Faculty of Medicine of Sao Paulo University-Preventive Medicine Department, Av. Dr. Arnaldo, 455-Cerqueira César, sala 2364, Sao Paulo, SP, 01246-903, Brazil.
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 445, Miraflores, Lima, Peru.
Hum Resour Health. 2021 Feb 5;19(1):16. doi: 10.1186/s12960-021-00556-5.
Task-shifting and technology in psychological interventions are two solutions to increasing access to mental health intervention and overcoming the treatment gap in low and middle-income countries. The CONEMO intervention combines a smartphone app with support from non-specialized professionals, aiming to treat depression in patients with diabetes and/or hypertension. The aim of this paper is to describe the process of recruitment, training and supervision of the non-specialized professionals who participated in the CONEMO task-shifting intervention in Brazil and Peru.
We described and analyzed data related to the recruitment, training and supervision of 62 nurse assistants from the health system in Sao Paulo, Brazil, and three hired nurses in Lima, Peru. The data were collected from information provided by nurses and nurse assistants, supervisor records from supervision meetings and the CONEMO platform database.
We found that task-shifting was feasible using existing resources in Sao Paulo and additional human resources in Lima. Training and supervision were found to be crucial and well received by the staff; however, time was a limitation when using existing human resources. Ensuring technological competence prior to the start of the intervention was essential. Group supervision meetings allowed non-specialized professionals to learn from each other's experiences.
Carefully considering recruitment, training and supervision of non-specialized professionals is important for effective task-shifting when delivering an mHealth intervention for depression. Opportunities and challenges of working in different health systems are described, which should be considered in future implementation, either for research or real settings. Trial registration NCT028406662 (Sao Paulo), NCT03026426 (Peru).
任务转移和心理干预技术是增加获得心理健康干预机会和克服中低收入国家治疗差距的两种解决方案。CONEMO 干预措施结合了智能手机应用程序和非专业人员的支持，旨在治疗糖尿病和/或高血压患者的抑郁症。本文旨在描述参与 CONEMO 任务转移干预的非专业人员在巴西和秘鲁的招募、培训和监督过程。
我们描述并分析了与巴西圣保罗的卫生系统中的 62 名护士助理和秘鲁利马的 3 名雇佣护士的招募、培训和监督相关的数据。这些数据是从护士和护士助理提供的信息、监督会议记录和 CONEMO 平台数据库中收集的。
我们发现，在圣保罗利用现有资源和在利马额外的人力资源，任务转移是可行的。培训和监督被发现是至关重要的，并且受到工作人员的欢迎；然而，在利用现有人力资源时，时间是一个限制因素。在干预开始前确保技术能力是必要的。小组监督会议使非专业人员能够从彼此的经验中学习。
在提供针对抑郁症的移动健康干预措施时，仔细考虑非专业人员的招募、培训和监督对于有效的任务转移至关重要。描述了在不同卫生系统中工作的机会和挑战，这应在未来的研究或实际环境中加以考虑。
NCT028406662（巴西圣保罗），NCT03026426（秘鲁）。
