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
Abstract
:1. Introduction
2. Material and Methods
2.1. Sample
2.2. Recruitment Procedure
2.3. Randomization
2.4. Training Programs
2.4.1. Conventional Face-to-Face Training (F2F)
2.4.2. Digital Training (DGT)
2.4.3. Digital Training with Remote Support (DGT+)
2.5. Outcome Assessment
2.5.1. Acceptability and Feasibility Indicators
2.5.2. Preliminary Effectiveness Outcome
2.6. Data Analysis
3. Results
3.1. Acceptability and Feasibility Indicators
3.2. Preliminary Effectiveness Outcome
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Socio-Demographic Characteristics | F2F n | DGT n | DGT+ n | p-Value |
---|---|---|---|---|
n = 14 | n = 14 | n = 14 | ||
Gender | 1 | |||
Female | 11 (79%) | 11 (79%) | 11 (79%) | |
Male | 3 (21%) | 3 (21%) | 3 (21%) | |
Designation | 1 | |||
ASHA | 8 (57%) | 7 (50%) | 8 (57%) | |
ASHA Facilitator | 3 (21%) | 4 (29%) | 3 (21%) | |
MPW | 3 (21%) | 3 (21%) | 3 (21%) | |
Education | 0.51 | |||
8th to 10th | 8 (57%) | 9 (64%) | 6 (43%) | |
Above 10th | 6 (43%) | 5 (36%) | 8 (57%) | |
Experience in years mean (95% CI) * | 9.73 (6.71, 12.76) | 8.96 (5.37, 12.55) | 8.38 (5.32, 11.44) | 0.8153 |
Age in years mean (95% CI) * | 36.07 (31.34, 40.80) | 37.71 (32.43, 42.99) | 36 (31.31, 40.68) | 0.8341 |
Type of mobile phone owned # | 0.931 | |||
Ordinary mobile phone | 7 (50%) | 6 (43%) | 6 (43%) | |
Smartphone | 7 (50%) | 7 (50%) | 8 (57%) | |
Family Size (number of persons in household) mean (95% CI) | 5.3 (4.19, 6.42) | 4.85 (3.07,6.63) | 5.35 (3.62, 7.09) | 0.868 |
Previous Experience in Mental Health Training ** | (n = 11) | (n = 12) | (n = 14) | 0.591 |
Yes | 5 (46%) | 8 (67%) | 8 (57%) | |
No | 6 (54%) | 4 (33%) | 6 (43%) | |
How many years before took part in the training mean (95% CI) * | 3 (0.67, 5.32) | 3 (2.22, 3.77) | 3.13 (1.6, 4.66) | 0.9814 |
Number of Participants | F2F (n = 14) | DGT (n = 14) | DGT+ (n = 14) |
---|---|---|---|
Started the training | 10 (71%) | 12 (86%) | 14 (100%) |
Completed the full training (all modules) | 8 (57%) | 8 (57%) | 11 (79%) |
Did not complete all of the modules in the training | 2 (14%) | 4 (29%) | 3 (21%) |
Number of phone calls made by participants for seeking technical assistance | NA | 149 | 57 |
Number of phone calls made by the research team to participants for follow up on their queries | NA | 106 | 87 |
Registered Queries by Phone | Specific Technical Challenges Encountered |
---|---|
Internet related |
|
Smartphone handling related |
|
Moodle Learning Management System app related |
|
Course navigation related |
|
Smartphone hardware/software related |
|
Domains of Satisfaction and Acceptability (F2F and DGT) | Study Arms | ||
---|---|---|---|
F2F (n = 11) | DGT (n = 12) | DGT+ (n = 13) | |
Mean (SD) | Mean (SD) | Mean (SD) | |
Acceptability | 5.6 (0.44) | 5.2 (1.10) | 5.5 (0.52) |
The instructor was available to answer my questions about the coursework (F2F)./I could find answers to questions I had about the coursework (DGT). | 5.6 (0.51) | 5.1 (1.16) | 5.5 (0.51) |
The instructor was willing to assist me if I needed help in the course (F2F)./Answers to questions about the coursework were easy to understand (DGT). | 5.4 (0.51) | 5.3 (1.40) | 5.2 (1.14) |
The instructor cared about how well I did in this course (F2F)./The instructor in the recorded lecture cared about helping me to learn (DGT). | 5.4 (1.26) | 5.3 (1.21) | 5.5 (0.66) |
The instructor was respectful of me (F2F)./The instructor in the recorded lecture used a respectful tone (DGT). | 5.7 (0.48) | 5.3 (1.21) | 5.5 (0.66) |
The instructor was friendly (F2F)./The instructor in the recorded lecture used a friendly tone (DGT). | 5.7 (0.48) | 4.8 (1.40) | 5.2 (1.16) |
I believe that the instructor cared about my feelings (F2F)./The recorded lecture used familiar language and expressions (DGT). | 5.6 (0.51) | 5.4 (1.24) | 5.8 (0.6) |
Appropriateness | 4.9 (0.57) | 5.0 (0.74) | 5.1 (0.64) |
