Community health worker-delivered counselling for common mental disorders among chronic disease patients in South Africa: a feasibility study.
Adult
Alcoholism
/ therapy
Chronic Disease
Community Health Workers
Counseling
Delivery of Health Care
/ organization & administration
Depressive Disorder
/ therapy
Diabetes Mellitus
/ therapy
Feasibility Studies
Female
HIV Infections
/ therapy
Humans
Male
Mental Disorders
/ therapy
Middle Aged
Motivational Interviewing
Patient Acceptance of Health Care
Primary Health Care
/ organization & administration
Problem Solving
South Africa
alcohol
chronic disease
community health worker
depression
mental health counselling
south Africa
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
15 01 2019
15 01 2019
Historique:
entrez:
17
1
2019
pubmed:
17
1
2019
medline:
11
2
2020
Statut:
epublish
Résumé
To examine the feasibility and acceptability of integrating a 'designated' approach to community health worker (CHW)-delivered mental health counselling (where existing CHWs deliver counselling in addition to usual duties) and a 'dedicated' approach (where additional CHWs have the sole responsibility of delivering mental health counselling) into chronic disease care. A feasibility test of a designated and dedicated approach to CHW-delivered counselling and qualitative interviews of CHWs delivering the counselling. Four primary healthcare clinics in the Western Cape, South Africa allocated to either a designated or dedicated approach and stratified by urban/rural status. Forty chronic disease patients (20 with HIV, 20 with diabetes) reporting hazardous alcohol use or depression. Interviews with seven CHWs. Three sessions of structured mental health counselling. We assessed feasibility by examining the proportion of patients who were willing to be screened, met inclusion criteria, provided consent, completed counselling and were retained in the study. Acceptability of these delivery approaches was assessed through qualitative interviews of CHWs. Regardless of approach, a fair proportion (67%) of eligible patients were willing to receive mental health counselling. Patients who screened positive for depression were more likely to be interested in counselling than those with hazardous alcohol only. Retention in counselling (85%) and the study (90%) was good and did not differ by approach. Both dedicated and designated CHWs viewed the counselling package as highly acceptable but requested additional training and support to facilitate implementation. Dedicated and designated approaches to CHW-delivered mental health counselling were matched in terms of their feasibility and acceptability. A comparative efficacy trial of these approaches is justified, with some adjustments to the training and implementation protocols to provide further support to CHWs.
Identifiants
pubmed: 30647043
pii: bmjopen-2018-024277
doi: 10.1136/bmjopen-2018-024277
pmc: PMC6340481
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e024277Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/M014290/1
Pays : United Kingdom
Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
J Psychiatr Ment Health Nurs. 2019 Jun;26(5-6):163-174
pubmed: 30983052
J Rural Health. 2018 Dec;34(1):48-62
pubmed: 28084667
Soc Sci Med. 2013 Nov;97:82-6
pubmed: 24161092
BMC Health Serv Res. 2017 Nov 21;17(1):746
pubmed: 29157230
PLoS Med. 2013;10(5):e1001443
pubmed: 23690753
S Afr Med J. 2007 Jun;97(6):438, 440
pubmed: 17691472
Implement Sci. 2009 Aug 07;4:50
pubmed: 19664226
J Acquir Immune Defic Syndr. 2002 Dec 15;31 Suppl 3:S123-7
pubmed: 12562034
Patient Prefer Adherence. 2018 Sep 18;12:1797-1803
pubmed: 30271123
Afr J Psychiatry (Johannesbg). 2012 Sep;15(5):346-51
pubmed: 23044889
Subst Abuse Treat Prev Policy. 2015 Nov 14;10:46
pubmed: 26576946
Int J Drug Policy. 2016 Apr;30:52-8
pubmed: 26797188
Soc Psychiatry Psychiatr Epidemiol. 2015 Mar;50(3):461-8
pubmed: 25096982
Health Policy Plan. 2017 Jun 1;32(5):699-709
pubmed: 28369396
Annu Rev Clin Psychol. 2017 May 8;13:149-181
pubmed: 28482687
Psychol Aging. 1997 Jun;12(2):277-87
pubmed: 9189988
PLoS One. 2018 Jul 10;13(7):e0199816
pubmed: 29990372
Trials. 2018 Mar 16;19(1):185
pubmed: 29548302
Glob Ment Health (Camb). 2017 Dec 04;4:e24
pubmed: 29230320
BMC Psychiatry. 2016 May 26;16:164
pubmed: 27228979
Cochrane Database Syst Rev. 2013 Nov 19;(11):CD009149
pubmed: 24249541
J Health Psychol. 2018 Mar;23(4):618-628
pubmed: 27091759
Glob Ment Health (Camb). 2018 Jul 27;5:e25
pubmed: 30128161
BMC Psychiatry. 2016 Feb 20;16:35
pubmed: 26897614
Patient Educ Couns. 2016 Oct;99(10):1558-67
pubmed: 27036083
Soc Psychiatry Psychiatr Epidemiol. 2008 Nov;43(11):889-97
pubmed: 18677573
SAHARA J. 2011;8(2):82-8
pubmed: 23237685
S Afr Med J. 2015 Sep 21;105(8):642-7
pubmed: 26449692
Patient Educ Couns. 2014 May;95(2):201-10
pubmed: 24629835