PDF(Pubmed)
Abstract：
BACKGROUND: The unmet need for mental health care affects millions of Americans. A growing body of evidence in implementation science supports the effectiveness of task sharing in the delivery of brief psychosocial interventions. The digitization of training and processes supporting supervision can rapidly scale up task-shared interventions and enable frontline health workers (FLWs) to learn, master, and deliver interventions with quality and support.
OBJECTIVE: We aimed to assess the perceived feasibility and acceptability of a novel mobile and web app designed and adapted to support the supervision, training, and quality assurance of FLWs delivering brief psychosocial interventions.
METHODS: We followed human-centered design principles to adapt a prototype app for FLWs delivering brief psychosocial interventions for depression, drawing from an app previously designed for use in rural India. Using a multimethod approach, we conducted focus group sessions comprising usability testing and group interviews with FLWs recruited from a large health system in Texas to assess the feasibility and acceptability of the app. The positive System Usability Scale was used to determine the app\'s overall usability. We also calculated the participants\' likelihood of recommending the app to others using ratings of 0 to 10 from least to most likely (net promoter score). Focus group transcripts were coded and analyzed thematically, and recommendations were summarized across 4 key domains.
RESULTS: A total of 18 FLWs varying in role and experience with client care participated in the study. Participants found the app to be usable, with an average System Usability Scale score of 72.5 (SD 18.1), consistent with the industry benchmark of 68. Participants\' likelihood of recommending the app ranged from 5 to 10, yielding a net promoter score of 0, indicating medium acceptability. Overall impressions of the app from participants were positive. Most participants (15/18, 83%) found the app easy to access and navigate. The app was considered important to support FLWs in delivering high-quality mental health care services. Participants felt that the app could provide more structure to FLW training and supervision processes through the systematic collection and facilitation of performance-related feedback. Key concerns included privacy-related and time constraints regarding implementing a separate peer supervision mechanism that may add to FLWs\' workloads.
CONCLUSIONS: We designed, built, and tested a usable, functional mobile and web app prototype that supports FLW-delivered psychosocial interventions in the United States through a structured supervision mechanism and systematic collection and review of performance measures. The app has the potential to scale the work of FLWs tasked with delivering these interventions to the hardest-to-reach communities they serve. The results of this project will inform future work to evaluate the app\'s use and efficacy in real-world settings to support task-shared mental health programs across the United States.
OBJECTIVE: We aimed to assess the perceived feasibility and acceptability of a novel mobile and web app designed and adapted to support the supervision, training, and quality assurance of FLWs delivering brief psychosocial interventions.
METHODS: We followed human-centered design principles to adapt a prototype app for FLWs delivering brief psychosocial interventions for depression, drawing from an app previously designed for use in rural India. Using a multimethod approach, we conducted focus group sessions comprising usability testing and group interviews with FLWs recruited from a large health system in Texas to assess the feasibility and acceptability of the app. The positive System Usability Scale was used to determine the app\'s overall usability. We also calculated the participants\' likelihood of recommending the app to others using ratings of 0 to 10 from least to most likely (net promoter score). Focus group transcripts were coded and analyzed thematically, and recommendations were summarized across 4 key domains.
RESULTS: A total of 18 FLWs varying in role and experience with client care participated in the study. Participants found the app to be usable, with an average System Usability Scale score of 72.5 (SD 18.1), consistent with the industry benchmark of 68. Participants\' likelihood of recommending the app ranged from 5 to 10, yielding a net promoter score of 0, indicating medium acceptability. Overall impressions of the app from participants were positive. Most participants (15/18, 83%) found the app easy to access and navigate. The app was considered important to support FLWs in delivering high-quality mental health care services. Participants felt that the app could provide more structure to FLW training and supervision processes through the systematic collection and facilitation of performance-related feedback. Key concerns included privacy-related and time constraints regarding implementing a separate peer supervision mechanism that may add to FLWs\' workloads.
CONCLUSIONS: We designed, built, and tested a usable, functional mobile and web app prototype that supports FLW-delivered psychosocial interventions in the United States through a structured supervision mechanism and systematic collection and review of performance measures. The app has the potential to scale the work of FLWs tasked with delivering these interventions to the hardest-to-reach communities they serve. The results of this project will inform future work to evaluate the app\'s use and efficacy in real-world settings to support task-shared mental health programs across the United States.
