Applying Human-Centered Design to Inform Mobile Technology-Mediated Supervision with Lay Counselors in Kenya

项目摘要 研究表明，基于证据的心理健康治疗可以通过任务转移来提供，在这种情况下 非专业人员在监督下提供护理。然而，转移任务的潜在前景是减少 如果没有可扩展和可持续方法的经验指导，心理健康治疗差距就无法实现 去监督业馀辅导员。鉴于全球获得数字技术的机会增加，可能存在以下机会 利用技术对业馀辅导员进行监督。在低资源的情况下最大限度地提高可接受性和可行性 设置、研究移动技术监督应植根于非专业辅导员和 主管。该项目建立在目前NIMH资助的一项研究的基础上，该研究名为《建立和维持干预措施 《儿童(基础)：低资源环境下的任务分担心理卫生保健》(R01MH112633)，旨在 以创伤为中心的认知行为疗法(TF-CBT)的有效性和实施 肯尼亚政府支持的系统：教育(通过教师)和卫生推广(通过社区 健康志愿者)。移动技术(即WhatsApp)作为一种常用的监管支持出现在 基础审判期间的一些顾问。这个项目利用了一种意想不到的，自然发生的 现象，并从以人为中心的设计(HCD)技术中获得 提供辅导员和主管使用移动技术进行临床督导的观点。学习 目的是：(1)调查移动技术目前被用来支持监督的方式； (1B)确定技术中介监管的障碍和促进者。我们进行定性的 与主管和业馀顾问面谈，以回答目标1中的研究问题。(2)参与 利益攸关方重新设计监管流程，以利用移动技术。我们雇佣了HCD 技术，如头脑风暴和角色扮演，在与主管和 非专业顾问系统地开发和选择三个最理想的工作流程，以便为实施提供信息 目标3中的移动技术监督。(3)检查移动设备的可接受性、可行性和可用性 技术监督，以及对试点试验的有效性的看法。我们考察了以下方面的差异 在完全通过移动技术接受监督的非专业咨询师中，这些结果与 辅导员接受标准的面对面监督。研究结果有助于了解更大的 依靠成本较低的现有移动技术在低资源环境中提供临床监督。

PROJECT ABSTRACT Research indicates that evidence-based mental health treatments can be delivered via task-shifting, in which non-professionals deliver care under supervision. However, the potential promise of task-shifting to reduce the mental health treatment gap goes unrealized without empirical guidance on scalable and sustainable methods to supervise lay counselors. Given the rise in access to digital technology worldwide, opportunities may exist to leverage technology to supervise lay counselors. To maximize acceptability and feasibility in low-resource settings, research on mobile technology supervision should be rooted in the needs of lay counselors and supervisors. This project builds on a current NIMH-funded study, “Building and Sustaining Interventions for Children (BASIC): Task-Sharing Mental Health Care in Low-Resource Settings” (R01MH112633), which aims to test the effectiveness and implementation of Trauma-focused Cognitive Behavioral Therapy (TF-CBT) in two government-supported systems in Kenya: Education (via teachers) and Health Extension (via community health volunteers). Mobile technology (i.e., WhatsApp) emerged as a frequently used supervision support for some counselors during the BASIC trial. This project capitalizes on an unexpected, naturally occurring phenomenon within an already funded trial, and draws from human-centered design (HCD) techniques to gain lay counselor and supervisor perspectives on using mobile technology to conduct clinical supervision. Study aims are to: (1a) Investigate the ways mobile technology is currently being used to support supervision; (1b) identify barriers and facilitators of technology-mediated supervision. We conduct qualitative interviews with supervisors and lay counselors to answer research questions in Aim 1. (2) Engage stakeholders to redesign supervision processes to leverage mobile technology. We employ HCD techniques, such as brainstorming and roleplaying, in an in-person collaborative meeting with supervisors and lay counselors to systematically develop and select three most optimal workflows to inform implementation of mobile technology supervision in Aim 3. (3) Examine the acceptability, feasibility, and usability of mobile technology supervision, as well as perceptions of effectiveness in a pilot trial. We examine differences in these outcomes among lay counselors receiving supervision exclusively via mobile technology, compared to counselors receiving standard in-person supervision. Study findings can help inform the potential for greater reliance on lower-cost, existing mobile technology to provide clinical supervision in low-resource settings.