭功能。我们描述了协同设计方法如何支持开发更可行，可接受和可持续的干预措施。Sangath是印度一家专注于心理健康服务研究的非政府组织，与哈佛医学院合作，为社区卫生工作者设计并评估了一项数字培训计划，以提供基于证据的简短抑郁症心理治疗，作为印度中央邦初级保健的一部分。我们描述了HCD如何应用于项目开发，并讨论了我们的方法来扩大培训和能力建设，以提供循证治疗抑郁症的初级保健。HCD涉及各种技术，可以灵活地进行调整，以使最终用户参与全球心理健康干预措施的概念化，实施，扩大和维持。使用HCD生成的社区解决方案为关键利益相关者提供了重要的好处。我们鼓励在全球精神卫生政策、研究和实践中广泛采用HCD，特别是用于解决服务不足人群的精神卫生差异。
We demonstrate how 2 global mental health research programs engaged end users to design tailored, culturally informed digital tools used to support the delivery of evidence-based interventions. Engaging end users in the development of mental health intervention delivery tools ensured that the design features reflected the perspectives and needs of those who would use them. Technology may increase the reach of mental health interventions and offers several potential benefits, including supporting capacity-building in low-resource settings; improving technical literacy in underserved communities; and achieving difficult scale-up processes. When developing mHealth tools with underserved populations or those with lower technical literacy, researchers and practitioners should build supportive mechanisms within the development process to help users engage in the design and evaluation of each product’s features. Policymakers, national stakeholders, researchers, and practitioners can potentially reduce mental health treatment gaps by recruiting and training lay health workers using task-sharing models. Human-centered design (HCD) refers to a diverse suite of interactive processes that engage end users in the development of a desired outcome. We showcase how 2 global mental health research teams applied HCD to develop mobile health tools, each directed at reducing treatment gaps in underserved populations. Refugees face higher risks for mental health problems, yet these communities face structural and cultural barriers that reduce access to and use of services. To address these challenges, the Research Program on Children and Adversity at the Boston College School of Social Work, in partnership with resettled refugee communities in the northeastern United States, used codesign methodology to digitally adapt delivery of the Family Strengthening Intervention for Refugees—a program designed to improve mental health and family functioning among resettled families. We describe how codesign methods support the development of more feasible, acceptable, and sustainable interventions. Sangath, an NGO in India focused on mental health services research, in partnership with Harvard Medical School, designed and evaluated a digital training program for community health workers to deliver an evidence-based, brief psychological treatment for depression as part of primary care in Madhya Pradesh, India. We describe how HCD was applied to program development and discuss our approach to scaling up training and capacity-building to deliver evidence-based treatment for depression in primary care. HCD involves a variety of techniques that can be flexibly adapted to engage end users in the conceptualization, implementation, scale-up, and sustainment of global mental health interventions. Community solutions generated using HCD offer important benefits for key stakeholders. We encourage widespread adoption of HCD within global mental health policy, research, and practice, especially for addressing mental health disparities with underserved populations.