The effectiveness of a psycho-education intervention on mental health literacy in communities affected by the COVID-19 pandemic—a cluster randomized trial of 24 villages in central Uganda—a research protocol

Abstract Background Literature shows a high prevalence of psychological distress (PD) as well as common mental disorders (CMD) such as major depressive disorders (MDD), generalized anxiety disorders (GAD), post-traumatic stress disorders (PTSD), and substance misuse disorders (SUD) among people exposed to disasters and pandemics like the COVID-19. Moreover, CMD are associated with increased mortality (mainly through suicide) and morbidity (loss of productivity). A number of countries have made deliberate efforts to identify and manage CMD in light of COVID-19. However, low levels of mental health literacy (MHL) manifested by the individual’s unawareness of CMD symptoms, limited human and mental health infrastructure resources, and high levels of mental illness stigma (MIS) are barriers to integration of mental health care in general health care during pandemics and epidemics such as the COVID-19. Objectives For the proposed study, we will determine effectiveness of a psycho-education intervention delivered by village health team (VHT) members. Methods We will employ a cluster randomized trial design in 24 villages in central Uganda. We will collect baseline data to and document the prevalence of MHL, PD, MDD, PTSD, GAD, and SUD. We will distribute information education and communication materials (IEC) aimed at improving MHL to 420 adult individuals in the intervention arm (n = 12 villages). In the control arm (n = 12 villages), VHTs will distribute ministry of health COVID-19 information leaflets to 420 participants. Within 7 days of distributing the materials, research assistants will conduct a follow-up interview and assess for the same parameters (MHL, PD, MDD, PTSD, GAD, and SUD). We will use an intention to treat analysis to estimate the effectiveness of the psycho-education intervention. Discussion Findings from this research will guide policy and practice regarding the integration of mental health services in the community in the context of epidemic preparedness and response. Trial registration ClinicalTrials.govNCT04616989. Registered on 05 November 2020

Download Full-text

Advancing successful implementation of task-shifted mental health care in low-resource settings (BASIC): protocol for a stepped wedge cluster randomized trial

BMC Psychiatry ◽

10.1186/s12888-019-2364-4 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 4

Author(s):

Shannon Dorsey ◽

Christine L. Gray ◽

Augustine I. Wasonga ◽

Cyrilla Amanya ◽

Bryan J. Weiner ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Randomized Trial ◽

Cluster Randomized Trial ◽

Task Shifting ◽

Mental Health Intervention ◽

Stepped Wedge ◽

Cluster Randomized ◽

Policies And Practices

Abstract Background The mental health treatment gap—the difference between those with mental health need and those who receive treatment—is high in low- and middle-income countries. Task-shifting has been used to address the shortage of mental health professionals, with a growing body of research demonstrating the effectiveness of mental health interventions delivered through task-shifting. However, very little research has focused on how to embed, support, and sustain task-shifting in government-funded systems with potential for scale up. The goal of the Building and Sustaining Interventions for Children (BASIC) study is to examine implementation policies and practices that predict adoption, fidelity, and sustainment of a mental health intervention in the education sector via teacher delivery and the health sector via community health volunteer delivery. Methods BASIC is a Hybrid Type II Implementation-Effectiveness trial. The study design is a stepped wedge, cluster randomized trial involving 7 sequences of 40 schools and 40 communities surrounding the schools. Enrollment consists of 120 teachers, 120 community health volunteers, up to 80 site leaders, and up to 1280 youth and one of their primary guardians. The evidence-based mental health intervention is a locally adapted version of Trauma-focused Cognitive Behavioral Therapy, called Pamoja Tunaweza. Lay counselors are trained and supervised in Pamoja Tunaweza by local trainers who are experienced in delivering the intervention and who participated in a Train-the-Trainer model of skills transfer. After the first sequence completes implementation, in-depth interviews are conducted with initial implementing sites’ counselors and leaders. Findings are used to inform delivery of implementation facilitation for subsequent sequences’ sites. We use a mixed methods approach including qualitative comparative analysis to identify necessary and sufficient implementation policies and practices that predict 3 implementation outcomes of interest: adoption, fidelity, and sustainment. We also examine child mental health outcomes and cost of the intervention in both the education and health sectors. Discussion The BASIC study will provide knowledge about how implementation of task-shifted mental health care can be supported in government systems that already serve children and adolescents. Knowledge about implementation policies and practices from BASIC can advance the science of implementation in low-resource contexts. Trial registration Trial Registration: ClinicalTrials.gov Identifier: NCT03243396. Registered 9th August 2017, https://clinicaltrials.gov/ct2/show/NCT03243396

