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A Digital Tool (Technology-Assisted Problem Management Plus) for Lay Health Workers to Address Common Mental Health

Maham Saleem1,2, Shamsa Zafar3, Thomas Klein4

  • 1Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.

JMIR Formative Research
|January 28, 2025
PubMed
Summary

Co-producing Technology-Assisted Problem Management Plus (TA-PM+) with lady health workers (LHWs) in Pakistan improved its usability and acceptability for delivering mental health support in communities.

Keywords:
Problem Management Plusco-productioncommon mental health disordersdigital interventiondigital mental healthdigital technologylay health worker programmelow- and middle-income countries

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Area of Science:

  • Global mental health interventions
  • Digital health technology development
  • Community health worker training

Background:

  • Mental health disorders represent a significant global disease burden with a notable treatment gap.
  • Problem Management Plus (PM+) is a WHO-endorsed intervention, but faces implementation challenges.
  • Digital technologies offer potential solutions for mental health care delivery and quality control.

Purpose of the Study:

  • To co-produce Technology-Assisted Problem Management Plus (TA-PM+) for lady health workers (LHWs) in Pakistan.
  • To enhance the efficient delivery of mental health services to women in community settings.
  • To conduct usability testing of TA-PM+ in community environments.

Main Methods:

  • A 3-stage framework involving evidence review, stakeholder consultation (focus groups, interviews), and thematic analysis using the COM-B model.
  • Co-production of TA-PM+ through online workshops with a multidisciplinary team.
  • Two rounds of usability testing in laboratory and community settings, collecting data via MUAQ and PSQ.

Main Results:

  • Barriers to TA-PM+ implementation included LHWs' digital skills, workload, resource scarcity, and training needs.
  • Enhancements for LHWs included training, professional support, user guidance, an automated interface, offline functionality, incentives, and community credibility.
  • TA-PM+ was developed with an automated interface, dashboard, videos, and a supervisory panel, showing improved usability scores (MUAQ 5.62 to 5.96) and high participant satisfaction (PSQ 40).

Conclusions:

  • The co-production of TA-PM+ successfully integrated contextual factors and evidence for LHWs in Pakistan.
  • An iterative, 3-stage development approach led to high usability and acceptability of TA-PM+ among LHWs and community participants.