Design and Pilot Evaluation of a Mechanism-Informed Blended Group Support Psychotherapy Training in Uganda: A Mixed Methods Study

Background: Blended learning approaches offer a promising strategy to address limited access to competency-based psychotherapy training in low-resource settings. This study describes the design and pilot evaluation of a mechanism-informed blended training programme to build the capacity of non-specialist health workers to deliver Group Support Psychotherapy (GSP). Methods: We conducted a mixed-methods study comprising two phases: (1) the design and development of the mechanism-informed SEEK-GSP Academy, a blended Learning Management System integrating self-paced online learning, live interactive teaching, supervised practical demonstrations, competency assessment, and implementation of GSP; and (2) a single-arm pilot evaluation among non-specialist health workers and lay providers in Uganda. Quantitative data included participant progression through the training pathway, platform utilization, module ratings, pre- and post-training knowledge assessments, and initiation of GSP delivery. Factors independently associated with knowledge gain and implementation of GSP groups were identified using multivariable linear and logistic regression models, respectively. Qualitative data on participant experiences, platform usability, and implementation challenges were collected through open-ended survey questions and analysed thematically. Results: Of 203 trainees enrolled, 157 (77.3%) completed the online training. Among completers, mean knowledge scores increased from 80.1 (SD 16.6) to 91.6 (SD 7.4), a mean gain of 11.5 points (p<0.001); 84.7% improved. Lower baseline knowledge (adjusted β=−0.72, 95% CI −1.00 to −0.44) and greater effort expectancy (adjusted β=1.43, 95% CI 0.16–2.70) independently predicted greater knowledge gain. Of the online completers, 116 (73.9%) progressed to practical demonstrations, of whom 72 (62.1%) initiated GSP groups. Older age independently predicted GSP adoption (adjusted OR=1.05 per year, 95% CI 1.01–1.10). Qualitative findings indicated high acceptability of the training, with participants valuing the blended approach and recommending greater opportunities for face-to-face interaction, practical demonstrations, role-plays and supervision. Conclusion: The mechanism-informed blended GSP training platform was feasible and acceptable, improved knowledge, and supported delivery of GSP sessions with high fidelity.