{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:31:55Z","timestamp":1790346715089,"version":"4.1.0"},"reference-count":34,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,12,13]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine the feasibility and acceptability of integrating a \u2018designated\u2019 approach to community health worker (CHW)-delivered mental health counselling (where existing CHWs deliver counselling in addition to usual duties) and a \u2018dedicated\u2019 approach (where additional CHWs have the sole responsibility of delivering mental health counselling) into chronic disease care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A feasibility test of a designated and dedicated approach to CHW-delivered counselling and qualitative interviews of CHWs delivering the counselling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Four primary healthcare clinics in the Western Cape, South Africa allocated to either a designated or dedicated approach and stratified by urban\/rural status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Forty chronic disease patients (20 with HIV, 20 with diabetes) reporting hazardous alcohol use or depression. Interviews with seven CHWs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Three sessions of structured mental health counselling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>We assessed feasibility by examining the proportion of patients who were willing to be screened, met inclusion criteria, provided consent, completed counselling and were retained in the study. Acceptability of these delivery approaches was assessed through qualitative interviews of CHWs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Regardless of approach, a fair proportion (67%) of eligible patients were willing to receive mental health counselling. Patients who screened positive for depression were more likely to be interested in counselling than those with hazardous alcohol only. Retention in counselling (85%) and the study (90%) was good and did not differ by approach. Both dedicated and designated CHWs viewed the counselling package as highly acceptable but requested additional training and support to facilitate implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dedicated and designated approaches to CHW-delivered mental health counselling were matched in terms of their feasibility and acceptability. A comparative efficacy trial of these approaches is justified, with some adjustments to the training and implementation protocols to provide further support to CHWs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-024277","type":"journal-article","created":{"date-parts":[[2019,1,15]],"date-time":"2019-01-15T14:55:29Z","timestamp":1547564129000},"page":"e024277","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":54,"title":["Community health worker-delivered counselling for common mental disorders among chronic disease patients in South Africa: a feasibility study"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0235-6716","authenticated-orcid":false,"given":"Bronwyn","family":"Myers","sequence":"first","affiliation":[{"name":"Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petal","family":"Petersen-Williams","sequence":"additional","affiliation":[{"name":"Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa"},{"name":"Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"van der Westhuizen","sequence":"additional","affiliation":[{"name":"Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crick","family":"Lund","sequence":"additional","affiliation":[{"name":"Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa"},{"name":"Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Lombard","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Unit, South African Medical Research Council, Tygerberg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A","family":"Joska","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi S","family":"Levitt","sequence":"additional","affiliation":[{"name":"Division for Diabetes and Endocrinology, Department of Medicine, University of Cape Town, cape town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Butler","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Services, Oxford 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