Improving Community Health Worker Performance by Using a Personalised Feedback Dashboard for Supervision: a Randomised Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 148
- 主要终点
- Quantity of care
研究概览
简要总结
Countries across sub-Saharan Africa are scaling up Community Health Worker (CHW) programmes, yet there remains little high-quality research assessing strategies for CHW supervision and performance improvement. This randomised controlled trial aims to determine the effect of a personalised performance dashboard used as a supervision tool on the quantity, speed, and quality of CHW care. This study is a randomised controlled trial in a large health catchment area in peri-urban Mali. One hundred forty-eight CHWs conducting proactive case-finding home visits were randomly allocated to receive individual monthly supervision with or without the CHW Performance Dashboard from January to June 2016. Randomisation was stratified by CHW supervisor, level of CHW experience, and CHW baseline performance for monthly quantity of care (number of household visits). With regression analysis, we used a difference-in-difference model to estimate the effect of the intervention on monthly quantity, timeliness (percentage of children under five treated within 24 hours of symptom onset), and quality (percentage of children under five treated without protocol error) of care over a six-month post-intervention period relative to a three-month pre-intervention period.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 45 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •To be a CHW in the study site at the time of enrolment (n=148)
排除标准
- •CHW who pretested the Dashboard tool (n=2)
研究组 & 干预措施
No dashboard supervision tool
CHWs received monthly individual supervision from a dedicated CHW supervisor. The supervisory feedback session for CHWs in the control arm was not facilitated by a visual Dashboard tool or any personalised quantitative feedback on quantity, speed, or quality of care. CHW supervisors were instructed to continue providing CHWs in the control arm with feedback informed by patient perspectives and direct observation during the individual supervision visit.
干预措施: The CHW-led health system (Other)
No dashboard supervision tool
CHWs received monthly individual supervision from a dedicated CHW supervisor. The supervisory feedback session for CHWs in the control arm was not facilitated by a visual Dashboard tool or any personalised quantitative feedback on quantity, speed, or quality of care. CHW supervisors were instructed to continue providing CHWs in the control arm with feedback informed by patient perspectives and direct observation during the individual supervision visit.
干预措施: The CHW Supervision model (Other)
Dashboard supervision tool
CHWs received monthly individual supervision from a dedicated CHW supervisor. For CHWs randomised to the intervention arm, a visual feedback tool, the CHW Performance Dashboard, was employed during individual supervision, starting in January 2016. During the individual supervisory feedback session, this personalised and relative (to the highest performer) quantitative performance feedback helped orient the discussion of strengths and weaknesses, and allowed the CHW to see quantitatively and visually how his/her performance fared the previous month. The feedback provided to CHWs in the intervention arm, therefore, was both quantitative, informed by the Dashboard, and qualitative, informed by patient perspectives and direct observation of CHW service provision during the individual supervision visit.
干预措施: The CHW-led health system (Other)
Dashboard supervision tool
CHWs received monthly individual supervision from a dedicated CHW supervisor. For CHWs randomised to the intervention arm, a visual feedback tool, the CHW Performance Dashboard, was employed during individual supervision, starting in January 2016. During the individual supervisory feedback session, this personalised and relative (to the highest performer) quantitative performance feedback helped orient the discussion of strengths and weaknesses, and allowed the CHW to see quantitatively and visually how his/her performance fared the previous month. The feedback provided to CHWs in the intervention arm, therefore, was both quantitative, informed by the Dashboard, and qualitative, informed by patient perspectives and direct observation of CHW service provision during the individual supervision visit.
干预措施: The CHW Supervision model (Other)
Dashboard supervision tool
CHWs received monthly individual supervision from a dedicated CHW supervisor. For CHWs randomised to the intervention arm, a visual feedback tool, the CHW Performance Dashboard, was employed during individual supervision, starting in January 2016. During the individual supervisory feedback session, this personalised and relative (to the highest performer) quantitative performance feedback helped orient the discussion of strengths and weaknesses, and allowed the CHW to see quantitatively and visually how his/her performance fared the previous month. The feedback provided to CHWs in the intervention arm, therefore, was both quantitative, informed by the Dashboard, and qualitative, informed by patient perspectives and direct observation of CHW service provision during the individual supervision visit.
干预措施: The CHW Performance Dashboard (Other)
结局指标
主要结局
Quantity of care
时间窗: 9 months
The number of proactive case-finding home visits during the month
次要结局
- Quality of care(9 months)
- Timeliness of care(9 months)
研究者
Ari Johnson, MD
Assistant Professor
University of California, San Francisco