Applying human-centered design to maximize acceptability, feasibility, and usability of mobile technology supervision in Kenya: a mixed methods pilot study protocol

Abstract

Background Although research continues to support task-shifting as an effective model of delivering evidence-based practices (EBPs), little scholarship has focused how to scale up and sustain task-shifting in low- and middle-income countries, including how to sustainably supervise lay counselors. Ongoing supervision is critical to ensure EBPs are delivered with fidelity; however, the resources and expertise required to provide ongoing supervision may limit the potential to scale up and sustain task shifting. Opportunities may exist to leverage mobile technology to replace or supplement in-person supervision in low-resource contexts, but contextual variables, such as network connectivity and lay counselor preferences surrounding mobile technology, must be examined and considered when designing and implementing mobile technology supervision. Methods This study builds from an existing randomized trial in Kenya, wherein teachers and community health volunteers have been trained to provide trauma-focused cognitive behavioral therapy as lay counselors. The study will use an iterative and mixed methods approach, with qualitative interviews and a Human-Centered Design (HCD) workshop informing a non-randomized pilot trial. Semi-structured interviews will be conducted with lay counselors and supervisors to understand how mobile technology is currently being used for supervision and determine the barriers and facilitators to mobile technology supervision. Data from these interviews will inform an HCD workshop, where lay counselors and supervisors “re-design” supervision to most effectively leverage mobile technology. Workshop participants will also participate in focus groups to gather perceptions on the use of HCD techniques. The final outcome of the workshop will be a set of refined workflows, which will be tested in a mixed method, nonrandomized pilot with newly trained lay counselors and existing supervisors. The pilot trial will evaluate the acceptability, feasibility, and usability of mobile technology supervision through self-report questionnaires as well as perceptions of effectiveness through qualitative interviews with a subset of lay counselors and all supervisors. Discussion This study will provide a launching point for future research on supervision and methods to engage stakeholders to design and tailor interventions and implementation supports to fit low-resourced contexts. Trial registration The parent trial from which this study builds was registered on ClinicalTrials.gov on August 9, 2017 (NCT03243396).

Co-developed implementation guidelines to maximize acceptability, feasibility, and usability of mobile phone supervision in Kenya

“…This study used an iterative and mixed methods approach, with qualitative interviews and a HCD workshop informing the development of the implementation guidelines and outreach strategy, which was subsequently tested in a randomized pilot trial. Full trial procedures are described elsewhere (Triplett et al, 2021). The trial was situated within a larger trial that examined the effectiveness and implementation of a locally adapted version of TF-CBT (Cohen et al, 2006) in Bungoma, Kenya (Building and Sustaining Interventions for Children [BASIC]; see Dorsey et al, 2020a for parent trial protocol).…”

Usability-Focused Development and Usage of NeoTree-Beta, an App for Newborn Care in a Low-Resource Neonatal Unit, Malawi

“…Increasingly academic publications are employing Agile methods. For example, a Kenyan mixed-method study combined qualitative interviews with human centred design workshops to engage users in designing and tailoring an intervention to fit the low-resource context ( 47 ).…”

Future Directions in Lay Health Worker Involvement in Children’s Mental Health Services in the U.S.

“…Methodologies such as human-centered design and community-based participatory research, which emphasize engagement with stakeholders to develop solutions to problems identified within the community, are recommended approaches to enhance the acceptability and feasibility of interventions to enhance adoption and eventually sustainment (Kia-Keating et al, 2017;Triplett et al, 2021). For example, LHWs in Chicago schools were trained to deliver an evidence-based parenting program, but engagement remained low, as very few parents attended the traditional parenting groups.…”