Noah S Triplett1, Sean Munson2, Anne Mbwayo3, Teresia Mutavi3, Bryan J Weiner4,5, Pamela Collins4,6, Cyrilla Amanya7, Shannon Dorsey8. 1. Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA, 98195, USA. nst7@uw.edu. 2. Department of Human Centered Design & Engineering, University of Washington, 428 Sieg Hall, Box 352315, Seattle, WA, 98195, USA. 3. Department of Psychiatry, University of Nairobi, P.O. Box 19676, Nairobi, 00202, Kenya. 4. Department of Global Health, University of Washington, Harris Hydraulics Laboratory, 1510 San Juan Road, Seattle, WA, 98195, USA. 5. Department of Health Services, School of Public Health, University of Washington, Box 357965, Seattle, WA, 98195, USA. 6. Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Box 356560, Seattle, WA, 98195, USA. 7. Research Department, Ace Africa Kenya, P.O. Box 1185, Bungoma, 50200, Kenya. 8. Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA, 98195, USA.
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 ).
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 ).
Entities:
Keywords:
Human-centered design; Mobile technology; Supervision; Task-shifting
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