task-shifting

任务转移
  • 文章类型: Journal Article
    存在利用移动电话代替或补充对非专业辅导员的亲自监督的机会。然而,上下文变量,例如网络连接和提供商首选项,必须考虑。使用迭代和混合方法的方法,我们共同制定了实施指南,以支持在肯尼亚西部与非专业咨询师和监督员一起实施手机监督,提供文化适应创伤的认知行为疗法.在主管领导的教育外展访问中,与非专业辅导员分享并讨论了准则。我们评估了指南和外展对可接受性的影响,可行性,和手机监管的可用性。指南与手机监督的可接受性和可用性的显着改善有关。没有证据表明可行性存在显着差异。与外行辅导员和主管的定性访谈将指南如何影响可接受性和可行性-通过设定对手机监督的期望,强调重要性,增加舒适度,和共享策略,以改善手机监管。引入和讨论共同制定的实施指南可以显着提高手机监督的可接受性和可用性。这种方法可以提供一个灵活和可扩展的模型,以应对在资源较少的地区实施循证实践和实施战略的挑战。
    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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