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在印度古吉拉特邦农村地区,调整并部署一个数字项目,用于培训非专科医疗服务提供者开展针对抑郁症的简短心理干预。

Adapting and deploying a digital program for training non-specialist providers on a brief psychological intervention for depression in rural Gujarat, India.

作者信息

Brahmbhatt Aakrushi, Rathod Darshana, Joshi Udita, Khan Azaz, Teja G Sai, Desai Shrey, Chauhan Ajay, Shah Shobha, Bhatt Deepti, Venkatraman Sethuraman, Tugnawat Deepak, Balsari Satchit, Patel Vikram, Bhan Anant, Naslund John A

机构信息

Sangath Bhopal Hub, Bhopal, Madhya Pradesh, India.

Society for Education Welfare and Action-Rural, SEWA RURAL, Jhagadia, Bharuch, Gujarat, India.

出版信息

PLOS Glob Public Health. 2024 Dec 5;4(12):e0003967. doi: 10.1371/journal.pgph.0003967. eCollection 2024.

DOI:10.1371/journal.pgph.0003967
PMID:39636831
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11620360/
Abstract

Workforce shortages represent a major bottleneck to delivering depression care, particularly in lower resource settings. This pilot study aimed to assess the acceptability and feasibility of a digital training program on developing knowledge and skills in the delivery of a brief behavioral activation intervention for depression among non-specialist providers (NSPs) in Gujarat, India. Participating NSPs, such as community health workers and other frontline providers without specialized training in mental health care, were provided access to a digital program covering the core skills and content necessary to deliver the Healthy Activity Program, an evidence-based behavioral activation intervention for depression. NSPs completed knowledge assessments before and after the digital training, followed by focus group discussions to gather their feedback about the program content and delivery format. Of 43 NSPs enrolled in this study, 67% (n = 29) were community health workers called Accredited Social Health Activists and 33% (n = 14) were frontline mid-level health providers called Community Health Officers. Most participants (n = 39; 91%) completed the full course. Knowledge assessment scores showed improvement from pre-training (mean = 29.96; 95% CI: 27.12-32.81) to post-training (mean = 34.62; 95% CI: 31.05-38.19; p = 0.0448). Focus group discussions revealed that participants appreciated the digital mode of training despite facing technical challenges while completing the course. This study further supports the feasibility and acceptability of digital approaches for training frontline providers to deliver brief psychological interventions for depression. With adequate resources and proper execution, digital training holds potential to serve as a key tool to build capacity of NSPs and expand the mental health workforce in India.

摘要

劳动力短缺是提供抑郁症护理的主要瓶颈,在资源较少的地区尤其如此。这项试点研究旨在评估一项数字培训计划的可接受性和可行性,该计划旨在培养印度古吉拉特邦非专科医疗服务提供者(NSPs)在提供抑郁症简短行为激活干预方面的知识和技能。参与的NSPs,如社区卫生工作者和其他未接受过精神卫生保健专门培训的一线医疗服务提供者,能够访问一个数字课程,该课程涵盖了实施健康活动计划所需的核心技能和内容,这是一种基于证据的抑郁症行为激活干预措施。NSPs在数字培训前后完成了知识评估,随后进行了焦点小组讨论,以收集他们对课程内容和授课形式的反馈。在这项研究纳入的43名NSPs中,67%(n = 29)是被称为“经认证的社会健康活动家”的社区卫生工作者,33%(n = 14)是被称为“社区卫生官员”的一线中级卫生服务提供者。大多数参与者(n = 39;91%)完成了全部课程。知识评估分数显示,从培训前(平均值 = 29.96;95%置信区间:27.12 - 32.81)到培训后(平均值 = 34.62;95%置信区间:31.05 - 38.19;p = 0.0448)有所提高。焦点小组讨论表明,尽管在完成课程时面临技术挑战,但参与者对数字培训模式表示赞赏。这项研究进一步支持了数字方法在培训一线医疗服务提供者以提供抑郁症简短心理干预方面的可行性和可接受性。有了充足的资源和妥善的实施,数字培训有潜力成为增强NSPs能力和扩大印度精神卫生劳动力队伍的关键工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7499/11620360/9945ca55c99b/pgph.0003967.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7499/11620360/9945ca55c99b/pgph.0003967.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7499/11620360/9945ca55c99b/pgph.0003967.g001.jpg

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