Download Full-text

4.57 Improved Access to Mental Health Care Using a Telehealth-Enhanced Referral Process in Pediatric Primary Care: A Cluster Randomized Trial

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2018.09.282 ◽

2018 ◽

Vol 57 (10) ◽

pp. S222

Author(s):

Tumaini R. Coker ◽

Lorena Porras-Javier ◽

Lily Zhang ◽

Neelkamal Soares ◽

Christine Park ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Mental Health Care ◽

Randomized Trial ◽

Cluster Randomized Trial ◽

Pediatric Primary Care ◽

Referral Process ◽

Cluster Randomized

Download Full-text

Developing Self-concept, Coping Skills, and Social Support in Grades 3–12: A Cluster-Randomized Trial of a Combined Mental Health Literacy and Dialectical Behavior Therapy Skills Program

School Mental Health ◽

10.1007/s12310-019-09353-x ◽

2019 ◽

Vol 12 (2) ◽

pp. 323-335 ◽

Cited By ~ 1

Author(s):

Jennifer Katz ◽

Sterett H. Mercer ◽

Sarah Skinner

Keyword(s):

Mental Health ◽

Social Support ◽

Health Literacy ◽

Behavior Therapy ◽

Dialectical Behavior Therapy ◽

Mental Health Literacy ◽

Coping Skills ◽

Cluster Randomized Trial ◽

Self Concept ◽

Cluster Randomized

Download Full-text

A Brief Sports-Based Mental Health Literacy Program for Male Adolescents: A Cluster-Randomized Controlled Trial

Journal of Applied Sport Psychology ◽

10.1080/10413200.2019.1653404 ◽

2019 ◽

pp. 1-25 ◽

Cited By ~ 3

Author(s):

Sarah K. Liddle ◽

Frank P. Deane ◽

Marijka Batterham ◽

Stewart A. Vella

Keyword(s):

Mental Health ◽

Randomized Controlled Trial ◽

Health Literacy ◽

Mental Health Literacy ◽

Controlled Trial ◽

Cluster Randomized Controlled Trial ◽

Literacy Program ◽

Male Adolescents ◽

Randomized Controlled ◽

Cluster Randomized

Download Full-text

School-based mental health intervention for children in war-affected Burundi: a cluster randomized trial

BMC Medicine ◽

10.1186/1741-7015-12-56 ◽

2014 ◽

Vol 12 (1) ◽

Cited By ~ 74

Author(s):

Wietse A Tol ◽

Ivan H Komproe ◽

Mark JD Jordans ◽

Aline Ndayisaba ◽

Prudence Ntamutumba ◽

...

Keyword(s):

Mental Health ◽

Randomized Trial ◽

Cluster Randomized Trial ◽

Health Intervention ◽

Mental Health Intervention ◽

School Based ◽

Cluster Randomized

Download Full-text

Assessing mental health literacy of primary health care workers in Kenya: a cross-sectional survey

International Journal of Mental Health Systems ◽

10.1186/s13033-021-00481-z ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Elijah Marangu ◽

Fethi Mansouri ◽

Natisha Sands ◽

David Ndetei ◽

Peterson Muriithi ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Primary Health Care ◽

Health Literacy ◽

Health Care Workers ◽

Health Care Services ◽

Mental Health Literacy ◽

Primary Health ◽

Primary Health Care Services ◽

Care Workers

Abstract Aim To assess mental health literacy of health workers in primary health care services in Kenya. Background Mental illness is common in Kenya, yet there are fewer than 500 specialist mental health workers to serve Kenya’s population of over 50 million. The World Health Organization recommends the integration of mental health care into primary health care services to improve access to and equity of this care, especially in low and middle-income countries. An important step to integrating mental health care into primary health care services is to determine mental health literacy levels of the primary health care workforce. Method A cross-sectional survey using Jorm’s Mental Health Literacy Instrument (adapted for the Kenyan context) was administered to 310 primary health care workers in four counties of Kenya. Results Of the 310 questionnaires distributed, 212 (68.3%) were returned. Of the respondents, 13% had a formal mental health qualification, while only 8.7% had received relevant continuing professional development in the five years preceding the survey. Just over one third (35.6%) of primary health care workers could correctly identify depression, with even fewer recognising schizophrenia (15.7%). Conclusions This study provides preliminary information about mental health literacy among primary health care workers in Kenya. The majority of respondents had low mental health literacy as indicated by their inability to identify common mental disorders. While identifying gaps in primary health care workers’ mental health knowledge, these data highlight opportunities for capacity building that can enhance mental health care in Kenya and similar low and middle-income countries.

Download Full-text