摘要：
背景：未满足的精神卫生保健需求影响着数百万美国人。实施科学中越来越多的证据支持任务共享在提供简短的社会心理干预方面的有效性。支持监督的培训和流程的数字化可以快速扩展任务共享干预措施，并使一线卫生工作者(FLW)能够学习，主人,并提供质量和支持的干预措施。
目的：我们旨在评估为支持监管而设计和调整的新型移动和网络应用程序的可行性和可接受性，培训,以及提供简短心理社会干预措施的FLW的质量保证。
方法：我们遵循以人为中心的设计原则，以适应FLW的原型应用程序，为抑郁症提供简短的心理社会干预措施，从以前设计用于印度农村的应用程序中绘制。使用多方法方法，我们开展了焦点小组会议,包括可用性测试和对从德克萨斯州一家大型卫生系统招募的FLW进行小组访谈,以评估该应用的可行性和可接受性.正的系统可用性量表用于确定应用程序的整体可用性。我们还计算了参与者向其他人推荐该应用程序的可能性，使用从最小到最可能的0到10的评分（净启动子得分）。焦点小组的转录本进行了主题编码和分析，并总结了4个关键领域的建议。
结果：共有18名不同角色和客户护理经验的FLW参加了这项研究。参与者发现该应用程序可用，系统可用性量表平均得分为72.5（SD18.1），与行业基准68一致。参与者推荐该应用程序的可能性在5到10之间，产生的净启动子得分为0，表明中等可接受性。参与者对该应用程序的总体印象是积极的。大多数参与者（15/18，83％）发现该应用程序易于访问和导航。该应用程序被认为对于支持FLW提供高质量的精神卫生保健服务很重要。参与者认为，该应用程序可以通过系统地收集和促进与绩效相关的反馈，为FLW培训和监督流程提供更多结构。主要问题包括与隐私相关的和关于实施可能增加FLW工作负载的单独对等监督机制的时间限制。
结论：我们设计了，已建成,并测试了一个可用的，功能性移动和Web应用程序原型，通过结构化的监督机制以及对绩效指标的系统收集和审查，支持美国FLW提供的心理社会干预措施。该应用程序有可能扩大FLW的工作范围，其任务是将这些干预措施提供给他们所服务的最难覆盖的社区。该项目的结果将为未来的工作提供信息，以评估该应用程序在现实世界中的使用和功效，以支持美国各地的任务共享心理健康计划。
目的：我们旨在评估为支持监管而设计和调整的新型移动和网络应用程序的可行性和可接受性，培训,以及提供简短心理社会干预措施的FLW的质量保证。
方法：我们遵循以人为中心的设计原则，以适应FLW的原型应用程序，为抑郁症提供简短的心理社会干预措施，从以前设计用于印度农村的应用程序中绘制。使用多方法方法，我们开展了焦点小组会议,包括可用性测试和对从德克萨斯州一家大型卫生系统招募的FLW进行小组访谈,以评估该应用的可行性和可接受性.正的系统可用性量表用于确定应用程序的整体可用性。我们还计算了参与者向其他人推荐该应用程序的可能性，使用从最小到最可能的0到10的评分（净启动子得分）。焦点小组的转录本进行了主题编码和分析，并总结了4个关键领域的建议。
结果：共有18名不同角色和客户护理经验的FLW参加了这项研究。参与者发现该应用程序可用，系统可用性量表平均得分为72.5（SD18.1），与行业基准68一致。参与者推荐该应用程序的可能性在5到10之间，产生的净启动子得分为0，表明中等可接受性。参与者对该应用程序的总体印象是积极的。大多数参与者（15/18，83％）发现该应用程序易于访问和导航。该应用程序被认为对于支持FLW提供高质量的精神卫生保健服务很重要。参与者认为，该应用程序可以通过系统地收集和促进与绩效相关的反馈，为FLW培训和监督流程提供更多结构。主要问题包括与隐私相关的和关于实施可能增加FLW工作负载的单独对等监督机制的时间限制。
结论：我们设计了，已建成,并测试了一个可用的，功能性移动和Web应用程序原型，通过结构化的监督机制以及对绩效指标的系统收集和审查，支持美国FLW提供的心理社会干预措施。该应用程序有可能扩大FLW的工作范围，其任务是将这些干预措施提供给他们所服务的最难覆盖的社区。该项目的结果将为未来的工作提供信息，以评估该应用程序在现实世界中的使用和功效，以支持美国各地的任务共享心理健康计划。
