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Triplett NS, Mbwayo A, Kiche S, Liu L, Silva J, AlRasheed R, Johnson C, Amanya C, Munson S, Weiner BJ, Collins PY, Dorsey S. Co-developed implementation guidelines to maximize acceptability, feasibility, and usability of mobile phone supervision in Kenya. Glob Ment Health (Camb) 2023; 10:e31. [PMID: 37854429 PMCID: PMC10579659 DOI: 10.1017/gmh.2023.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/11/2023] [Accepted: 05/16/2023] [Indexed: 10/20/2023] Open
Abstract
Opportunities exist to leverage mobile phones to replace or supplement in-person supervision of lay counselors. However, contextual variables, such as network connectivity and provider preferences, must be considered. Using an iterative and mixed methods approach, we co-developed implementation guidelines to support the implementation of mobile phone supervision with lay counselors and supervisors delivering a culturally adapted trauma-focused cognitive behavioral therapy in Western Kenya. Guidelines were shared and discussed with lay counselors in educational outreach visits led by supervisors. We evaluated the impact of guidelines and outreach on the acceptability, feasibility, and usability of mobile phone supervision. Guidelines were associated with significant improvements in acceptability and usability of mobile phone supervision. There was no evidence of a significant difference in feasibility. Qualitative interviews with lay counselors and supervisors contextualized how guidelines impacted acceptability and feasibility - by setting expectations for mobile phone supervision, emphasizing importance, increasing comfort, and sharing strategies to improve mobile phone supervision. Introducing and discussing co-developed implementation guidelines significantly improved the acceptability and usability of mobile phone supervision. This approach may provide a flexible and scalable model to address challenges with implementing evidence-based practices and implementation strategies in lower-resourced areas.
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Affiliation(s)
- Noah S. Triplett
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Anne Mbwayo
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | - Sharon Kiche
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Lucy Liu
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Jacinto Silva
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Rashed AlRasheed
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Clara Johnson
- Department of Psychology, University of Washington, Seattle, WA, USA
| | | | - Sean Munson
- Department of Human Centered Design & Engineering, University of Washington, Seattle, WA, USA
| | - Bryan J. Weiner
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Pamela Y. Collins
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Shannon Dorsey
- Department of Psychology, University of Washington, Seattle, WA, USA
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Mavragani A, Johnson C, Kiche S, Dastrup K, Nguyen J, Daniels A, Mbwayo A, Amanya C, Munson S, Collins PY, Weiner BJ, Dorsey S. Understanding Lay Counselor Perspectives on Mobile Phone Supervision in Kenya: Qualitative Study. JMIR Form Res 2023; 7:e38822. [PMID: 36729591 PMCID: PMC9936369 DOI: 10.2196/38822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 12/15/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Task shifting is an effective model for increasing access to mental health treatment via lay counselors with less specialized training that deliver care under supervision. Mobile phones may present a low-technology opportunity to replace or decrease reliance on in-person supervision in task shifting, but important technical and contextual limitations must be examined and considered. OBJECTIVE Guided by human-centered design methods, we aimed to understand how mobile phones are currently used when supervising lay counselors, determine the acceptability and feasibility of mobile phone supervision, and generate solutions to improve mobile phone supervision. METHODS Participants were recruited from a large hybrid effectiveness implementation study in western Kenya wherein teachers and community health volunteers were trained to provide trauma-focused cognitive behavioral therapy. Lay counselors (n=24) and supervisors (n=3) participated in semistructured interviews in the language of the participants' choosing (ie, English or Kiswahili). Lay counselor participants were stratified by supervisor-rated frequency of mobile phone use such that interviews included high-frequency, average-frequency, and low-frequency phone users in equal parts. Supervisors rated lay counselors on frequency of phone contact (ie, calls and SMS text messages) relative to their peers. The interviews were transcribed, translated when needed, and analyzed using thematic analysis. RESULTS Participants described a range of mobile phone uses, including providing clinical updates, scheduling and coordinating supervision and clinical groups, and supporting research procedures. Participants liked how mobile phones decreased burden, facilitated access to clinical and personal support, and enabled greater independence of lay counselors. Participants disliked how mobile phones limited information transmission and relationship building between supervisors and lay counselors. Mobile phone supervision was facilitated by access to working smartphones, ease and convenience of mobile phone supervision, mobile phone literacy, and positive supervisor-counselor relationships. Limited resources, technical difficulties, communication challenges, and limitations on which activities can be effectively performed via mobile phone were barriers to mobile phone supervision. Lay counselors and supervisors generated 27 distinct solutions to increase the acceptability and feasibility of mobile phone supervision. Strategies ranged in terms of the resources required and included providing phones and airtime to support supervision, identifying quiet and private places to hold mobile phone supervision, and delineating processes for requesting in-person support. CONCLUSIONS Lay counselors and supervisors use mobile phones in a variety of ways; however, there are distinct challenges to their use that must be addressed to optimize acceptability, feasibility, and usability. Researchers should consider limitations to implementing digital health tools and design solutions alongside end users to optimize the use of these tools. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s43058-020-00102-9.