The coursework held my attention (F2F/DGT). | 5.4 (0.51) | 5.3 (0.65) | 5.3 (1.10) |
The instructional methods used in this course held my attention (F2F/DGT). | 4.9 (1.59) | 5.0 (1.27) | 4.9 (1.38) |
I enjoyed the instructional methods used in this course (F2F/DGT). | 5.3 (0.48) | 5.3 (0.98) | 5.5 (0.77) |
The instructional methods engaged me in the course (F2F/DGT). | 2.7 (1.88) | 3.3 (1.82) | 4.0 (1.77) |
I enjoyed completing the coursework (F2F/DGT). | 5.7 (0.48) | 5.3 (1.13) | 5.5 (0.66) |
The coursework was interesting to me (F2F/DGT). | 5.5 (0.52) | 5.6 (0.66) | 5.5 (0.51) |
Adoption | 5.5 (0.38) | 5.5 (0.79) | 5.6 (0.43) |
In general, the coursework was useful to me (F2F/DGT). | 5.2 (0.42) | 5.5 (0.52) | 5.5 (0.51) |
The coursework was beneficial to me (F2F/DGT). | 5.3 (0.48) | 5.7 (0.65) | 5.7 (0.48) |
I found the coursework to be relevant to my future (F2F/DGT). | 5.7 (0.48) | 5.4 (0.79) | 5.6 (0.50) |
I will be able to use the knowledge I gained in this course (F2F/DGT). | 5.6 (0.51) | 5.4 (1.24) | 5.6 (0.50) |
The knowledge I gained in this course is important for my future (F2F/DGT). | 5.6 (0.51) | 5.6 (1.16) | 5.6 (0.50) |
Feasibility | 5.2 (0.40) | 5.4 (0.81) | 5.5 (0.42) |
I had the opportunity to decide for myself how to meet the course goals (F2F/DGT). | 4.9 (1.10) | 5.7 (0.49) | 5.8 (0.43) |
I was confident that I could succeed in the coursework (F2F/DGT). | 5.1 (1.19) | 5.3 (1.21) | 5.6 (0.50) |
I had the freedom to complete the coursework my own way (F2F/DGT). | 5.4 (0.51) | 5.3 (0.65) | 5.8 (0.43) |
I felt that I could be successful in meeting the academic challenges in this course (F2F/DGT). | 5.3 (0.48) | 5.2 (1.19) | 5.2 (1.21) |
I had options on how to achieve the goals of the course (F2F/DGT). | 4.4 (1.26) | 5.4 (0.79) | 5.2 (1.09) |
I was capable of getting a high grade in this course (F2F/DGT). | 5.5 (0.52) | 5.0 (1.53) | 5.5 (0.66) |
I had control over how I learned the course content (F2F/DGT). | 5.0 (1.15) | 5.2 (1.33) | 5.5 (0.66) |
Throughout the course, I felt that I could be successful on the coursework (F2F/DGT). | 5.3 (0.48) | 5.4 (1.16) | 5.6 (0.51) |
I had flexibility in what I was allowed to do in this course (F2F/DGT). | 5.5 (0.52) | 5.8 (0.38) | 5.6 (0.51) |
Focus Group Discussion Themes | F2F (n = 8) | DGT (n = 9) and DGT+ (n = 11) |
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Acceptability | ||
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Appropriateness | ||
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Adoption | ||
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Feasibility | ||
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Challenges and/or suggestions to address challenges |
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Muke, S.S.; Tugnawat, D.; Joshi, U.; Anand, A.; Khan, A.; Shrivastava, R.; Singh, A.; Restivo, J.L.; Bhan, A.; Patel, V.; et al. 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, 17, 6368. https://doi.org/10.3390/ijerph17176368
Muke SS, Tugnawat D, Joshi U, Anand A, Khan A, Shrivastava R, Singh A, Restivo JL, Bhan A, Patel V, et al. 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. International Journal of Environmental Research and Public Health. 2020; 17(17):6368. https://doi.org/10.3390/ijerph17176368
Chicago/Turabian StyleMuke, Shital S., Deepak Tugnawat, Udita Joshi, Aditya Anand, Azaz Khan, Ritu Shrivastava, Abhishek Singh, Juliana L. Restivo, Anant Bhan, Vikram Patel, and et al. 2020. "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" International Journal of Environmental Research and Public Health 17, no. 17: 6368. https://doi.org/10.3390/ijerph17176368
APA StyleMuke, S. S., Tugnawat, D., Joshi, U., Anand, A., Khan, A., Shrivastava, R., Singh, A., Restivo, J. L., Bhan, A., Patel, V., & Naslund, J. A. (2020). 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. International Journal of Environmental Research and Public Health, 17(17), 6368. https://doi.org/10.3390/ijerph17176368