Competency-based Training in Problem Management Plus: a Randomized Controlled Trial (EQUIP-PM+)

Comparing Strategies for Competency-based Training in Problem Management Plus to Improve Non-specialist Competencies for Responding to Psychological Distress: a Randomized Controlled Trial

The proposed study in Nepal will evaluate if non-specialists participating in Equip-based Problem Management Plus training show greater competencies compared to non-specialists participating in standard Problem Management Plus training. The proposed study is a randomized controlled trial with mixed-methods components evaluating both quantitative outcomes and qualitative outcomes among non-specialists participating in the training and their trainers.

Study Overview

• Status: Completed
• Conditions: Depression
• Intervention / Treatment: Behavioral: Standard Problem Management Plus training (training as usual); Behavioral: Equip-based Problem Management Plus training

Detailed Description

There is increasing recognition of the high burden of psychological distress among populations around the world. Increasingly, non-specialists (persons who do not have expertise in formal mental health training) are being used to deliver psychological services. There is a long history of successful implementation of psychological services by non-specialists in Nepal. Recently, a cluster randomized controlled trial of Problem Management Plus showed modest benefit over enhanced care as usual in southeastern Nepal. A recent initiative by the World Health Organization is being rolled out to improve the competencies of non-specialists participating in Problem Management Plus and similar trainings. This initiative is Ensuring Quality in Psychological Services (Equip). The proposed study in Nepal will evaluate if non-specialists participating in Equip-based Problem Management Plus training show greater competencies compared to non-specialists participating in standard Problem Management Plus training. The proposed study is a randomized controlled trial with mixed-methods components evaluating both quantitative outcomes and qualitative outcomes among non-specialists participating in the training and their trainers.

• Study Type: Interventional
• Enrollment (Actual): 99
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Nepal
  • Kathmandu, Nepal
    • Transcultural Psychosocial Organization Nepal

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• No prior mental health professional training
• Literate in Nepali

Exclusion Criteria:

• Any prior mental health professional training

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Training as usual; Standard Problem Management Plus training.	Behavioral: Standard Problem Management Plus training (training as usual); 10-day training on Problem Management Plus.
Experimental: Equip-based training; Training that uses the Equip platform to assess competencies and incorporate this information into trainers and supervisors activities.	Behavioral: Equip-based Problem Management Plus training; Training and supervision for Problem Management Plus in which the trainers and supervisors use the EQUIP platform for competency assessment and feedback.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Enhancing Assessment of Common Therapeutic Factors (unabbreviated title: Enhancing Assessment of Common Therapeutic Factors)	15-item tool with 4 response levels, range is 15 to 60, with higher scores equating to more competency	Immediately after Problem Management Plus training (10-days post-baseline)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Enhancing Assessment of Common Therapeutic Factors (unabbreviated title: Enhancing Assessment of Common Therapeutic Factors)	15-item tool with 4 response levels, range is 15 to 60, with higher scores equating to more competency	After Problem Management Plus supervision (approximately 45-days post-baseline)
Problem Management Plus Competency Assessment (unabbreviated title: Problem Management Plus Competency Assessment)	12-item tool with 4 response levels, range is 12 to 48, with higher scores equating to more competency	Immediately after Problem Management Plus training (10-days post-baseline)
Problem Management Plus Competency Assessment (unabbreviated title: Problem Management Plus Competency Assessment)	12-item tool with 4 response levels, range is 12 to 48, with higher scores equating to more competency	After Problem Management Plus supervision (approximately 45-days post-baseline)
Group Facilitation Competency Assessment (unabbreviated title: Group Facilitation Competency Assessment)	8-item tool with 4 response levels, range is 8 to 32, with higher scores equating to more competency	Immediately after Problem Management Plus training (10-days post-baseline)
Group Facilitation Competency Assessment (unabbreviated title: Group Facilitation Competency Assessment)	8-item tool with 4 response levels, range is 8 to 32, with higher scores equating to more competency	After Problem Management Plus supervision (approximately 45-days post-baseline)

Collaborators and Investigators

• Sponsor: George Washington University
• Collaborators: Transcultural Psychosocial Organization Nepal
• Investigators: Principal Investigator: Brandon A Kohrt, MD, PhD, George Washington University

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2021
• Primary Completion (Actual): December 31, 2021
• Study Completion (Actual): December 31, 2021

Study Registration Dates

• First Submitted: June 29, 2021
• First Submitted That Met QC Criteria: June 29, 2021
• First Posted (Actual): July 8, 2021

Study Record Updates

• Last Update Posted (Actual): September 29, 2022
• Last Update Submitted That Met QC Criteria: September 27, 2022
• Last Verified: September 1, 2022

More Information

Terms related to this study

• Keywords: Training; Psychological treatment; Competency
• Additional Relevant MeSH Terms: Behavioral Symptoms; Depression
• Other Study ID Numbers: NCR191797-v2

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Researchers can contact the principal investigator for access to data.
• IPD Sharing Time Frame: After publication of primary results
• IPD Sharing Access Criteria: Submit a proposal for intended analysis to the principal investigator.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No