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Affiliation(s)
| | - Clara Johnson
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Sharon Kiche
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Kara Dastrup
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Julie Nguyen
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Alayna Daniels
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Anne Mbwayo
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | | | - Sean Munson
- Human Centered Design & Engineering, University of Washington, Seattle, WA, United States
| | - Pamela Y Collins
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States
| | - Bryan J Weiner
- Department of Global Health, University of Washington, Seattle, WA, United States.,Department of of Health Services, University of Washington, Seattle, WA, United States
| | - Shannon Dorsey
- Department of Psychology, University of Washington, Seattle, WA, United States
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Triplett NS, Munson S, Mbwayo A, Mutavi T, Weiner BJ, Collins P, Amanya C, Dorsey S. Applying human-centered design to maximize acceptability, feasibility, and usability of mobile technology supervision in Kenya: a mixed methods pilot study protocol. Implement Sci Commun 2021; 2:2. [PMID: 33413688 PMCID: PMC7792108 DOI: 10.1186/s43058-020-00102-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/14/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although research continues to support task-shifting as an effective model of delivering evidence-based practices (EBPs), little scholarship has focused how to scale up and sustain task-shifting in low- and middle-income countries, including how to sustainably supervise lay counselors. Ongoing supervision is critical to ensure EBPs are delivered with fidelity; however, the resources and expertise required to provide ongoing supervision may limit the potential to scale up and sustain task shifting. Opportunities may exist to leverage mobile technology to replace or supplement in-person supervision in low-resource contexts, but contextual variables, such as network connectivity and lay counselor preferences surrounding mobile technology, must be examined and considered when designing and implementing mobile technology supervision. METHODS This study builds from an existing randomized trial in Kenya, wherein teachers and community health volunteers have been trained to provide trauma-focused cognitive behavioral therapy as lay counselors. The study will use an iterative and mixed methods approach, with qualitative interviews and a Human-Centered Design (HCD) workshop informing a non-randomized pilot trial. Semi-structured interviews will be conducted with lay counselors and supervisors to understand how mobile technology is currently being used for supervision and determine the barriers and facilitators to mobile technology supervision. Data from these interviews will inform an HCD workshop, where lay counselors and supervisors "re-design" supervision to most effectively leverage mobile technology. Workshop participants will also participate in focus groups to gather perceptions on the use of HCD techniques. The final outcome of the workshop will be a set of refined workflows, which will be tested in a mixed method, nonrandomized pilot with newly trained lay counselors and existing supervisors. The pilot trial will evaluate the acceptability, feasibility, and usability of mobile technology supervision through self-report questionnaires as well as perceptions of effectiveness through qualitative interviews with a subset of lay counselors and all supervisors. DISCUSSION This study will provide a launching point for future research on supervision and methods to engage stakeholders to design and tailor interventions and implementation supports to fit low-resourced contexts. TRIAL REGISTRATION The parent trial from which this study builds was registered on ClinicalTrials.gov on August 9, 2017 ( NCT03243396 ).
