Using technology to scale-up training and supervision of community health workers in the psychosocial management of perinatal depression: a non-inferiority, randomised controlled trial



Rahman, A ORCID: 0000-0002-2066-4467, Akhter, P, Hamdani, Syed, Atif, Najia, Nazir, H, Uddin, Iftikhar, Nisar, A, Huma, Zille ORCID: 0000-0002-2681-1771, Maselko, J, Sikander, S ORCID: 0000-0002-0223-7234
et al (show 1 more authors) (2019) Using technology to scale-up training and supervision of community health workers in the psychosocial management of perinatal depression: a non-inferiority, randomised controlled trial. Global Mental Health, 6. e8-.

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Abstract

<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>Results indicated no significant differences between health workers trained using TACTS and supervised from distance <i>v.</i> those trained and supervised by a specialist face-to-face (<i>mean ENACT score M</i>  =  24.97, s.d.  =  5.95 <i>v</i>. <i>M</i> =  27.27, s.d.  =  5.60, <i>p</i>  =  0.079, 95% CI 4.87-0.27) and at 3 months follow-up assessment (<i>M</i>  =  44.48, s.d.  =  3.97 <i>v</i>. <i>M</i> =  43.63, s.d.  =  6.34, <i>p</i>  =  0.53, CI -1.88 to 3.59).<h4>Conclusions</h4>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.

Item Type: Article
Uncontrolled Keywords: Low, and middle-income countries, perinatal depression, psychosocial intervention, technology-assisted training and supervision, Thinking Healthy Programme
Depositing User: Symplectic Admin
Date Deposited: 29 May 2019 10:50
Last Modified: 19 Jan 2023 00:42
DOI: 10.1017/gmh.2019.7
Open Access URL: https://doi.org/10.1017/gmh.2019.7
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3043521

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