Designing an App to Support Measurement-Based Peer Supervision of Frontline Health Workers Delivering Brief Psychosocial Interventions in Texas: Multimethod Study

BackgroundThe 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 suppo...

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Main Authors: Anubhuti Poudyal, Delta-Marie Lewis, Sarah Taha, Alyssa J Martinez, Lauren Magoun, Y Xian Ho, Natali Carmio, John A Naslund, Katherine Sanchez, Neal Lesh, Vikram Patel
Format: Article
Language:English
Published: JMIR Publications 2024-03-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2024/1/e55205
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author Anubhuti Poudyal
Delta-Marie Lewis
Sarah Taha
Alyssa J Martinez
Lauren Magoun
Y Xian Ho
Natali Carmio
John A Naslund
Katherine Sanchez
Neal Lesh
Vikram Patel
author_facet Anubhuti Poudyal
Delta-Marie Lewis
Sarah Taha
Alyssa J Martinez
Lauren Magoun
Y Xian Ho
Natali Carmio
John A Naslund
Katherine Sanchez
Neal Lesh
Vikram Patel
author_sort Anubhuti Poudyal
collection DOAJ
description BackgroundThe 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. ObjectiveWe 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. MethodsWe 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. ResultsA 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. ConclusionsWe 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.
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spelling doaj.art-b8227fa446124006bd904048b6d97a9a2024-03-11T16:30:34ZengJMIR PublicationsJMIR Formative Research2561-326X2024-03-018e5520510.2196/55205Designing an App to Support Measurement-Based Peer Supervision of Frontline Health Workers Delivering Brief Psychosocial Interventions in Texas: Multimethod StudyAnubhuti Poudyalhttps://orcid.org/0000-0002-6426-2646Delta-Marie Lewishttps://orcid.org/0000-0002-5707-1796Sarah Tahahttps://orcid.org/0009-0001-8199-7978Alyssa J Martinezhttps://orcid.org/0000-0003-4493-0472Lauren Magounhttps://orcid.org/0000-0003-4073-5071Y Xian Hohttps://orcid.org/0000-0002-1885-6136Natali Carmiohttps://orcid.org/0000-0002-2399-5982John A Naslundhttps://orcid.org/0000-0001-6777-0104Katherine Sanchezhttps://orcid.org/0000-0002-2249-3024Neal Leshhttps://orcid.org/0000-0003-0027-3247Vikram Patelhttps://orcid.org/0000-0003-1066-8584 BackgroundThe 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. ObjectiveWe 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. MethodsWe 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. ResultsA 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. ConclusionsWe 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.https://formative.jmir.org/2024/1/e55205
spellingShingle Anubhuti Poudyal
Delta-Marie Lewis
Sarah Taha
Alyssa J Martinez
Lauren Magoun
Y Xian Ho
Natali Carmio
John A Naslund
Katherine Sanchez
Neal Lesh
Vikram Patel
Designing an App to Support Measurement-Based Peer Supervision of Frontline Health Workers Delivering Brief Psychosocial Interventions in Texas: Multimethod Study
JMIR Formative Research
title Designing an App to Support Measurement-Based Peer Supervision of Frontline Health Workers Delivering Brief Psychosocial Interventions in Texas: Multimethod Study
title_full Designing an App to Support Measurement-Based Peer Supervision of Frontline Health Workers Delivering Brief Psychosocial Interventions in Texas: Multimethod Study
title_fullStr Designing an App to Support Measurement-Based Peer Supervision of Frontline Health Workers Delivering Brief Psychosocial Interventions in Texas: Multimethod Study
title_full_unstemmed Designing an App to Support Measurement-Based Peer Supervision of Frontline Health Workers Delivering Brief Psychosocial Interventions in Texas: Multimethod Study
title_short Designing an App to Support Measurement-Based Peer Supervision of Frontline Health Workers Delivering Brief Psychosocial Interventions in Texas: Multimethod Study
title_sort designing an app to support measurement based peer supervision of frontline health workers delivering brief psychosocial interventions in texas multimethod study
url https://formative.jmir.org/2024/1/e55205
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