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Affiliation(s)
- Noah S. Triplett
- Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA 98195 USA
| | - Sean Munson
- Department of Human Centered Design & Engineering, University of Washington, 428 Sieg Hall, Box 352315, Seattle, WA 98195 USA
| | - Anne Mbwayo
- Department of Psychiatry, University of Nairobi, P.O. Box 19676, Nairobi, 00202 Kenya
| | - Teresia Mutavi
- Department of Psychiatry, University of Nairobi, P.O. Box 19676, Nairobi, 00202 Kenya
| | - Bryan J. Weiner
- Department of Global Health, University of Washington, Harris Hydraulics Laboratory, 1510 San Juan Road, Seattle, WA 98195 USA
- Department of Health Services, School of Public Health, University of Washington, Box 357965, Seattle, WA 98195 USA
| | - Pamela Collins
- Department of Global Health, University of Washington, Harris Hydraulics Laboratory, 1510 San Juan Road, Seattle, WA 98195 USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Box 356560, Seattle, WA 98195 USA
| | - Cyrilla Amanya
- Research Department, Ace Africa Kenya, P.O. Box 1185, Bungoma, 50200 Kenya
| | - Shannon Dorsey
- Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA 98195 USA
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Meza RD, Kiche S, Soi C, Khairuzzaman AN, Nales CJR, Whetten K, Wasonga AI, Amanya C, Dorsey S. Barriers and facilitators of child and guardian attendance in task-shifted mental health services in schools in western Kenya. Glob Ment Health (Camb) 2020; 7:e16. [PMID: 32742674 PMCID: PMC7379319 DOI: 10.1017/gmh.2020.9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/12/2020] [Accepted: 05/22/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Globally, nearly 140 million children have experienced the death of one or both parents, and as a result many experience higher rates of mental health problems. Trauma-focused cognitive behavioral therapy (TF-CBT) delivered by lay counselors has been shown to improve mental health outcomes for children experiencing traumatic grief due to parental loss; however, challenges with treatment attendance limit the public health impact of mental health services. This study used qualitative methods to assess barriers and facilitators of child and guardian attendance of school-based lay counselor delivered TF-CBT. METHODS Semi-structured interviews were conducted with 36 lay counselors (18 teachers; 18 community health volunteers) who delivered TF-CBT to explore their perceptions of barriers of facilitators of child and guardian attendance of group-based sessions delivered in schools. RESULTS Counselors identified attendance barriers and facilitators related to the delivery setting, resources, participant characteristics, intervention characteristics and counselor behaviors. The findings revealed a greater number of facilitators than barriers. Common facilitators included participant and counselor resources, counselor commitment behaviors and communication efforts to encourage attendance. Barriers were less frequently endorsed, with participant resources, child or guardian illness and communication challenges most commonly mentioned. CONCLUSIONS Attention to barriers and facilitators of attendance in the context in which mental health interventions are delivered allows for identification of ways to improve attendance and treatment engagement and achieve the potential promise of providing accessible mental health services.
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Affiliation(s)
- Rosemary D. Meza
- Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA98195, USA
| | - Sharon Kiche
- SMART Center, Psychiatry and Behavioral Sciences, University of Washington, 6200 NE 74th Street, Suite 110, Seattle, WA98115, USA
| | - Caroline Soi
- Department of Global Health, Harris Hydraulics Laboratory, University of Washington, 1510 San Juan Road, Seattle, WA98195, USA
| | - Alya N. Khairuzzaman
- Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA98195, USA
| | - Cristian J. Rivera Nales
- Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA98195, USA
| | - Kathryn Whetten
- Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Box 90519, Durham, NC27708, USA
- Terry Sanford Institute of Public Policy, Duke Global Health Institute, Duke University, Box 90239, Durham, NC27708, USA
| | | | - Cyrilla Amanya
- Research Department, Ace Africa Kenya, P.O. Box 1185, 50200 Bungoma, Kenya
| | - Shannon Dorsey
- Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA98195, USA
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Eagle DE, Kinghorn WA, Parnell H, Amanya C, Vann V, Tzudir S, Kaza VGK, Safu CT, Whetten K, Proeschold-Bell RJ. Religion and Caregiving for Orphans and Vulnerable Children: A Qualitative Study of Caregivers Across Four Religious Traditions and Five Global Contexts. J Relig Health 2020; 59:1666-1686. [PMID: 31808025 DOI: 10.1007/s10943-019-00955-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Studies of caregivers of orphans and vulnerable children (OVC) rarely examine the role religion plays in their lives. We conducted qualitative interviews of 69 caregivers in four countries: Ethiopia, Kenya, Cambodia, and India (Hyderabad and Nagaland), and across four religious traditions: Christian (Orthodox, Roman Catholic, and Protestant), Muslim, Buddhist, and Hindu. We asked respondents to describe the importance of religion for their becoming a caregiver, the way in which religion has helped them make sense of why children are orphans, and how religion helps them face the challenges of their occupation. Using qualitative descriptive analysis, three major themes emerged. Respondents discussed how religion provided a strong motivation for their work, reported that religious institutions were often the way in which they were introduced to caregiving as an occupation, and spoke of the ways religious practices sustain them in their work. They rarely advanced religion as an explanation for why OVC exist-only when pressed did they offer explicitly religious accounts. This study has implications for OVC care, including the importance of engaging religious institutions to support caregivers, the significance of attending to local religious context, and the vital need for research outside of Christian contexts.
