Cargando…
Using technology to scale-up training and supervision of community health workers in the psychosocial management of perinatal depression: a non-inferiority, randomized controlled trial
BACKGROUND. The Thinking Healthy Programme (THP) is an evidence-based psychological intervention endorsed by the World Health Organization, tailored for non-specialist health workers in low- and middle-income countries. However, training and supervision of large numbers of health workers is a major...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6533850/ https://www.ncbi.nlm.nih.gov/pubmed/31157115 http://dx.doi.org/10.1017/gmh.2019.7 |
_version_ | 1783421290785275904 |
---|---|
author | Rahman, Atif Akhtar, Parveen Hamdani, Syed Usman Atif, Najia Nazir, Huma Uddin, Iftikhar Nisar, Anum Huma, Zille Maselko, Joanna Sikander, Siham Zafar, Shamsa |
author_facet | Rahman, Atif Akhtar, Parveen Hamdani, Syed Usman Atif, Najia Nazir, Huma Uddin, Iftikhar Nisar, Anum Huma, Zille Maselko, Joanna Sikander, Siham Zafar, Shamsa |
author_sort | Rahman, Atif |
collection | PubMed |
description | BACKGROUND. The Thinking Healthy Programme (THP) is an evidence-based psychological intervention endorsed by the World Health Organization, tailored for non-specialist health workers in low- and middle-income countries. However, training and supervision of large numbers of health workers is a major challenge for the scale-up of THP. We developed a ‘Technology-Assisted Cascaded Training and Supervision system’ (TACTS) for THP consisting of a training application and cascaded supervision delivered from a distance. METHODS. A single-blind, non-inferiority, randomized controlled trial was conducted in District Swat, a post-conflict area of North Pakistan. Eighty community health workers (called Lady Health Workers or LHWs) were randomly assigned to either TACTS or conventional face-to-face training and supervision by a specialist. Competence of LHWs in delivering THP post-training was assessed by independent observers rating a therapeutic session using a standardized measure, the ‘Enhancing Assessment of Common Therapeutic factors’ (ENACT), immediately post-training and after 3 months. ENACT uses a Likert scale to score an observed interaction on 18 dimensions, with a total score of 54, and a higher score indicating greater competence. RESULTS. Results indicated no significant differences between health workers trained using TACTS and supervised from distance v. those trained and supervised by a specialist face-to-face (mean ENACT score M = 24.97, s.d. = 5.95 v. M = 27.27, s.d. = 5.60, p = 0.079, 95% CI 4.87–0.27) and at 3 months follow-up assessment (M = 44.48, s.d. = 3.97 v. M = 43.63, s.d. = 6.34, p = 0.53, CI −1.88 to 3.59). CONCLUSIONS. TACTS can provide a promising tool for training and supervision of front-line workers in areas where there is a shortage of specialist trainers and supervisors. |
format | Online Article Text |
id | pubmed-6533850 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-65338502019-05-31 Using technology to scale-up training and supervision of community health workers in the psychosocial management of perinatal depression: a non-inferiority, randomized controlled trial Rahman, Atif Akhtar, Parveen Hamdani, Syed Usman Atif, Najia Nazir, Huma Uddin, Iftikhar Nisar, Anum Huma, Zille Maselko, Joanna Sikander, Siham Zafar, Shamsa Glob Ment Health (Camb) Original Research Paper BACKGROUND. The Thinking Healthy Programme (THP) is an evidence-based psychological intervention endorsed by the World Health Organization, tailored for non-specialist health workers in low- and middle-income countries. However, training and supervision of large numbers of health workers is a major challenge for the scale-up of THP. We developed a ‘Technology-Assisted Cascaded Training and Supervision system’ (TACTS) for THP consisting of a training application and cascaded supervision delivered from a distance. METHODS. A single-blind, non-inferiority, randomized controlled trial was conducted in District Swat, a post-conflict area of North Pakistan. Eighty community health workers (called Lady Health Workers or LHWs) were randomly assigned to either TACTS or conventional face-to-face training and supervision by a specialist. Competence of LHWs in delivering THP post-training was assessed by independent observers rating a therapeutic session using a standardized measure, the ‘Enhancing Assessment of Common Therapeutic factors’ (ENACT), immediately post-training and after 3 months. ENACT uses a Likert scale to score an observed interaction on 18 