scholarly journals Community Health Workers Supporting Clinical Pharmacists in Diabetes Management: A Randomized Controlled Trial

2017 ◽  
Vol 38 (1) ◽  
pp. 58-68 ◽  
Author(s):  
Lisa K. Sharp ◽  
Jessica J. Tilton ◽  
Daniel R. Touchette ◽  
Yinglin Xia ◽  
Daniel Mihailescu ◽  
...  
2019 ◽  
Vol 6 ◽  
Author(s):  
Atif Rahman ◽  
Parveen Akhtar ◽  
Syed Usman Hamdani ◽  
Najia Atif ◽  
Huma Nazir ◽  
...  

Background.The Thinking Healthy Programme (THP) is an evidence-based psychological intervention endorsed by the World Health Organization, tailored for non-specialist health workers in low- and middle-income countries. However, training and supervision of large numbers of health workers is a major challenge for the scale-up of THP. We developed a ‘Technology-Assisted Cascaded Training and Supervision system’ (TACTS) for THP consisting of a training application and cascaded supervision delivered from a distance.Methods.A single-blind, non-inferiority, randomized controlled trial was conducted in District Swat, a post-conflict area of North Pakistan. Eighty community health workers (called Lady Health Workers or LHWs) were randomly assigned to either TACTS or conventional face-to-face training and supervision by a specialist. Competence of LHWs in delivering THP post-training was assessed by independent observers rating a therapeutic session using a standardized measure, the ‘Enhancing Assessment of Common Therapeutic factors’ (ENACT), immediately post-training and after 3 months. ENACT uses a Likert scale to score an observed interaction on 18 dimensions, with a total score of 54, and a higher score indicating greater competence.Results.Results indicated no significant differences between health workers trained using TACTS and supervised from distancev.those trained and supervised by a specialist face-to-face (mean ENACT score M  =  24.97,s.d.  =  5.95v.M =  27.27,s.d.  =  5.60,p  =  0.079, 95% CI 4.87–0.27) and at 3 months follow-up assessment (M  =  44.48,s.d.  =  3.97v.M =  43.63,s.d.  =  6.34,p  =  0.53, CI −1.88 to 3.59).Conclusions.TACTS can provide a promising tool for training and supervision of front-line workers in areas where there is a shortage of specialist trainers and supervisors.


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