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Adaptation and translation of a scalable measure for assessing health worker competence to deliver a brief psychological intervention: A case study from central India of its comparison to a performance-based measure

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Abstract

Efforts to reduce the global burden of common mental disorders have focused on scaling up evidence-based training programs for non-specialist providers to deliver brief psychological interventions. To evaluate these provider training programs, appropriate and scalable assessments of competency need to be developed alongside them. We followed a systematic approach for the cultural adaptation and translation into Hindi of a valid, English, multiple-choice applied knowledge measure to assess non-specialists’ competence to deliver a brief psychological intervention for depression in rural India. We then explored the relationship between the performance of 30 non-specialist providers on the same written measure compared with a structured performance-based measure consisting of two role-plays. The results of the multiple-choice assessment had an overall mean score of 37.40 (SD = 11.31) compared to the mean scores of role-play A (the easier role-play) of 43.25 (SD = 14.50) and role-play B (the more difficult role-play) of 43.25 (SD = 13.00). Role-play performance-based measures and written applied knowledge measures represent different approaches with unique strengths and challenges to measuring competence. Scaling up training programs requires the development of scalable methods for competency assessment. Exploring the relationship between these two measures, our team found no apparent differences between the two modes of assessment. Continued comparison of these approaches is needed to determine the consistency of outcomes across the two formats and to link the scores on these measures with clinical performance as reflected by the quality of care and patient outcomes.

Trial Registration: ClinicalTrials.gov Identifier: NCT04157816; 8th November 2019.

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Acknowledgements

We acknowledge Aditya Anand and Minakshi Vishwakarma who provided support in data management and analysis. Lauren Mitchell who provided an overview of back translation, Abhijit Nadkarni and Steve Hollon who provided support at various stages in this research. Subhash Pednekar, Pranali Kundaikar, Lalan Karapurkar, and Suneina Haldankar who rated the role-play-based competency assessments Psychologists at Sangath Delhi who provided an overview of translations: Sanjana Guha and Sreepriya Menon.

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Authors and Affiliations

  1. Sangath, Bhopal, Madhya Pradesh, India

    Udita Joshi & Anant Bhan

  2. Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Ave, 02115, Boston, MA, USA

    Juliana Restivo Haney, Vikram Patel & John A. Naslund

  3. Sangath, Porvorim, Goa, India

    Miriam Sequeira

  4. Campbell Family Mental Health Research Institute, Center of Addiction and Mental Health, Toronto, Canada

    Daisy R. Singla

  5. Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada

    Daisy R. Singla

  6. Lunenfeld Tanenbaum Research Institute, Sinai Health, Toronto, Canada

    Daisy R. Singla

  7. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Vikram Patel

  8. Department of Psychiatry, Yale School of Medicine, New Haven, USA

    Zafra Cooper

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Correspondence to John A. Naslund.

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All procedures performed in this study were approved by the ethics review boards at Sangath, India, and Harvard Medical School, United States, and are in accordance with the 1964 Helsinki declaration and its later amendments.

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Udita Joshi and Juliana Restivo Haney are joint first authors

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Joshi, U., Haney, J.R., Sequeira, M. et al. Adaptation and translation of a scalable measure for assessing health worker competence to deliver a brief psychological intervention: A case study from central India of its comparison to a performance-based measure. Psychiatr Q 94, 33–47 (2023). https://doi.org/10.1007/s11126-022-10007-6

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