Effectiveness and implementation of pre-training interpersonal skills assessment of community health workers in South Africa to predict post-training competence in mental health care

南非社区卫生工作者培训前人际技能评估的有效性和实施情况，以预测培训后的精神卫生保健能力

• 批准号: 10320351
• 负责人: Alexandra Leah Rose
• 金额: $ 4.68万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-03 至 2024-01-02
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10320351
• 关键词: Affect; Area; Characteristics; Clinical Psychology; Clinical Research; Collaborations; Communities; Community Health Aides; Competence; Consolidated Framework for Implementation Research; Country; Data; Data Set; Development; Effectiveness; Ensure; Epidemic; Ethics; Focus Groups; Foundations; Future; Goals; HIV; Health; Health Services Accessibility; Healthcare; Income; Knowledge; Maryland; Measures; Mental Competency; Mental Health; Mental Health Services; Mentors; Mentorship; Methods; Modeling; National Institute of Mental Health; Outcome Measure; Persons; Policies; Policy Maker; Predictive Factor; Problem Solving; Psychometrics; Qualitative Research; Research; Research Personnel; Resource-limited setting; Resources; Role; South Africa; Specialist; State Government; Statistical Methods; System; Testing; Therapeutic; Training; Universities; Validation; Work; Workforce Development; acceptability and feasibility; care delivery; career; classification trees; dissemination science; doctoral student; effectiveness implementation design; effectiveness implementation study; experience; health care delivery; health training; implementation barriers; implementation evaluation; implementation framework; implementation outcomes; implementation research; implementation science; improved; individual variation; innovation; interest; low and middle-income countries; programs; regression trees; research study; response; scale up; secondary analysis; service delivery; skills; tool development

PROJECT SUMMARY A worldwide shortage of mental health (MH) specialists contributes to a substantial global MH treatment gap. Despite evidence that lay health workers (LHWs), or health workers with little formal training, can effectively deliver MH care, LHWs vary widely in their abilities to deliver MH care. Prior research from high-income countries and formative work in low- and middle-income countries suggests this variability may be predicted by LHW interpersonal skills . However, there are no methods for assessing LHW interpersonal skills in order to predict competence in MH care. This evidence gap represents a barrier to LHW delivery of quality MH care at scale. The need for a pre-training LHW interpersonal skills assessment is particularly urgent in South Africa (SA), which is actively moving towards integrating MH care delivery into LHW roles. In response to NIMH Strategic Priority 4.1 to “improve the efficiency and effectiveness of existing mental health services through research,” this study aims to develop and pilot a pre-training interpersonal skills assessment for LHWs in SA. This assessment could, in the future, help implementers align trainees with the appropriate type and amount of training and help ensure the quality of LHW-delivered MH care. The proposed study will leverage the ongoing research and collaborations of the sponsor (Magidson) and co-sponsor (Kohrt). Our first research aim is to identify interpersonal skills to pilot as predictors of LHW competence in MH care . We will conduct secondary analysis of existing LHW data (n=205) using a classification and regression tree (CART) approach to identify interpersonal skills assessed before MH training that predict competence in MH care after training. Next, guided by the Therapist Characteristics and Barriers to Implementation Framework, we will conduct focus groups in SA (n=20, researchers, policymakers, NGO staff) to culturally validate quantitative findings and identify additional interpersonal skills for piloting. Our second research aim is to pilot assessment of the identified interpersonal skills among LHWs (n=30) in Cape Town, SA. We will assess the preliminary effectiveness of interpersonal skills in predicting LHW competence in MH care. Finally, guided by the Consolidated Framework for Implementation Research, our third research aim is to evaluate the feasibility and acceptability of the pre-training assessment using focus groups and a validated quantitative measure (n= 20 NGO staff). Research aims align with the training goals of the candidate, Ms. Alexandra Rose, a PhD student in Clinical Psychology at the University of Maryland. Training goals include: gaining expertise in dissemination and implementation science in global mental health research; developing strong skill sets in statistical methods for tool development and evaluating psychometrics; and obtaining advanced training in ethics and professional development. The tailored training plan will prepare Ms. Rose to become an independent researcher in task- shared MH workforce development. She will be guided by mentors in the US and SA with complementary expertise in the implementation science, statistical, and psychometric methods required for the study.

项目概要 全球范围内心理健康 (MH) 专家的短缺造成了全球心理健康治疗方面的巨大缺口。 尽管有证据表明非专业卫生工作者 (LHW) 或几乎没有接受过正规培训的卫生工作者可以有效地 尽管提供 MH 护理，LHW 提供 MH 护理的能力差异很大。 先前对高收入人群的研究 国家和低收入和中等收入国家的形成性工作表明，这种变异性可以通过以下方式预测： LHW 人际交往能力 。然而，目前还没有评估 LHW 人际交往能力的方法，以便 预测 MH 护理能力。这一证据差距对 LHW 提供优质 MH 护理构成了障碍。 规模。在南非，培训前 LHW 人际技能评估的需求尤为迫切 (SA)，正在积极致力于将 MH 护理服务整合到 LHW 角色中。回应 NIMH 战略重点 4.1“通过以下方式提高现有精神卫生服务的效率和效果” 研究”，本研究旨在为南澳的 LHW 开发和试点培训前人际技能评估。 这项评估将来可以帮助实施者使受训者适应适当类型和数量的培训 培训并帮助确保 LHW 提供的 MH 护理的质量。拟议的研究将利用正在进行的 赞助商（Magidson）和共同赞助商（Kohrt）的研究和合作。 我们的第一个研究目标是 确定人际关系技能，作为 MH 护理中 LHW 能力的预测指标 。我们将进行二次 使用分类和回归树 (CART) 方法分析现有 LHW 数据 (n=205)，以识别 MH 培训前评估的人际交往能力可预测培训后的 MH 护理能力。下一个， 在治疗师特征和实施框架障碍的指导下，我们将重点开展 SA 的团体（n = 20，研究人员，政策制定者，非政府组织工作人员）在文化上验证定量研究结果和 确定飞行员的额外人际关系技能。我们的第二个研究目标是对 确定了南澳州开普敦 LHW（n=30）的人际交往能力。我们将初步评估 人际关系技巧在预测 MH 护理中 LHW 能力方面的有效性。最后，在指导下 实施研究综合框架，我们的第三个研究目标是评估可行性和 使用焦点小组和经过验证的定量测量进行培训前评估的可接受性（n = 20 非政府组织工作人员）。研究目标与博士生 Alexandra Rose 女士的培训目标一致 马里兰大学临床心理学博士。培训目标包括： 获得传播方面的专业知识 全球心理健康研究中的和实施科学； 培养强大的统计方法技能 用于工具开发和心理测量评估；并获得道德和专业方面的高级培训 发展。 量身定制的培训计划将使罗斯女士成为一名独立研究员 共享 MH 劳动力发展。她将在美国和南非的导师的指导下进行互补 研究所需的实施科学、统计和心理测量方法的专业知识。