Training and Supervising Lay-providers in Low-income Settings: A Mixed-methods Study of Task-sharing from the Shamiri Randomized Controlled Trial
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Date
2020
Authors
Venturo-Conerly, Katherine
Roe, Elizabeth
Wasil, Akash
Osborn, Tom
Ndetei, David
Musyimi, Christine
Mutiso, Victoria
Wasanga, Christine
Weisz, John
Journal Title
Journal ISSN
Volume Title
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Abstract
Objective: Training lay-providers to deliver mental health interventions is both effective
and cost-effective. However, more research is needed to document training and supervision
procedures and to collect lay-providers’ feedback. We analyzed the acceptability of a 10-hour
lay-provider training and supervision delivered primarily by undergraduates. We also tested layprovider
fidelity and quality. Methods: This study documents training and supervision from an
RCT of the Shamiri intervention, a 4-session, school-based intervention which significantly
reduced symptoms of anxiety and depression in Kenyan adolescents. We delivered a 10-hour
training to 13 lay providers (M(SD)age=21.00(1.95), %female=61.54). We also hosted 30-minute
supervision meetings twice weekly. Independent raters coded session recordings for fidelity and
quality. We also collected quantitative and qualitative feedback from lay-providers. Results:
Reliability and mean ratings for all six of our fidelity and quality measures (delivering required
content, adhering to specified details, thoroughness, skillfulness, clarity, and purity) were very
good to excellent. Lay-provider quantitative ratings of training were also overwhelmingly
positive, with an overall satisfaction rating of 6.46/7.00. We identified central qualitative themes
in lay provider comments: Generally, comments about training style, content, and personal
interactions were overwhelmingly positive, and many lay-providers reported personal growth.
Comments about timing and location were mixed. Conclusions: This study provides preliminary
evidence that a very brief training delivered primarily by undergraduates can teach high-schoolgraduate
lay-providers to deliver effective mental health interventions. Additionally, we discuss
lessons-learned and implications for future research, including the importance of considering
local context when planning and of continuously collecting and addressing lay-provider
feedback.
Description
A preprint of a Randomized Controlled Trial
Keywords
Lay-providers, Task-sharing, Shamiri Randomized Controlled Trial, Global Mental Health
Citation
Venturo-Conerly, K., Roe, E., Wasil, A., & Osborn, T. L. (2020). Training and Supervising Lay-providers in Low-income Settings: A Mixed-methods Study of Task-sharing from the Shamiri Randomized Controlled Trial.