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培养非专科医疗服务提供者基于知识的心理治疗能力:一项前后对照研究,其中嵌套了一项随机对照试验,比较在印度针对解决问题的心理干预开展的由教练支持的数字培训课程与自主学习数字培训课程。

Developing knowledge-based psychotherapeutic competencies in non-specialist providers: A pre-post study with a nested randomised controlled trial of a coach-supported versus self-guided digital training course for a problem-solving psychological intervention in India.

作者信息

Mathur Sonal, Weiss Helen A, Neuman Melissa, Leurent Baptiste, Field Andy P, Shetty Tejaswi, J James E, Nair Pooja, Mathews Rhea, Malik Kanika, Michelson Daniel, Patel Vikram

机构信息

Sangath, New Delhi, India.

Medical Research Council International Statistics and Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.

出版信息

Glob Ment Health (Camb). 2023 Nov 29;10:e87. doi: 10.1017/gmh.2023.81. eCollection 2023.


DOI:10.1017/gmh.2023.81
PMID:38161749
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10755375/
Abstract

We evaluated a digital learning programme for non-specialists to develop knowledge-based competencies in a problem-solving intervention for adolescents to examine the overall impact of training on knowledge-based competencies among learners; and to compare the effects of two training conditions (self-guided digital training with or without coaching) in a nested parallel, two-arm, individually randomised controlled trial. Eligible participants were 18 or older; fluent in Hindi or English; able to access digital training; and had no prior experience of delivering structured psychotherapies. 277 participants were enrolled from 31 March 2022 to 19 June 2022 of which 230 (83%) completed the study. There was a significant increase in competency score from pre-training (Mean = 7.01, SD = 3.29) to post-training (Mean = 8.88, SD = 3.80), 6 weeks after the pre-training assessment. Knowledge competency scores showed larger increase among participants randomised to the coaching arm (AMD = 1.09, 95% CI 0.26-1.92,  = 0.01) with an effect size () of 0.33 (95% CI 0.08-0.58). More participants completed training in the coaching arm ( = 96, 69.6%) compared to the self-guided training arm ( = 56, 40.3%). In conclusion, a coach-supported remote digital training intervention is associated with enhanced participation by learners and increased psychotherapeutic knowledge competencies.

摘要

我们评估了一个针对非专业人员的数字学习项目,该项目旨在通过针对青少年的问题解决干预来培养基于知识的能力,以检验培训对学习者基于知识的能力的总体影响;并在一项嵌套平行、双臂、个体随机对照试验中比较两种培训条件(有或没有辅导的自我指导数字培训)的效果。符合条件的参与者年龄在18岁及以上;能流利使用印地语或英语;能够进行数字培训;且此前没有提供结构化心理治疗的经验。从2022年3月31日至2022年6月19日共招募了277名参与者,其中230名(83%)完成了研究。在预培训评估6周后的培训后,能力得分从培训前(平均值=7.01,标准差=3.29)显著提高到培训后(平均值=8.88,标准差=3.80)。随机分配到辅导组的参与者的知识能力得分增幅更大(平均差=1.09,95%置信区间0.26 - 1.92,P = 0.01),效应量(Cohen's d)为0.33(95%置信区间0.08 - 0.58)。与自我指导培训组(n = 56,40.3%)相比,辅导组完成培训的参与者更多(n = 96,69.6%)。总之,由教练支持的远程数字培训干预与学习者参与度提高和心理治疗知识能力增强相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d85/10755375/02e48c30e232/S205442512300081X_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d85/10755375/a13d7f922bb2/S205442512300081X_figAb.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d85/10755375/02e48c30e232/S205442512300081X_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d85/10755375/a13d7f922bb2/S205442512300081X_figAb.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d85/10755375/02e48c30e232/S205442512300081X_fig1.jpg

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本文引用的文献

[1]
Knowledge of Problem Solving (KOPS) Scale: Design and Evaluation of a Digitally Administered Competence Measure for a Common Practice Element in Task-Shared Youth Mental Health Interventions.

J Technol Behav Sci. 2024

[2]
Coach-Supported Versus Self-guided Digital Training Course for a Problem-solving Psychological Intervention for Nonspecialists: Protocol for a Pre-Post Nested Randomized Controlled Trial.

JMIR Res Protoc. 2023-6-13

[3]
Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review.

JMIR Ment Health. 2022-5-12

[4]
Effectiveness and costs associated with a lay counselor-delivered, brief problem-solving mental health intervention for adolescents in urban, low-income schools in India: 12-month outcomes of a randomized controlled trial.

PLoS Med. 2021-9

[5]
Primary-level worker interventions for the care of people living with mental disorders and distress in low- and middle-income countries.

Cochrane Database Syst Rev. 2021-8-5

[6]
Design and Development of a Digital Program for Training Non-Specialist Health Workers to Deliver an Evidence-Based Psychological Treatment for Depression in Primary Care in India.

J Technol Behav Sci. 2020-12

[7]
Therapist training in evidence-based interventions for mental health: A systematic review of training approaches and outcomes.

Clin Psychol (New York). 2020-9

[8]
Digital training for non-specialist health workers to deliver a brief psychological treatment for depression in India: Protocol for a three-arm randomized controlled trial.

Contemp Clin Trials. 2021-3

[9]
Digital Training for Non-Specialist Health Workers to Deliver a Brief Psychological Treatment for Depression in Primary Care in India: Findings from a Randomized Pilot Study.

Int J Environ Res Public Health. 2020-9-1

[10]
Effectiveness of a brief lay counsellor-delivered, problem-solving intervention for adolescent mental health problems in urban, low-income schools in India: a randomised controlled trial.

Lancet Child Adolesc Health. 2020-6-23

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