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Affiliation(s)
- David E Eagle
- Center for Health Policy and Inequalities Research, Duke University, 310 Trent Drive CB 90392, Durham, NC, 27708, USA.
| | - Warren A Kinghorn
- Duke University Medical Center and Duke Divinity School, Durham, USA
| | - Heather Parnell
- Center for Health Policy and Inequalities Research, Duke University, 310 Trent Drive CB 90392, Durham, NC, 27708, USA
| | | | - Vanroth Vann
- Development for Cambodian Children, Battambang City, Cambodia
| | - Senti Tzudir
- Sahara Centre for Residential Care & Rehabilitation, Hyderabad, India
| | | | | | - Kathryn Whetten
- Center for Health Policy and Inequalities Research, Duke University, 310 Trent Drive CB 90392, Durham, NC, 27708, USA
| | - Rae Jean Proeschold-Bell
- Center for Health Policy and Inequalities Research, Duke University, 310 Trent Drive CB 90392, Durham, NC, 27708, USA
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Dorsey S, Gray CL, Wasonga AI, Amanya C, Weiner BJ, Belden CM, Martin P, Meza RD, Weinhold AK, Soi C, Murray LK, Lucid L, Turner EL, Mildon R, Whetten K. Advancing successful implementation of task-shifted mental health care in low-resource settings (BASIC): protocol for a stepped wedge cluster randomized trial. BMC Psychiatry 2020; 20:10. [PMID: 31914959 PMCID: PMC6947833 DOI: 10.1186/s12888-019-2364-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 11/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The mental health treatment gap-the difference between those with mental health need and those who receive treatment-is high in low- and middle-income countries. Task-shifting has been used to address the shortage of mental health professionals, with a growing body of research demonstrating the effectiveness of mental health interventions delivered through task-shifting. However, very little research has focused on how to embed, support, and sustain task-shifting in government-funded systems with potential for scale up. The goal of the Building and Sustaining Interventions for Children (BASIC) study is to examine implementation policies and practices that predict adoption, fidelity, and sustainment of a mental health intervention in the education sector via teacher delivery and the health sector via community health volunteer delivery. METHODS BASIC is a Hybrid Type II Implementation-Effectiveness trial. The study design is a stepped wedge, cluster randomized trial involving 7 sequences of 40 schools and 40 communities surrounding the schools. Enrollment consists of 120 teachers, 120 community health volunteers, up to 80 site leaders, and up to 1280 youth and one of their primary guardians. The evidence-based mental health intervention is a locally adapted version of Trauma-focused Cognitive Behavioral Therapy, called Pamoja Tunaweza. Lay counselors are trained and supervised in Pamoja Tunaweza by local trainers who are experienced in delivering the intervention and who participated in a Train-the-Trainer model of skills transfer. After the first sequence completes implementation, in-depth interviews are conducted with initial implementing sites' counselors and leaders. Findings are used to inform delivery of implementation facilitation for subsequent sequences' sites. We use a mixed methods approach including qualitative comparative analysis to identify necessary and sufficient implementation policies and practices that predict 3 implementation outcomes of interest: adoption, fidelity, and sustainment. We also examine child mental health outcomes and cost of the intervention in both the education and health sectors. DISCUSSION The BASIC study will provide knowledge about how implementation of task-shifted mental health care can be supported in government systems that already serve children and adolescents. Knowledge about implementation policies and practices from BASIC can advance the science of implementation in low-resource contexts. TRIAL REGISTRATION Trial Registration: ClinicalTrials.gov Identifier: NCT03243396. Registered 9th August 2017, https://clinicaltrials.gov/ct2/show/NCT03243396.
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Affiliation(s)
- Shannon Dorsey
- Department of Psychology, University of Washington Guthrie Hall 119A, Box 351525, Seattle, WA, 98195, USA.
