Dataset Information

Teacher, caregiver, and student acceptability of teachers delivering task-shifted mental health care to students in Darjeeling, India: a mixed methods pilot study.

ABSTRACT:

Background

The acceptability of teachers delivering task-shifted mental health care to their school-aged students is understudied. Here, we evaluate teachers', students', and caregivers' acceptability of Tealeaf (Teachers Leading the Frontlines), an alternative system of care in which teachers are trained and supervised to deliver transdiagnostic, non-manualized task-shifted care to their students.

Methods

In a 2019 single-arm, mixed methods, pragmatic acceptability pilot study in Darjeeling, India, 13 teachers delivered task-shifted child mental health care to 26 students in need. Teachers delivered care through using a transdiagnostic, non-manualized therapy modality, "education as mental health therapy" (Ed-MH). Measured with validated scales, teachers' and students' acceptability were compared after teacher training (PRE) and at the end of intervention (POST) using paired t tests. Teachers (n = 7), students (n = 7), and caregivers (n = 7) completed semi-structured interviews POST.

Results

Teachers' quantitative measures indicated moderate acceptability PRE and POST and did not change PRE to POST. Children's measures showed acceptability PRE and POST but decreased PRE to POST. Teachers and caregivers universally expressed acceptability in interviews. Facilitators of acceptability included impact, trust of teachers, and teachers' ability to make adaptations. Conditions required for acceptability included supervision and teachers emphasizing academics benefits over mental health benefits to caregivers. Barriers to acceptability included a lack of teacher time and stigma. Interviewed students universally were unaware of receiving care; teachers intentionally avoided singling them out.

Conclusion

Teachers, caregivers, and children found teacher delivering task-shifted care acceptable, a key factor in care adoption and sustainability, though interviewed children were unaware of receiving care.Trial registration The trial was registered on January 01, 2018 with Clinical Trials Registry-India (CTRI), Reg. No. CTRI/2018/01/011471, Ref. No. REF/2017/11/015895. http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=21129&EncHid=&modid=&compid=%27,%2721129det%27.

Supplementary information

The online version contains supplementary material available at 10.1007/s44192-022-00024-z.

SUBMITTER: Cruz CM

PROVIDER: S-EPMC9622553 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Teacher, caregiver, and student acceptability of teachers delivering task-shifted mental health care to students in Darjeeling, India: a mixed methods pilot study.

Cruz Christina M CM Dukpa Choden C Vanderburg Juliana L JL Rauniyar Abhishek K AK Giri Priscilla P Bhattarai Surekha S Thapa Arpana A Hampanda Karen K Gaynes Bradley N BN Lamb Molly M MM Matergia Michael M

Discover mental health 20221031 1

<h4>Background</h4>The acceptability of teachers delivering task-shifted mental health care to their school-aged students is understudied. Here, we evaluate teachers', students', and caregivers' acceptability of <i>Tealeaf</i> (Teachers Leading the Frontlines), an alternative system of care in which teachers are trained and supervised to deliver transdiagnostic, non-manualized task-shifted care to their students.<h4>Methods</h4>In a 2019 single-arm, mixed methods, pragmatic acceptability pilot s ...[more]

PMID: 36341156

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Project description:BackgroundTeacher self-efficacy and emotional stability are considered crucial resources for coping with classroom demands. We examined how class and subject teachers' self-efficacy beliefs and emotional stability are related to teachers' and students' perceptions of the teacher-student relationship, classroom management, and classroom disruptions.MethodsIn a sample of eighty-two swiss german 5th and 6th grade classes, 1290 students, their class teacher (N = 82), and a selected subject teacher (N = 82) filled out a questionnaire assessing classroom disruptions, teacher-student relationships, and classroom management. In a first step, we conducted t-tests on whether class teachers and subject teachers differ in their self-efficacy beliefs and emotional stability. In a second step, we explored by correlation analyses the relations between teacher self-efficacy in classroom management and emotional stability and the teachers' and students' perceptions of classroom disruptions, teacher-student relationships, and classroom management. In a third step, we examined by stepwise multiple regression analyses to what extent psychological variables predict teacher perceptions after controlling for students' ratings, representing rather "objective" classroom features.ResultsIn class teachers, high self-rated emotional stability and self-efficacy are associated with a more positive appraisal of teacher-student relationships and classroom management skills (compared with student ratings). By contrast, in subject teachers, high self-efficacy beliefs are associated with a more favorable perception of classroom disruptions, teacher-student relationships, and classroom management, from both the teachers' and students' perspectives.ConclusionsThe results of the present study show a distinctive pattern for class teachers and subject teachers. In class teachers, high self-rated emotional stability and self-efficacy are associated with a more positive evaluation (compared to student ratings) of the teacher-student relationship and classroom management skills but not teacher perceptions of student misbehavior. On the contrary, subject teachers' firm self-efficacy beliefs are associated with more favorable perceptions of classroom characteristics, both from the teachers' and students' perspectives.

Project description:BackgroundPerinatal depression (PND) is prevalent and negatively impacts HIV care among women living with HIV (WLHIV), yet PND remains under-identified in Malawian WLHIV. Accordingly, this formative study explored perceptions of the feasibility and acceptability of an integrated, task-shifted approach to PND screening and treatment in maternity clinics.MethodsWe completed consecutive PND screenings of HIV+ women attending pre- or post-natal appointments at 5 clinics in Lilongwe district, Malawi. We conducted in-depth interviews with the first 4-5 women presenting with PND per site (n = 24 total) from July to August 2018. PND classification was based on a score ≥ 10 on the Edinburgh Postnatal Depression Scale (EPDS). We conducted 10 additional in-depth interviews with HIV and mental health providers at the 5 clinics.ResultsMost participants endorsed the feasibility of integrated PND screening, as they believed that PND had potential for significant morbidity. Among providers, identified barriers to screening were negative staff attitudes toward additional work, inadequate staffing numbers and time constraints. Suggested solutions to barriers were health worker training, supervision, and a brief screening tool. Patient-centered counselling strategies were favored over medication by WLHIV as the acceptable treatment of choice, with providers supporting the role of medication to be restricted to severe depression. Providers identified nurses as the most suitable health workers to deliver task-shifted interventions and emphasized further training as a requirement to ensure successful task shifting.ConclusionImproving PND in a simple, task-shifted intervention is essential for supporting mental health among women with PND and HIV. Our results suggest that an effective PND intervention for this population should include a brief, streamlined PND screening questionnaire and individualized counselling for those who have PND, with supplemental support groups and depression medication readily available. These study results support the development of a PND intervention to address the gap in treatment of PND and HIV among WLHIV in Malawi.

Dataset Information

Teacher, caregiver, and student acceptability of teachers delivering task-shifted mental health care to students in Darjeeling, India: a mixed methods pilot study.

Background

Methods

Results

Conclusion

Supplementary information

Publications

Teacher, caregiver, and student acceptability of teachers delivering task-shifted mental health care to students in Darjeeling, India: a mixed methods pilot study.

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