Bondre Ameya P, Khan Azaz, Singh Abhishek, Singh Spriha, Shrivastava Ritu, Verma Narendra, Ranjan Aashish, Agrawal Jyotsna, Mehrotra Seema, Shidhaye Rahul, Bhan Anant, Naslund John A, Hollon Steve D, Tugnawat Deepak
Sangath, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh, 462042, India.
National Institute of Mental Health and Neurosciences, Hosur Road, Lakkasandra, Wilson Garden, Bengaluru, Karnataka, 560029, India.
Contemp Clin Trials Commun. 2024 Sep 27;42:101377. doi: 10.1016/j.conctc.2024.101377. eCollection 2024 Dec.
There is scarce knowledge on the use of structured positive psychology interventions for reducing work-stress and improving wellbeing of rural community health workers in India, particularly the Accredited Social Health Activists (ASHAs) who are village-level (resident women, incentivised) lay health workers. This trial will test the effectiveness of a 'character-strengths' based coaching intervention compared to routine supervision on wellbeing ('authentic happiness') of ASHAs.
This protocol is for a single-blind, parallel group randomized controlled trial comparing the effectiveness of a five-day residential workshop focusing on the use of character-strengths and subsequent 8- to 10-week remote telephonic coaching (weekly) to individually support ASHAs to improve their wellbeing, against routine health system support. The arms are intervention added to routine ASHA supervision (weekly, by the ASHA supervisor), and routine supervision alone (control arm). The target sample comprises 330 rural ASHAs in Madhya Pradesh, India. The primary outcome of mean Authentic Happiness Inventory (AHI) scores will be compared between arms at 3-month follow-up. Secondary outcomes will include an assessment of ASHA's self-reported affect, self-efficacy, flourishing, burnout, motivation, physical health symptoms, quality of life, and routine work performance indicators, and the consequent patient-level outcomes [e.g., service satisfaction and depression remission rates after receiving brief psychological treatment by trained ASHAs]. We will also evaluate the costs of developing and delivering the intervention.
This trial will determine whether a character-strengths based coaching intervention is an effective and scalable approach for reducing work-stress and improving wellbeing of rural ASHAs in low-resource settings.
对于在印度使用结构化积极心理学干预措施来减轻农村社区卫生工作者的工作压力并改善其幸福感，尤其是村一级（常住女性，有激励措施）的非专业卫生工作者——经认证的社会健康活动家（ASHAs），人们了解甚少。本试验将测试一种基于“性格优势”的辅导干预措施与常规监督相比，对ASHAs幸福感（“真实幸福”）的有效性。
本方案为单盲、平行组随机对照试验，比较一个为期五天的聚焦于性格优势运用的住宿式工作坊以及随后8至10周的远程电话辅导（每周一次）以单独支持ASHAs改善其幸福感的效果，与常规卫生系统支持相对比。试验组为在常规ASHAs监督（由ASHAs监督员每周进行）基础上增加干预，对照组为仅进行常规监督。目标样本包括印度中央邦的330名农村ASHAs。在3个月随访时，将比较两组的主要结局指标——平均真实幸福量表（AHI）得分。次要结局指标将包括对ASHAs自我报告的情感、自我效能感、蓬勃发展、倦怠、动机、身体健康症状、生活质量和常规工作绩效指标的评估，以及随之而来的患者层面的结局[例如，接受经过培训的ASHAs简短心理治疗后的服务满意度和抑郁缓解率]。我们还将评估开发和实施该干预措施的成本。
本试验将确定基于性格优势的辅导干预措施是否是一种在资源匮乏环境中减轻农村ASHAs工作压力并改善其幸福感的有效且可扩展的方法。
