Readiness for Change Scale: Adaptation and Validation for Mental Health Task-Sharing

变化准备量表：心理健康任务分担的适应和验证 项目概要： 精神卫生任务分担，或非专业卫生工作者（NSHW）的参与，如社区 卫生工作者（CHW），使精神卫生保健更容易获得和获得，已被证明是 在多个低资源环境（包括低收入和中等收入）的随机对照试验中有效 国家然而，在常规护理环境中，基于任务分担的心理健康计划的影响 范例的成功与否在很大程度上取决于CHW的采用以及他们实现它的忠诚度，反过来， 他们的变化准备（RFC）。然而，缺乏文献评估RFC的作用 作为一个重要的预测CHW采用和忠诚度在心理健康任务分担。重要的是，研究 在RFC之间的CHW在心理健康任务分担是阻碍了缺乏一个文化适应， 可靠和有效的测量工具。为了解决研究和知识的这一重大差距，我们建立在 我们以前的定性工作调查的文化和特定上下文的细微差别的RFC之间的认可 社会健康活动家（ASHA），印度女性CHW骨干，从事心理健康任务分担。 利用我们的定性研究结果，我们的目标是调整变革准备量表，并将其翻译成马拉地语 根据世界卫生组织关于量表翻译的建议，另外我们 目的是评估内容和结构效度，以及翻译（马拉地语）版本的内部一致性 2010年12月，在Ahmednagar区Rahata分区的n = 330个ASHA中， 印度马哈拉施特拉邦。我们将通过专家小组评估内容的有效性，并计算 内容有效性比率和内容有效性指数。为了评估结构（收敛）有效性，我们将计算 修订后的量表得分与一般自我效能感量表得分之间的相关性。此外，委员会认为， 我们将使用Cronbach's alpha来评估修订后量表的内部一致性，并使用因素分析来 确定缩放结构。这项研究的结果-一个适应和验证的措施，RFC之间的CHW 精神卫生任务分担-将建立一个坚实的基础，以制定和测试实施战略， 通过NIH的R21资助机制，在CHW中建立RFC，以分担心理健康任务， 这对包括美国在内的全球低资源环境非常有用。

Readiness for Change Scale: Adaptation and Validation for Mental Health Task-Sharing PROJECT SUMMARY: Mental health task-sharing, or the involvement of non-specialist health workers (NSHWs) such as community health workers (CHWs) to make mental health care more available and accessible, has been proven to be efficacious in randomized controlled trials in multiple low-resource settings including low- and middle-income countries. However, in routine care settings, the impact of mental health programs based on task-sharing paradigm greatly depend on its adoption by CHWs and the fidelity with which they implement it which, in-turn, is influenced by their readiness for change (RFC). However, there is dearth of literature assessing the role of RFC as an important predictor of CHW adoption and fidelity within mental health task-sharing. Importantly, research on RFC among CHWs within mental health task-sharing is hindered by the absence of a culturally-adapted, reliable, and valid measurement tool. To address this significant gap in research and knowledge, we build on our previous qualitative work investigating the cultural- and context-specific nuances of RFC among Accredited Social Health Activists (ASHAs), a cadre of female CHWs in India, for engaging in mental health task-sharing. Utilizing our qualitative findings, we aim to adapt the Readiness for Change Scale and translate it into Marathi language by following the World Health Organization's recommendations on scale translation. In addition, we aim to assess the content and construct validity, as well as internal consistency of the translated (Marathi) version of the Readiness for Change Scale among n=330 ASHAs in Rahata sub-district of Ahmednagar district in the state of Maharashtra, India. We will assess content validity through involving an expert panel, and calculate content validity ratios and a content validity index. For evaluating construct (convergent) validity, we will calculate the correlation between the revised scale scores and scores from the General Self-Efficacy Scale. Furthermore, we will use Cronbach's alpha to assess the internal consistency of the revised scale, and factor analysis to identify scale constructs. The outcome of this study—an adapted and validated measure for RFC among CHWs for mental health task-sharing—will build a solid foundation to develop and test an implementation strategy to build RFC among CHWs for mental health task-sharing through NIH's R21 funding mechanism which will be useful for low-resource setting globally, including the United States.