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

项目总结 全球精神卫生(MH)专科医生的短缺导致了全球MH治疗的巨大缺口。 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式培训的卫生工作者可以有效地 提供MH护理，LHW提供MH护理的能力差异很大。 来自高收入人群的先前研究 低收入和中等收入国家的形成工作表明，这种变异性可以通过以下方式预测 LHW人际交往技巧 。然而，目前还没有评估LHW人际交往能力的方法 预测MH护理方面的能力。这一证据差距是LHW提供优质MH护理的障碍 比例。在南非，对LHW人际交往技能进行培训前评估的需求尤为迫切 (SA)，它正在积极地将MH护理提供纳入LHW的角色。对NIMH的回应 战略优先事项4.1“通过以下途径提高现有精神卫生服务的效率和效力 这项研究的目的是开发和试点培训前的人际交往技能评估在南澳的LHW。 这项评估可以在未来帮助实施者将受训者与适当类型和数量的 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 确定人际交往技能作为男婴护理中LHW能力的预测指标 。我们将进行第二次 使用分类和回归树(CART)方法分析现有LHW数据(n=205)以确定 MH培训前评估的人际交往技能预测培训后MH护理的能力。下一首, 根据治疗师的特点和实施障碍框架，我们将进行重点 SA中的小组(n=20，研究人员、政策制定者、非政府组织工作人员)从文化上验证量化结果和 确定飞行员的其他人际交往技能。我们的第二个研究目标是试行评估 确定了南卡罗来纳州开普敦LHW(n=30)的人际交往技能。我们将评估初步的 人际交往技能在预测男婴护理LHW能力中的有效性。最后，在 实施研究的综合框架，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量化测量(n=20)进行培训前评估的可接受性 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专业。培训目标包括：获得传播方面的专门知识 和全球心理健康研究中的实施科学； 发展强大的统计方法技能 用于开发工具和评估心理测量学；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做好准备，成为任务的独立研究员-- 共享MH员工发展。她将在美国和SA的导师的指导下进行补充 具备研究所需的实施科学、统计学和心理测量学方法方面的专业知识。

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.