scholarly journals Single-Session Digital Intervention for Adolescent Depression, Anxiety and Well-being: Outcomes of a Randomized Controlled Trial with Kenyan Adolescents

2019 ◽  
Author(s):  
Tom L Osborn ◽  
Micaela Rodriguez ◽  
Akash Wasil ◽  
Katherine E. Venturo-Conerly ◽  
Jenny Gan ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Study Skills ◽  
Help Seeking ◽  
Adolescent Depression ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Depression Symptoms ◽  
Single Session ◽  
Registration Number ◽  
Sub Saharan

Background: Adolescent depression and anxiety symptoms are prevalent in Sub-Saharan African countries, yet treatment options are scarce, and stigma limits help-seeking. Brief, computerized single-session interventions (SSIs) that contain empirically supported stigma-reducing elements may help expand access to treatment. We developed and evaluated such an intervention for Kenyan adolescents. Method: High school students (N=103, age 13-18) were randomized to a digital SSI Shamiri-Digital (Shamiri means “thrive” in Kiswahili) or a study-skills control intervention. Shamiri-Digital consisted of reading and writing activities about three concepts: growth mindset, gratitude, and value affirmation. Both Shamiri-Digital and the study-skills control condition were delivered electronically in schools. Results: Compared to the control, Shamiri-Digital produced greater reduction in adolescent depression symptoms in both the full sample (p = 0.028, d = 0.50) and a sub-sample of youths with moderate-to-severe depression symptoms (p = 0.010, d = 0.83) from baseline to two-week follow-up. The effects exceed the mean effects reported in meta-analyses of full-length, face-to-face psychotherapy for youth depression. There were no significant effects on anxiety symptoms, well-being, or happiness. Conclusion: This is the first report that a brief, computerized SSI may reduce depressive symptoms in adolescents in Sub-Saharan Africa. Replication trials with extended follow-ups will help gauge the strength and durability of these effects. Trial Registration Number: (registration number masked). Pan African Clinical Trials Registry (PACTR). Public Health Significance: This study provides evidence that a brief single-session positive-psychology intervention may help reduce depressive symptoms of adolescents living in Sub Saharan Africa, where there are few mental health professionals, and stigma limits help-seeking

scholarly journals Virtual Reality and Web-Based Growth Mindset Interventions for Adolescent Depression: Protocol for a Three-Arm Randomized Trial (Preprint)

2019 ◽  
Author(s):  
Jessica Lee Schleider ◽  
Michael C Mullarkey ◽  
John R Weisz
Keyword(s):  
Virtual Reality ◽  
Depressive Symptoms ◽  
Perceived Control ◽  
Adolescent Depression ◽  
Growth Mindset ◽  
Depression Symptoms ◽  
Single Session ◽  
Post Intervention ◽  
Web Based ◽  
The Web

BACKGROUND Depression is the leading cause of disability in youth, with a global economic burden of US >$210 billion annually. However, up to 70% of youth with depression do not receive services. Even among those who do access treatment, 30% to 65% fail to respond and many dropout prematurely, demonstrating a need for more potent, accessible interventions. In a previous trial, a single-session Web-based growth mindset (GM) intervention significantly reduced depressive symptoms in high-symptom adolescents; however, this intervention did not benefit adolescents uniformly. For instance, the intervention reduced depression in adolescents who reported post intervention increases in perceived control, but it did not lead to significant depression reductions in adolescents who reported no significant post intervention increases in perceived control. OBJECTIVE The goal of this project is to test the acceptability and efficacy of a novel, single-session, virtual reality (VR) depression intervention—the VR Personality Project—teaching GM, the belief that personal attributes are malleable rather than fixed. The VR Personality Project was designed to systematically target and increase adolescents’ perceived control by offering a more immersive, engaging, user-directed intervention experience than the Web-based intervention can provide. By targeting an identified predictor of intervention response, the VR Personality Project may lead to larger reductions in depressive symptoms than existing Web-based mindset interventions. METHODS Adolescents with elevated depressive symptoms or a recent history of depression (N=159; ages 12 to 16 years) will be randomized to one of 3 intervention conditions: the VR Personality Project; the Web-based GM intervention tested previously; or an active, Web-based control. Adolescents and their parents will report on the adolescents’ depression symptoms, perceived control, and related domains of functioning at preintervention, postintervention, and at 3- and 9-month follow-up assessments. RESULTS We predict that the VR and Web-based mindset interventions will both lead to larger reductions in adolescent symptoms than the control intervention. Additionally, we predict that the VR-based single session intervention will lead to larger reductions in depression than the online mindset intervention and that these symptom reductions will be mediated by increases in adolescents’ perceived control from pre- to postintervention. CONCLUSIONS The results may suggest an efficient strategy for reducing adolescent depressive symptoms: One that is mechanism-targeted, relatively affordable (less than US $200 for a commercially available VR headset, a fraction of the cost of long-term psychotherapy) and potentially engaging to adolescents experiencing mood-related distress. CLINICALTRIAL ClinicalTrials.gov NCT0385881; https://clinicaltrials.gov/ct2/show/NCT03858881 (Archived by WebCite at http://www.webcitation.org/78C3roDgA). INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13368

