Publication: Effectiveness and cost-effectiveness of digital approaches for training frontline health workers in depression care: a randomized controlled trial

This randomized controlled trial tested whether digital training can effectively and affordably prepare frontline health workers to deliver behavioral activation for depression. Accredited Social Health Activists in rural Madhya Pradesh, India (n=339) were randomized to self-guided digital training (DGT), digital training plus remote coaching (DGT+), or face-to-face classroom training (F2F). Completion rates were high across all arms (87–96%), and knowledge scores improved significantly in all groups. F2F and DGT+ yielded similar knowledge gains, while DGT performed slightly worse but not significantly so. Digital training was substantially cheaper per participant (US$121–150) than F2F (US$209), and was more cost-effective at lower willingness-to-pay thresholds. These findings indicate that digitally delivered training, particularly with coaching support, is a scalable, lower-cost alternative to traditional classroom-based training for strengthening the depression care workforce.