Thais Izabel Ugeda Rocha1, Suzana Crismanis de Almeida Lopes Aschar2, Liliana Hidalgo-Padilla3, Kate Daley2, Heloísa Garcia Claro2, Hellen Carolina Martins Castro2, Daniela Vera Cruz Dos Santos2, J Jaime Miranda3, Ricardo Araya4, Paulo Rossi Menezes5. 1. Faculty of Medicine of Sao Paulo University-Preventive Medicine Department, Av. Dr. Arnaldo, 455-Cerqueira César, sala 2364, Sao Paulo, SP, 01246-903, Brazil. thais.ugeda@usp.br. 2. Faculty of Medicine of Sao Paulo University-Preventive Medicine Department, Av. Dr. Arnaldo, 455-Cerqueira César, sala 2364, Sao Paulo, SP, 01246-903, Brazil. 3. CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 445, Miraflores, Lima, Peru. 4. Centre for Global Mental Health and Primary Care Research, Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 18 De Crespigny Park, London, SE5 8AF, UK. 5. Faculty of Medicine of Sao Paulo University-Preventive Medicine Department, Av. Dr. Arnaldo, 455-Cerqueira César, sala 2364, Sao Paulo, SP, 01246-903, Brazil. pmenezes@usp.br.
Abstract
BACKGROUND: Task-shifting and technology in psychological interventions are two solutions to increasing access to mental health intervention and overcoming the treatment gap in low and middle-income countries. The CONEMO intervention combines a smartphone app with support from non-specialized professionals, aiming to treat depression in patients with diabetes and/or hypertension. The aim of this paper is to describe the process of recruitment, training and supervision of the non-specialized professionals who participated in the CONEMO task-shifting intervention in Brazil and Peru. METHODS: We described and analyzed data related to the recruitment, training and supervision of 62 nurse assistants from the health system in Sao Paulo, Brazil, and three hired nurses in Lima, Peru. The data were collected from information provided by nurses and nurse assistants, supervisor records from supervision meetings and the CONEMO platform database. RESULTS: We found that task-shifting was feasible using existing resources in Sao Paulo and additional human resources in Lima. Training and supervision were found to be crucial and well received by the staff; however, time was a limitation when using existing human resources. Ensuring technological competence prior to the start of the intervention was essential. Group supervision meetings allowed non-specialized professionals to learn from each other's experiences. CONCLUSION: Carefully considering recruitment, training and supervision of non-specialized professionals is important for effective task-shifting when delivering an mHealth intervention for depression. Opportunities and challenges of working in different health systems are described, which should be considered in future implementation, either for research or real settings. Trial registration NCT028406662 (Sao Paulo), NCT03026426 (Peru).
BACKGROUND: Task-shifting and technology in psychological interventions are two solutions to increasing access to mental health intervention and overcoming the treatment gap in low and middle-income countries. The CONEMO intervention combines a smartphone app with support from non-specialized professionals, aiming to treat depression in patients with diabetes and/or hypertension. The aim of this paper is to describe the process of recruitment, training and supervision of the non-specialized professionals who participated in the CONEMO task-shifting intervention in Brazil and Peru. METHODS: We described and analyzed data related to the recruitment, training and supervision of 62 nurse assistants from the health system in Sao Paulo, Brazil, and three hired nurses in Lima, Peru. The data were collected from information provided by nurses and nurse assistants, supervisor records from supervision meetings and the CONEMO platform database. RESULTS: We found that task-shifting was feasible using existing resources in Sao Paulo and additional human resources in Lima. Training and supervision were found to be crucial and well received by the staff; however, time was a limitation when using existing human resources. Ensuring technological competence prior to the start of the intervention was essential. Group supervision meetings allowed non-specialized professionals to learn from each other's experiences. CONCLUSION: Carefully considering recruitment, training and supervision of non-specialized professionals is important for effective task-shifting when delivering an mHealth intervention for depression. Opportunities and challenges of working in different health systems are described, which should be considered in future implementation, either for research or real settings. Trial registration NCT028406662 (Sao Paulo), NCT03026426 (Peru).
