#  SAMBHAV 

 



---

## **S**tress **A**lleviation **M**ethods for community-**B**ased **H**ealth **A**cti**V**ists 

Completed project (2021-2022).

###   
  
The Aim of the Study:

  
Led by **Dr. John Naslund & Anant Bhan,** SAMBHAV aimed to innovate a scalable digital program for stress reduction tailored for Community Health Workers (CHWs) in rural India, leveraging the WHO's Self Help Plus (SH+) intervention.  
  
This initiative intended to adapt SH+ to the unique needs, cultural contexts, and digital landscapes of CHWs, transforming it into a smartphone application developed under the ESSENCE project. The primary goals included assessing the program's feasibility, acceptability, and preliminary effectiveness in alleviating stress among CHWs.

### The Background:

  
There has been a rising need to mitigate psychological distress among CHWs that was amplified by the COVID-19 pandemic's challenges. Situated within the larger NIMH U19 ESSENCE (Enabling Science to Service to ENhance depression CarE) project, which focuses on enhancing depression care in rural primary settings in India, SAMBHAV addresses the significant gap in mental health support for CHWs through a digital stress reduction and mental health promotion platform.

###   
The Project Plan:

  
The central components of SAMBHAV, i.e., the adapted digital SH+ intervention, were the instructional videos. These short videos consisted of lectures covering the core content of SH+, as well as role-play videos demonstrating the application of the various skills and techniques for managing stress in everyday scenarios, tailored to what ASHAs may typically encounter. Additionally, the SAMBHAV manual was designed to specifically include storytelling and relatable examples for ASHAs, and is closely aligned with the original WHO SH+ manual content and layout.

### Supporters and Project Duration:

SAMBHAV was supported by the **Harvard Global Health Institute** (HGHI) and ran from 2021 to 2022.

### Findings:

The feasibility, acceptability, and initial impact of SAMBHAV were evaluated through a pilot study involving CHWs. This assessment utilized self-reported metrics, objective engagement data, and focus group discussions to gauge program reception and effectiveness. Preliminary outcomes were measured in terms of reductions in psychological distress, improvements in job performance, and improvements in quality of life.

### Next Steps:

The SAMBHAV team has plans to submit a scale-up proposal for this project. Check back soon for more updates.

### Publications:

- January 2026 Publication: [A digital adaptation of the WHO's Self-Help Plus psychological intervention to alleviate stress among community health workers: a mixed-methods evaluation of the SAMBHAV program in rural India](https://drive.google.com/file/d/1Iri8EYqgZI4ajO6e3k5_lvQ5T6gF2D3U/view?usp=sharing)
- December 2023 Publication: [Stress Alleviation Methods for community-Based Health ActiVists (SAMBHAV): Development of a digital program for stress reduction for community health workers in rural India](https://www.sciencedirect.com/science/article/pii/S2666560323000452)

###  



 

     ![SAMBHAV Manual.](/sites/g/files/omnuum8326/files/styles/hwp_3_2__480x320/public/mentalhealthlab/files/27.jpg?itok=g19vwZsP) 

 



 

  

 

     ![SAMBHAV training videos](/sites/g/files/omnuum8326/files/styles/hwp_3_2__480x320/public/mentalhealthlab/files/28.jpg?itok=3kIQCtkA) 

 



 

  

 

 

 

 

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