| | - Christine L Gray
- Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Campus Box 90392, Durham, NC, 27710, USA
| | | | - Cyrilla Amanya
- Research Department, Ace Africa Kenya, P.O. Box 1185, Bungoma, 50200, Kenya
| | - Bryan J Weiner
- Department of Global Health, University of Washington, Harris Hydraulics Laboratory, 1510 San Juan Road, Seattle, WA, 98195, USA
- Department of Health Services, School of Public Health, University of Washington, Box 357965, Seattle, WA, 98195, USA
| | - C Micha Belden
- Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Campus Box 90392, Durham, NC, 27710, USA
| | - Prerna Martin
- Department of Psychology, University of Washington Guthrie Hall 119A, Box 351525, Seattle, WA, 98195, USA
| | - Rosemary D Meza
- Department of Psychology, University of Washington Guthrie Hall 119A, Box 351525, Seattle, WA, 98195, USA
| | - Andrew K Weinhold
- Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Campus Box 90392, Durham, NC, 27710, USA
| | - Caroline Soi
- Department of Global Health, University of Washington, Harris Hydraulics Laboratory, 1510 San Juan Road, Seattle, WA, 98195, USA
| | - Laura K Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, 8th floor, Baltimore, MD, 21205, USA
| | - Leah Lucid
- Department of Psychology, University of Washington Guthrie Hall 119A, Box 351525, Seattle, WA, 98195, USA
| | - Elizabeth L Turner
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Duke University, Durham, NC, 27710, USA
- Duke Global Health Institute, Duke University, Campus Box 90519, Durham, NC, 27708, USA
| | - Robyn Mildon
- Centre for Evidence and Implementation, 33 Lincoln Square South, Carlton, Victoria, 3053, Australia
| | - Kathryn Whetten
- Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Campus Box 90392, Durham, NC, 27710, USA
- Terry Sanford Institute of Public Policy, Duke University, Box 90239, Durham, NC, 27708, USA
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Dorsey S, Meza RD, Martin P, Gray CL, Triplett NS, Soi C, Woodard GS, Lucid L, Amanya C, Wasonga A, Whetten K. Lay Counselor Perspectives of Providing a Child-Focused Mental Health Intervention for Children: Task-Shifting in the Education and Health Sectors in Kenya. Front Psychiatry 2019; 10:860. [PMID: 31920736 PMCID: PMC6928041 DOI: 10.3389/fpsyt.2019.00860] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 11/01/2019] [Indexed: 01/23/2023] Open
Abstract
The global mental health treatment gap has increasingly been addressed using task-shifting; however, very little research has focused on lay counselors' perspectives on the acceptability, feasibility, and appropriateness of mental health interventions in specific government-supported sectors that might scale up and sustain mental health care for children and adolescents. In western Kenya, these sectors include Education and Health. Data come from a large hybrid effectiveness-implementation study examining implementation practices and policies in either or both sectors that support successful implementation of a child-focused intervention, Trauma-focused Cognitive Behavioral Therapy (TF-CBT), for children and adolescents who had experienced parental death. We examined lay counselors' self-report of acceptability, feasibility, and appropriateness of TF-CBT. Lay counselors were teachers (n = 30) from the Education sector and Community Health Volunteers (CHVs; n = 30) from the Health sector, who were part of Sequence 1 of a large stepped-wedge, cluster randomized trial. Lay counselor self-report surveys included reflective and formative measurement of acceptability, feasibility, and appropriateness administered after lay counselors in both sectors had experience delivering the locally-adapted, group-based TF-CBT intervention. Descriptive statistics (means, standard deviations) were used to understand counselors' perspectives stratified by sector. Both teachers and CHVs endorsed high acceptability, feasibility, and appropriateness of TF-CBT, with lay counselors' responses on items from the formative measures providing some insight into specific aspects of acceptability, feasibility, and appropriateness that may be important to consider when planning for implementation support. These early findings suggest that both sectors may hold promise for task-shifting of mental health care for children and adolescents but also underline the importance of considering the multiple facets of these three implementation outcomes as well as lay counselor context (Education vs. Health).
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Affiliation(s)
- Shannon Dorsey
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Rosemary D. Meza
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Prerna Martin
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Christine L. Gray
- Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Noah S. Triplett
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Caroline Soi
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Grace S. Woodard
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Leah Lucid
- Department of Psychology, University of Washington, Seattle, WA, United States
| | | | | | - Kathryn Whetten
- Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC, United States
- Terry Sanford Institute of Public Policy, Duke University, Durham, NC, United States
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Kinghorn WA, Keyes CLM, Parnell HE, Eagle DE, Biru BM, Amanya C, Vann V, Krishna Kaza VG, Tzudir S, Saddo YB, Whetten K, Proeschold-Bell RJ. Putting virtues in context: engaging the VIA classification of character strengths in caregiving for orphans and vulnerable children across cultures. The Journal of Positive Psychology 2019. [DOI: 10.1080/17439760.2019.1579363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Warren A. Kinghorn
- Department of Psychiatry and Behavioral Sciences, Duke Divinity School, Duke University Medical Center, Durham, NC, USA
| | | | - Heather E. Parnell
- Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA
| | - David E. Eagle
- Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA
| | - Blen M. Biru
- Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA
| | | | - Vanroth Vann
- Development for Cambodian Children, Battambang, Cambodia
| | | | - Senti Tzudir
- Sahara Centre for Residential Care & Rehabilitation, New Delhi, India
| | | | - Kathryn Whetten
- Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA
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