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Lessons learned through piloting a community-based SMS referral system for common mental health disorders used by female community health volunteers in rural Nepal.

Publication ,  Journal Article
Bhardwaj, A; Subba, P; Rai, S; Bhat, C; Ghimire, R; Jordans, MJD; Green, E; Vasudevan, L; Kohrt, BA
Published in: BMC Res Notes
July 1, 2020

OBJECTIVE: The Community Informant Detection Tool (CIDT) is a paper-based proactive case detection strategy with evidence for improving help-seeking behavior for mental healthcare. Key implementation barriers for the paper-based CIDT include delayed reporting of cases and lack of active follow up. We used mobile phones and structured text messages to improve timeliness of case reporting, encouraging follow up, and case record keeping. 36 female community health volunteers piloted this mobile phone CIDT (mCIDT) for three months in 2017 in rural Nepal. RESULTS: Only 8 cases were identified by health volunteers using mCIDT, and only two of these cases engaged with health services post-referral. Accuracy with the mCIDT was considerably lower than paper-based CIDT, especially among older health volunteers, those with lower education, and those having difficulties sending text messages. Qualitative findings revealed implementation challenges including cases not following through on referrals due to perceived lack of staff at health facilities, assumptions among health volunteers that all earthquake-related mental health needs had been met, and lack of financial incentives for use of mCIDT. Based on study findings, we provide 5 recommendations-in particular attitudinal and system preparedness changes-to effectively introduce new mental healthcare technology in low resource health systems.

Duke Scholars

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Published In

BMC Res Notes

DOI

EISSN

1756-0500

Publication Date

July 1, 2020

Volume

13

Issue

1

Start / End Page

309

Location

England

Related Subject Headings

  • Text Messaging
  • Telemedicine
  • Rural Population
  • Process Assessment, Health Care
  • Pilot Projects
  • Patient Acceptance of Health Care
  • Nepal
  • Mental Disorders
  • Humans
  • Female
 

Citation

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Bhardwaj, A., Subba, P., Rai, S., Bhat, C., Ghimire, R., Jordans, M. J. D., … Kohrt, B. A. (2020). Lessons learned through piloting a community-based SMS referral system for common mental health disorders used by female community health volunteers in rural Nepal. BMC Res Notes, 13(1), 309. https://doi.org/10.1186/s13104-020-05148-5
Bhardwaj, Anvita, Prasansa Subba, Sauharda Rai, Chaya Bhat, Renasha Ghimire, Mark J. D. Jordans, Eric Green, Lavanya Vasudevan, and Brandon A. Kohrt. “Lessons learned through piloting a community-based SMS referral system for common mental health disorders used by female community health volunteers in rural Nepal.BMC Res Notes 13, no. 1 (July 1, 2020): 309. https://doi.org/10.1186/s13104-020-05148-5.
Bhardwaj, Anvita, et al. “Lessons learned through piloting a community-based SMS referral system for common mental health disorders used by female community health volunteers in rural Nepal.BMC Res Notes, vol. 13, no. 1, July 2020, p. 309. Pubmed, doi:10.1186/s13104-020-05148-5.
Bhardwaj A, Subba P, Rai S, Bhat C, Ghimire R, Jordans MJD, Green E, Vasudevan L, Kohrt BA. Lessons learned through piloting a community-based SMS referral system for common mental health disorders used by female community health volunteers in rural Nepal. BMC Res Notes. 2020 Jul 1;13(1):309.
Journal cover image

Published In

BMC Res Notes

DOI

EISSN

1756-0500

Publication Date

July 1, 2020

Volume

13

Issue

1

Start / End Page

309

Location

England

Related Subject Headings

  • Text Messaging
  • Telemedicine
  • Rural Population
  • Process Assessment, Health Care
  • Pilot Projects
  • Patient Acceptance of Health Care
  • Nepal
  • Mental Disorders
  • Humans
  • Female