Scaling Up Task-Shared Depression Care in Texas: Evaluating the Preliminary Effectiveness and Acceptability of a Digital Program for Training Non-Specialist Providers.
Digital technologies hold promise for building capacity of non-specialist providers to scale-up access to depression care. This study evaluated the preliminary effectiveness and acceptability of a digital program to train non-specialists in the delivery of an evidence-based behavioral activation (BA) intervention for depression.
Non-specialist providers without prior mental health counseling experience employed within the Baylor Scott & White Health system in Texas were recruited to complete a two-course digital training, and knowledge assessments-at baseline and follow up-to determine preliminary effectiveness. Acceptability and feasability were assessed through focus groups.
Of 73 non-specialist providers enrolled in the program, 42 completed both courses. Intent-to-treat analysis showed pre-post improvement in knowledge assessment scores (mean difference = 5.4; 95% CI: 1.6, 9.2; t(53) = 2.87, p = 0.006). Subgroup analyses demonstrated that participants who fully completed the training had pre-post improvement in knowledge scores (mean difference = 6.8; 95% CI = 2.8, 10.8; t(39) = 3.46, p = 0.001), whereas those who did not start or who only partially completed the training did not show improved knowledge scores. Framework analysis of the focus groups revealed four themes: training program evaluation, participant feedback and improvements, communication strategies, and support and resources.
This digital program shows potential for building skills and knowledge of non-specialist providers in delivering BA. Continued efforts are needed to support these providers in practice, and ensure quality through supervision.
The program offers a scalable solution to expanding the behavioral health workforce, representing an opportunity to overcome the significant mental health workforce shortages and ensuring access to quality mental health services.
Non-specialist providers without prior mental health counseling experience employed within the Baylor Scott & White Health system in Texas were recruited to complete a two-course digital training, and knowledge assessments-at baseline and follow up-to determine preliminary effectiveness. Acceptability and feasability were assessed through focus groups.
Of 73 non-specialist providers enrolled in the program, 42 completed both courses. Intent-to-treat analysis showed pre-post improvement in knowledge assessment scores (mean difference = 5.4; 95% CI: 1.6, 9.2; t(53) = 2.87, p = 0.006). Subgroup analyses demonstrated that participants who fully completed the training had pre-post improvement in knowledge scores (mean difference = 6.8; 95% CI = 2.8, 10.8; t(39) = 3.46, p = 0.001), whereas those who did not start or who only partially completed the training did not show improved knowledge scores. Framework analysis of the focus groups revealed four themes: training program evaluation, participant feedback and improvements, communication strategies, and support and resources.
This digital program shows potential for building skills and knowledge of non-specialist providers in delivering BA. Continued efforts are needed to support these providers in practice, and ensure quality through supervision.
The program offers a scalable solution to expanding the behavioral health workforce, representing an opportunity to overcome the significant mental health workforce shortages and ensuring access to quality mental health services.
Authors
Taha Taha, Carmio Carmio, Hill Hill, Floyd Floyd, Rodriguez Rodriguez, Meredith Meredith, Brune Brune, Keller Keller, Patel Patel, Sanchez Sanchez, Naslund Naslund
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