TY - JOUR
T1 - Investigating software requirements for systems supporting task-shifted interventions
T2 - Usability study
AU - Van De Ven, Pepijn
AU - Araya, Ricardo
AU - De Paula Couto, Maria Clara P.
AU - Henrique, Maiara Garcia
AU - Meere, Damien
AU - Mendes, Ana Vilela
AU - Peters, Tim J.
AU - Seabra, Antônio
AU - Franzin, Renato M.
AU - Pereda, Paula Carvalho
AU - Scazufca, Marcia
N1 - Publisher Copyright:
© Pepijn Van de Ven, Ricardo Araya, Maria Clara P de Paula Couto, Maiara Garcia Henrique, Damien Meere, Ana Vilela Mendes, Tim J Peters, Antônio Seabra, Renato M Franzin, Paula Carvalho Pereda, Marcia Scazufca.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Background: There is a considerable shortfall in specialized health care professionals worldwide to deliver health services, and this shortfall is especially pronounced in low-middle-income countries. This has led to the implementation of task-shifted interventions, in which specific tasks are moved away from highly qualified health workers to health workers with less training. The World Health Organization (WHO) has published recommendations for such interventions, but guidelines for software and systems supporting such interventions are not included. Objective: The objective of this study was to formulate a number of software requirements for computer systems supporting task-shifted interventions. As the treatment of mental health problems is generally considered to be a task for highly trained health care professionals, it poses interesting case studies for task-shifted interventions. Therefore, we illustrated the use of the identified software requirements in a mobile system created for a task-shifted depression intervention to be provided to older adults in deprived areas of São Paulo, Brazil. Methods: Using a set of recommendations based on the WHO’s guidance documentation for task-shifted interventions, we identified 9 software requirements that aim to support health workers in management and supervision, training, good relationship with other health workers, and community embeddedness of the intervention. These 9 software requirements were used to implement a system for the provision of a psychosocial depression intervention with mobile Android interfaces to structure interventions and collect data, and Web interfaces for supervision and support of the health care workers delivering the intervention. The system was tested in a 2-arm pilot study with 33 patients and 11 health workers. In all, 8 of these 11 health workers participated in a usability study subsequent to the pilot. Results: The qualitative and quantitative feedback obtained with the System Usability Scale suggest that the system was deemed to have a usability of between OK and Good. Nevertheless, some participants’ responses indicated that they felt they needed technical assistance to use the system. This was reinforced by answers obtained with perceived usefulness and ease of use questionnaires, which indicated some users felt that they had issues around correct use of the system and perceived ability to become skillful at using the system. Conclusions: Overall, these high-level requirements adequately captured the functionality required to enable the health workers to provide the intervention successfully. Nevertheless, the analysis of results indicated that some improvements were required for the system to be useable in a task-shifted intervention. The most important of these were better access to a training environment, access for supervisors to metadata such as duration of sessions or exercises to identify issues, and a more robust and human-error–proof approach to the availability of patient data on the mobile devices used during the intervention.
AB - Background: There is a considerable shortfall in specialized health care professionals worldwide to deliver health services, and this shortfall is especially pronounced in low-middle-income countries. This has led to the implementation of task-shifted interventions, in which specific tasks are moved away from highly qualified health workers to health workers with less training. The World Health Organization (WHO) has published recommendations for such interventions, but guidelines for software and systems supporting such interventions are not included. Objective: The objective of this study was to formulate a number of software requirements for computer systems supporting task-shifted interventions. As the treatment of mental health problems is generally considered to be a task for highly trained health care professionals, it poses interesting case studies for task-shifted interventions. Therefore, we illustrated the use of the identified software requirements in a mobile system created for a task-shifted depression intervention to be provided to older adults in deprived areas of São Paulo, Brazil. Methods: Using a set of recommendations based on the WHO’s guidance documentation for task-shifted interventions, we identified 9 software requirements that aim to support health workers in management and supervision, training, good relationship with other health workers, and community embeddedness of the intervention. These 9 software requirements were used to implement a system for the provision of a psychosocial depression intervention with mobile Android interfaces to structure interventions and collect data, and Web interfaces for supervision and support of the health care workers delivering the intervention. The system was tested in a 2-arm pilot study with 33 patients and 11 health workers. In all, 8 of these 11 health workers participated in a usability study subsequent to the pilot. Results: The qualitative and quantitative feedback obtained with the System Usability Scale suggest that the system was deemed to have a usability of between OK and Good. Nevertheless, some participants’ responses indicated that they felt they needed technical assistance to use the system. This was reinforced by answers obtained with perceived usefulness and ease of use questionnaires, which indicated some users felt that they had issues around correct use of the system and perceived ability to become skillful at using the system. Conclusions: Overall, these high-level requirements adequately captured the functionality required to enable the health workers to provide the intervention successfully. Nevertheless, the analysis of results indicated that some improvements were required for the system to be useable in a task-shifted intervention. The most important of these were better access to a training environment, access for supervisors to metadata such as duration of sessions or exercises to identify issues, and a more robust and human-error–proof approach to the availability of patient data on the mobile devices used during the intervention.
KW - Community health workers
KW - Depression
KW - Medical informatics
KW - Task-shifting
UR - http://www.scopus.com/inward/record.url?scp=85074834658&partnerID=8YFLogxK
U2 - 10.2196/11346
DO - 10.2196/11346
M3 - Article
C2 - 31714246
AN - SCOPUS:85074834658
SN - 1438-8871
VL - 21
SP - -e11346
JO - Journal of Medical Internet Research
JF - Journal of Medical Internet Research
IS - 11
M1 - e11346
ER -