Coach-Supported Versus Self-guided Digital Training Course for a Problem-solving Psychological Intervention for Nonspecialists: Protocol for a Pre-Post Nested Randomized Controlled Trial

Abstract

Background Psychosocial interventions delivered by nonspecialists can be effective at reducing common adolescent mental health problems in low-resource settings. However, there is a lack of evidence on resource-efficient methods for building capacity to deliver these interventions. Objective The objective of this study is to evaluate the effects of a digital training (DT) course, delivered in a self-guided format or with coaching, on nonspecialists’ competency to deliver a problem-solving intervention intended for adolescents with common mental health problems in India. Methods We will conduct a pre-post study with a nested parallel, 2-arm, individually randomized controlled trial. The study aims to recruit 262 participants, randomized 1:1 to receive either a self-guided DT course or a DT course with weekly individualized coaching provided remotely by telephone. In both arms, the DT will be accessed over 4 to 6 weeks. Participants will be nonspecialists (ie, without prior practice-based training in psychological therapies) recruited from among university students and affiliates of nongovernmental organizations in Delhi and Mumbai, India. Results Outcomes will be assessed at baseline and 6 weeks post randomization using a knowledge-based competency measure that incorporates a multiple-choice quiz format. The primary hypothesis is that self-guided DT will lead to increased competency scores among novices with no prior experience of delivering psychotherapies. The secondary hypothesis is that digital training with coaching will have an incremental effect on competency scores compared with DT alone. The first participant was enrolled on April 4, 2022. Conclusions The study will address an evidence gap on the effectiveness of training methods for nonspecialist providers of adolescent mental health interventions in low-resource settings. The findings from this study will be used to support wider efforts to scale up evidence-based mental health interventions for young people. Trial Registration ClinicalTrials.gov NCT05290142; https://clinicaltrials.gov/ct2/show/NCT05290142 International Registered Report Identifier (IRRID) DERR1-10.2196/41981

Intervention for School Anxiety and Absenteeism (ISAAC): Mixed-method feasibility study of a coach-assisted, parent-focused online program

“…Speci c feasibility indicators related to retention (number of participants who completed all three modules as a proportion of those who started the intervention); module participation (mean number of modules completed and mean number/duration of coaching sessions attended by those who started the intervention); time taken to complete the intervention; and coaching delity. Following a method used in other guided intervention studies with a facilitating "coach" (Mathur et al, 2023), delity was assessed by an independent rater who scored all recorded coaching sessions using a 3-point scale (0 = not completed, 1 = partially completed, 2 = fully completed) across six items: (1) engaging the participant and setting the agenda; (2) reviewing progress with module content; (3) answering queries about module content; (4) reviewing homework learning task; (5) planning the next module; and (6) concluding the session. Scores across the six components were summed for each module with a higher score indicating greater coaching delity.…”

Developing knowledge-based psychotherapeutic competencies in non-specialist providers: A pre-post study with a nested randomised controlled trial of a coach-supported versus self-guided digital training course for a problem-solving psychological intervention in India

“…The steps taken to translate the manual into a digital curriculum are described in the published study protocol paper (Mathur et al, 2023b). The course was available in two languages, English and Hindi, either of which could be selected by the participants.…”

“…Peers and supervisors also provided formative feedback on recordings and offered suggestions for future coaching sessions, as required. The development and content of the coaching protocol have been described in greater detail in the published study protocol (Mathur et al, 2023b).…”

“…These durable effects were obtained despite a rapid delivery schedule comprising only 4-5 face-to-face sessions (lasting 20-30 min each) over 3 weeks. The steps taken to translate the manual into a digital curriculum are described in the published study protocol paper (Mathur et al, 2023b). The course was available in two languages, English and Hindi, either of which could be selected by the participants.…”

Knowledge Of Problem Solving (KOPS) scale: Design and evaluation of a scalable competency measure for a common practice element in task-shared youth mental health interventions

“…This phase was embedded within a larger study that evaluated two digital formats (with and without coaching) for training NSPs in the PRIDE problem-solving intervention (Mathur et al, 2022). The participants were 277 NSPs recruited from four universities (located in Delhi, Bangalore and Mumbai) and five non-governmental organisations (NGOs) working in the fields of adolescent health and education.…”