dimensions, with a total score of 54, and a higher score indicating greater competence. RESULTS. Results indicated no significant differences between health workers trained using TACTS and supervised from distance v. those trained and supervised by a specialist face-to-face (mean ENACT score M = 24.97, s.d. = 5.95 v. M = 27.27, s.d. = 5.60, p = 0.079, 95% CI 4.87–0.27) and at 3 months follow-up assessment (M = 44.48, s.d. = 3.97 v. M = 43.63, s.d. = 6.34, p = 0.53, CI −1.88 to 3.59). CONCLUSIONS. TACTS can provide a promising tool for training and supervision of front-line workers in areas where there is a shortage of specialist trainers and supervisors. Cambridge University Press 2019-05-16 /pmc/articles/PMC6533850/ /pubmed/31157115 http://dx.doi.org/10.1017/gmh.2019.7 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by/4.0/ This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited |
spellingShingle | Original Research Paper Rahman, Atif Akhtar, Parveen Hamdani, Syed Usman Atif, Najia Nazir, Huma Uddin, Iftikhar Nisar, Anum Huma, Zille Maselko, Joanna Sikander, Siham Zafar, Shamsa Using technology to scale-up training and supervision of community health workers in the psychosocial management of perinatal depression: a non-inferiority, randomized controlled trial |
title | Using technology to scale-up training and supervision of community health workers in the psychosocial management of perinatal depression: a non-inferiority, randomized controlled trial |
title_full | Using technology to scale-up training and supervision of community health workers in the psychosocial management of perinatal depression: a non-inferiority, randomized controlled trial |
title_fullStr | Using technology to scale-up training and supervision of community health workers in the psychosocial management of perinatal depression: a non-inferiority, randomized controlled trial |
title_full_unstemmed | Using technology to scale-up training and supervision of community health workers in the psychosocial management of perinatal depression: a non-inferiority, randomized controlled trial |
title_short | Using technology to scale-up training and supervision of community health workers in the psychosocial management of perinatal depression: a non-inferiority, randomized controlled trial |
title_sort | using technology to scale-up training and supervision of community health workers in the psychosocial management of perinatal depression: a non-inferiority, randomized controlled trial |
topic | Original Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6533850/ https://www.ncbi.nlm.nih.gov/pubmed/31157115 http://dx.doi.org/10.1017/gmh.2019.7 |
work_keys_str_mv | AT rahmanatif usingtechnologytoscaleuptrainingandsupervisionofcommunityhealthworkersinthepsychosocialmanagementofperinataldepressionanoninferiorityrandomizedcontrolledtrial AT akhtarparveen usingtechnologytoscaleuptrainingandsupervisionofcommunityhealthworkersinthepsychosocialmanagementofperinataldepressionanoninferiorityrandomizedcontrolledtrial AT hamdanisyedusman usingtechnologytoscaleuptrainingandsupervisionofcommunityhealthworkersinthepsychosocialmanagementofperinataldepressionanoninferiorityrandomizedcontrolledtrial AT atifnajia usingtechnologytoscaleuptrainingandsupervisionofcommunityhealthworkersinthepsychosocialmanagementofperinataldepressionanoninferiorityrandomizedcontrolledtrial AT nazirhuma usingtechnologytoscaleuptrainingandsupervisionofcommunityhealthworkersinthepsychosocialmanagementofperinataldepressionanoninferiorityrandomizedcontrolledtrial AT uddiniftikhar usingtechnologytoscaleuptrainingandsupervisionofcommunityhealthworkersinthepsychosocialmanagementofperinataldepressionanoninferiorityrandomizedcontrolledtrial AT nisaranum usingtechnologytoscaleuptrainingandsupervisionofcommunityhealthworkersinthepsychosocialmanagementofperinataldepressionanoninferiorityrandomizedcontrolledtrial AT humazille usingtechnologytoscaleuptrainingandsupervisionofcommunityhealthworkersinthepsychosocialmanagementofperinataldepressionanoninferiorityrandomizedcontrolledtrial AT maselkojoanna usingtechnologytoscaleuptrainingandsupervisionofcommunityhealthworkersinthepsychosocialmanagementofperinataldepressionanoninferiorityrandomizedcontrolledtrial AT sikandersiham usingtechnologytoscaleuptrainingandsupervisionofcommunityhealthworkersinthepsychosocialmanagementofperinataldepressionanoninferiorityrandomizedcontrolledtrial AT zafarshamsa usingtechnologytoscaleuptrainingandsupervisionofcommunityhealthworkersinthepsychosocialmanagementofperinataldepressionanoninferiorityrandomizedcontrolledtrial |