- Kathryn Kanzler, PsyD, ABPP, UT Health San Antonio, San Antonio, TX
- Yajaira Johnson-Esparza, PhD, UT Health San Antonio, San Antonio, TX
- Patricia J. Robinson, Mountainview Consulting Group, Portland, OR
“Task-shifting” or “task-sharing” is a dissemination and implementation strategy for increasing behavioral health care availability in lower-resource and underserved communities. Evidence is robust for the effectiveness of task-shifting behavioral health interventions, whereby licensed mental health professionals “shift” specific tasks to non-specialist or lay health workers, thereby increasing availability of evidence-based care (Barnett et al., 2018). In primary care settings, task-shifting can extend the care of behavioral health providers and bridge the gap between clinic and community, thereby promoting fair and just healthcare for underserved and lower-resource communities. Community health workers (CHWs) are ideally situated for task-shifting roles due to their trusted positions in the community, skills in addressing social determinants of health, and potential cost-effectiveness. However, little has been established regarding the actual steps (methods) required to adapt interventions that were initially developed for delivery by licensed clinicians so that they can be appropriately delivered by lay personnel. Therefore, we are conducting a systematic review to identify the key steps used to effectively adapt evidence-based psychological treatments for delivery by lay/non-licensed CHWs. Following a detailed pre-published protocol aligned with PRISMA-P guidelines (2015), we have searched multiple databases from 2000 – 2020 and reviewed 218 articles to date; we anticipate approximately 25 studies will meet inclusion criteria for data abstraction. We are assessing risk of bias using the Cochrane Risk of Bias (RoB 2) tool, and publication bias using the Cochrane GRADE approach. Abstracted data will be organized based on an established framework for operationalizing implementation strategies (Proctor et al., 2013).
During this presentation, we will report our final results, including best practices for task-shifting behavioral health treatments to CHWs and implications for integrated primary care teams. We will also discuss how task-shifting is an avenue for increased health equity for underserved and low-resource communities.
- Provide an updated evidence-based summary of the benefits of task-shifting/task-sharing
- Identify best practices for adapting behavioral health interventions for use in task-shifting research & practice based on systematic review data
- Discuss how task-shifting can be applied in integrated primary care settings to expand access to behavioral health care in underserved communities