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，其中 非专业人员在监督下提供护理。然而，转移任务以减少 如果没有可扩展和可持续方法的经验指导，心理健康治疗差距将无法实现 监督非专业顾问鉴于全球数字技术的普及， 利用技术来监督非专业顾问。最大限度地提高可接受性和可行性， 背景下，移动的技术督导研究应植根于非专业辅导员的需求， 监事该项目建立在目前NIMH资助的研究“建立和维持干预措施， 儿童（基础）：在低资源环境下的任务分担精神卫生保健”（R 01 MH 112633），其目的是 测试创伤集中认知行为疗法（TF-CBT）的有效性和实施情况， 肯尼亚政府支持的系统：教育（通过教师）和健康推广（通过社区 健康志愿者）。移动的技术（即，WhatsApp）成为一种经常使用的监督支持， 在BASIC试验期间的一些顾问。这个项目利用了一个意想不到的，自然发生的 现象，并借鉴以人为本的设计（HCD）技术，以获得 使用移动的技术进行临床监督的非专业顾问和主管观点。研究 目的是：（1a）调查目前使用移动的技术支持监督的方式; (1b)确定技术中介监督的障碍和促进因素。我们进行定性分析 与主管和非专业顾问面谈，回答目标1中的研究问题。(2)接合 利益攸关方重新设计监督流程，以利用移动的技术。我们采用HCD 技术，如头脑风暴和角色扮演，在与主管的面对面协作会议中， 非专业顾问系统地制定和选择三个最佳工作流程， 目标3中的移动的技术监督。(3)检查移动的的可接受性、可行性和可用性 技术监督，以及在试点试验的有效性的看法。我们研究了 与仅通过移动的技术接受监督的非专业咨询师相比， 辅导员接受标准的亲自监督。研究结果可以帮助了解更大的潜力 依靠成本较低的现有移动的技术在资源匮乏的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.