Community health worker-delivered counselling for common mental disorders among chronic disease patients in South Africa: A feasibility study
Objectives: 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...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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BMJ PUBLISHING GROUP
2019
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| Online Access: | http://hdl.handle.net/20.500.11937/85597 |
| _version_ | 1848764748155322368 |
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| author | Myers-Franchi, Bronwyn Petersen-Williams, P. Van Der Westhuizen, C. Lund, C. Lombard, C. Joska, J.A. Levitt, N.S. Butler, C. Naledi, T. Milligan, P. Stein, D.J. Sorsdahl, K. |
| author_facet | Myers-Franchi, Bronwyn Petersen-Williams, P. Van Der Westhuizen, C. Lund, C. Lombard, C. Joska, J.A. Levitt, N.S. Butler, C. Naledi, T. Milligan, P. Stein, D.J. Sorsdahl, K. |
| author_sort | Myers-Franchi, Bronwyn |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objectives: 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.
Design: A feasibility test of a designated and dedicated approach to CHW-delivered counselling and qualitative interviews of CHWs delivering the counselling.
Setting: Four primary healthcare clinics in the Western Cape, South Africa allocated to either a designated or dedicated approach and stratified by urban/rural status.
Participants: Forty chronic disease patients (20 with HIV, 20 with diabetes) reporting hazardous alcohol use or depression.
Interviews: with seven CHWs. Intervention Three sessions of structured mental health counselling. Main outcome measures: 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.
Results: 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.
Conclusions: 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. |
| first_indexed | 2025-11-14T11:24:17Z |
| format | Journal Article |
| id | curtin-20.500.11937-85597 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:24:17Z |
| publishDate | 2019 |
| publisher | BMJ PUBLISHING GROUP |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-855972021-10-07T01:34:30Z Community health worker-delivered counselling for common mental disorders among chronic disease patients in South Africa: A feasibility study Myers-Franchi, Bronwyn Petersen-Williams, P. Van Der Westhuizen, C. Lund, C. Lombard, C. Joska, J.A. Levitt, N.S. Butler, C. Naledi, T. Milligan, P. Stein, D.J. Sorsdahl, K. Science & Technology Life Sciences & Biomedicine Medicine, General & Internal General & Internal Medicine MIDDLE-INCOME COUNTRIES CAPE-TOWN CARE SERVICES STRESS Objectives: 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. Design: A feasibility test of a designated and dedicated approach to CHW-delivered counselling and qualitative interviews of CHWs delivering the counselling. Setting: Four primary healthcare clinics in the Western Cape, South Africa allocated to either a designated or dedicated approach and stratified by urban/rural status. Participants: Forty chronic disease patients (20 with HIV, 20 with diabetes) reporting hazardous alcohol use or depression. Interviews: with seven CHWs. Intervention Three sessions of structured mental health counselling. Main outcome measures: 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. Results: 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. Conclusions: 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. 2019 Journal Article http://hdl.handle.net/20.500.11937/85597 10.1136/bmjopen-2018-024277 English https://creativecommons.org/licenses/by/4.0/ BMJ PUBLISHING GROUP fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Medicine, General & Internal General & Internal Medicine MIDDLE-INCOME COUNTRIES CAPE-TOWN CARE SERVICES STRESS Myers-Franchi, Bronwyn Petersen-Williams, P. Van Der Westhuizen, C. Lund, C. Lombard, C. Joska, J.A. Levitt, N.S. Butler, C. Naledi, T. Milligan, P. Stein, D.J. Sorsdahl, K. Community health worker-delivered counselling for common mental disorders among chronic disease patients in South Africa: A feasibility study |
| title | Community health worker-delivered counselling for common mental disorders among chronic disease patients in South Africa: A feasibility study |
| title_full | Community health worker-delivered counselling for common mental disorders among chronic disease patients in South Africa: A feasibility study |
| title_fullStr | Community health worker-delivered counselling for common mental disorders among chronic disease patients in South Africa: A feasibility study |
| title_full_unstemmed | Community health worker-delivered counselling for common mental disorders among chronic disease patients in South Africa: A feasibility study |
| title_short | Community health worker-delivered counselling for common mental disorders among chronic disease patients in South Africa: A feasibility study |
| title_sort | community health worker-delivered counselling for common mental disorders among chronic disease patients in south africa: a feasibility study |
| topic | Science & Technology Life Sciences & Biomedicine Medicine, General & Internal General & Internal Medicine MIDDLE-INCOME COUNTRIES CAPE-TOWN CARE SERVICES STRESS |
| url | http://hdl.handle.net/20.500.11937/85597 |