Authors: Ritsuko Kakuma; Harry Minas; Nadja van Ginneken; Mario R Dal Poz; Keshav Desiraju; Jodi E Morris; Shekhar Saxena; Richard M Scheffler Journal: Lancet Date: 2011-10-16 Impact factor: 79.321
Authors: Johan Ormel; Maria Petukhova; Somnath Chatterji; Sergio Aguilar-Gaxiola; Jordi Alonso; Matthias C Angermeyer; Evelyn J Bromet; Huibert Burger; Koen Demyttenaere; Giovanni de Girolamo; Josep Maria Haro; Irving Hwang; Elie Karam; Norito Kawakami; Jean Pierre Lépine; María Elena Medina-Mora; José Posada-Villa; Nancy Sampson; Kate Scott; T Bedirhan Ustün; Michael Von Korff; David R Williams; Mingyuan Zhang; Ronald C Kessler Journal: Br J Psychiatry Date: 2008-05 Impact factor: 9.319
Authors: Philip S Wang; Sergio Aguilar-Gaxiola; Jordi Alonso; Matthias C Angermeyer; Guilherme Borges; Evelyn J Bromet; Ronny Bruffaerts; Giovanni de Girolamo; Ron de Graaf; Oye Gureje; Josep Maria Haro; Elie G Karam; Ronald C Kessler; Viviane Kovess; Michael C Lane; Sing Lee; Daphna Levinson; Yutaka Ono; Maria Petukhova; José Posada-Villa; Soraya Seedat; J Elisabeth Wells Journal: Lancet Date: 2007-09-08 Impact factor: 79.321
Authors: Koen Demyttenaere; Ronny Bruffaerts; Jose Posada-Villa; Isabelle Gasquet; Viviane Kovess; Jean Pierre Lepine; Matthias C Angermeyer; Sebastian Bernert; Giovanni de Girolamo; Pierluigi Morosini; Gabriella Polidori; Takehiko Kikkawa; Norito Kawakami; Yutaka Ono; Tadashi Takeshima; Hidenori Uda; Elie G Karam; John A Fayyad; Aimee N Karam; Zeina N Mneimneh; Maria Elena Medina-Mora; Guilherme Borges; Carmen Lara; Ron de Graaf; Johan Ormel; Oye Gureje; Yucun Shen; Yueqin Huang; Mingyuan Zhang; Jordi Alonso; Josep Maria Haro; Gemma Vilagut; Evelyn J Bromet; Semyon Gluzman; Charles Webb; Ronald C Kessler; Kathleen R Merikangas; James C Anthony; Michael R Von Korff; Philip S Wang; Traolach S Brugha; Sergio Aguilar-Gaxiola; Sing Lee; Steven Heeringa; Beth-Ellen Pennell; Alan M Zaslavsky; T Bedirhan Ustun; Somnath Chatterji Journal: JAMA Date: 2004-06-02 Impact factor: 56.272
Authors: Philip S Wang; Matthias Angermeyer; Guilherme Borges; Ronny Bruffaerts; Wai Tat Chiu; Giovanni DE Girolamo; John Fayyad; Oye Gureje; Josep Maria Haro; Yueqin Huang; Ronald C Kessler; Viviane Kovess; Daphna Levinson; Yoshibumi Nakane; Mark A Oakley Brown; Johan H Ormel; José Posada-Villa; Sergio Aguilar-Gaxiola; Jordi Alonso; Sing Lee; Steven Heeringa; Beth-Ellen Pennell; Somnath Chatterji; T Bedirhan Ustün Journal: World Psychiatry Date: 2007-10 Impact factor: 49.548
Authors: Mauricio Toyama; Humberto Castillo; Jerome T Galea; Lena R Brandt; María Mendoza; Vanessa Herrera; Martha Mitrani; Yuri Cutipé; Victoria Cavero; Francisco Diez-Canseco; J Jaime Miranda Journal: Int J Health Policy Manag Date: 2017-09-01
Authors: Paulo Menezes; Julieta Quayle; Heloísa Garcia Claro; Simone da Silva; Lena R Brandt; Francisco Diez-Canseco; J Jaime Miranda; LeShawndra N Price; David C Mohr; Ricardo Araya Journal: JMIR Ment Health Date: 2019-04-26
Authors: V Cavero; M Toyama; H Castro; M T Couto; L Brandt; J Quayle; P R Menezes; D C Mohr; R Araya; J J Miranda; F Diez-Canseco Journal: Discov Ment Health Date: 2022-06-03
Authors: Mauricio Toyama; Victoria Cavero; Ricardo Araya; Paulo Rossi Menezes; David C Mohr; J Jaime Miranda; Francisco Diez-Canseco Journal: JMIR Hum Factors Date: 2022-09-15