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
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 fo...
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Published in | Global mental health Vol. 6; p. e8 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
Cambridge University Press
2019
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Subjects | |
Online Access | Get full text |
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Summary: | 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.
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 indicated no significant differences between health workers trained using TACTS and supervised from distance
those trained and supervised by a specialist face-to-face (
= 24.97, s.d. = 5.95
.
= 27.27, s.d. = 5.60,
= 0.079, 95% CI 4.87-0.27) and at 3 months follow-up assessment (
= 44.48, s.d. = 3.97
.
= 43.63, s.d. = 6.34,
= 0.53, CI -1.88 to 3.59).
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. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Siham Sikander and Shamsa Zafar are joint last authors. |
ISSN: | 2054-4251 2054-4251 |
DOI: | 10.1017/gmh.2019.7 |