Comparing implementation strategies for training and supervising nonspecialists in Group Problem Management Plus: A...

Area of Science:

• Global Mental Health
• Implementation Science
• Public Health Interventions

Background:

• Migrants and refugees experience high rates of mental health issues.
• Access to mental health services remains a significant barrier for these populations.
• Scalable psychological interventions are needed to address this gap.

Purpose of the Study:

• To compare two task-sharing strategies for delivering Group Problem Management Plus (gPM+) to women with psychological distress.
• To evaluate the effectiveness and implementation outcomes of specialized versus nonspecialized technical support for nonspecialist facilitators.

Main Methods:

• A mixed-methods study randomized 128 women to receive gPM+ from nonspecialists supervised by either a psychologist (specialized support) or a trained nonspecialist (nonspecialized support).
• Effectiveness, fidelity, attendance, cost, adoption, and implementation outcomes were assessed.

Main Results:

• Intervention attendance was higher with specialized technical support.
• Nonspecialized technical support demonstrated higher fidelity to gPM+ and lower implementation costs.
• Other effectiveness and implementation indicators were comparable across both conditions.

Conclusions:

• Implementing mental health interventions like gPM+ through lower-resource, community-embedded task-sharing models is feasible.
• Nonspecialist-led support models can maintain intervention safety and fidelity.
• Further research is needed to confirm the relative cost-effectiveness of these models.