scholarly journals Relationships with caregivers and mental health outcomes among adolescents living with HIV: a prospective cohort study in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yulia Shenderovich ◽  
Mark Boyes ◽  
Michelle Degli Esposti ◽  
Marisa Casale ◽  
Elona Toska ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Cohort Study ◽  
Mental Health Problems ◽  
Health Problems ◽  
Sub Saharan Africa ◽  
Depression Symptoms ◽  
Sub Saharan ◽  
Positive Caregiving ◽  
Living With Hiv

Abstract Background Mental health problems may impact adherence to anti-retroviral treatment, retention in care, and consequently the survival of adolescents living with HIV. The adolescent-caregiver relationship is an important potential source of resilience. However, there is a lack of longitudinal research in sub-Saharan Africa on which aspects of adolescent-caregiver relationships can promote mental health among adolescents living with HIV. We draw on a prospective longitudinal cohort study undertaken in South Africa to address this question. Methods The study traced adolescents aged 10–19 initiated on antiretroviral treatment in government health facilities (n = 53) within a health district of the Eastern Cape province. The adolescents completed standardised questionnaires during three data collection waves between 2014 and 2018. We used within-between multilevel regressions to examine the links between three aspects of adolescent-caregiver relationships (caregiver supervision, positive caregiving, and adolescent-caregiver communication) and adolescent mental health (depression symptoms and anxiety symptoms), controlling for potential confounders (age, sex, rural/urban residence, mode of infection, household resources), n=926 adolescents. Results Improvements in caregiver supervision were associated with reductions in anxiety (0.98, 95% CI 0.97–0.99, p=0.0002) but not depression symptoms (0.99, 95% CI 0.98–1.00, p=.151), while changes in positive caregiving were not associated with changes in mental health symptoms reported by adolescents. Improvements in adolescent-caregiver communication over time were associated with reductions in both depression (IRR=0.94, 95% CI 0.92–0.97, p<.0001) and anxiety (0.91, 95% CI 0.89–0.94, p<.0001) symptoms reported by adolescents. Conclusions Findings highlight open and supportive adolescent-caregiver communication and good caregiver supervision as potential factors for guarding against mental health problems among adolescents living with HIV in South Africa. Several evidence-informed parenting programmes aim to improve adolescent-caregiver communication and caregiver supervision, and their effect on depression and anxiety among adolescents living with HIV should be rigorously tested in sub-Saharan Africa. How to improve communication in other settings, such as schools and clinics, and provide communication support for caregivers, adolescents, and service providers through these existing services should also be considered.

scholarly journals Intersectional stigma and its impact on HIV prevention and care among MSM and WSW in sub-Saharan African countries: a protocol for a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047280
Author(s):  
Gamji M’Rabiu Abubakari ◽  
Debbie Dada ◽  
Jemal Nur ◽  
DeAnne Turner ◽  
Amma Otchere ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Data Extraction ◽  
Grey Literature ◽  
Secondary Data ◽  
Well Being ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Scoping Reviews ◽  
Sub Saharan ◽  
Meta Analyses

IntroductionResearch has established that various forms of stigma (HIV stigma, gender non-conforming stigma and same-gender sex stigma) exist across Sub-Saharan Africa and have consequences for the utilisation of HIV prevention and care services. Stigmas are typically investigated in HIV literature individually or through investigating individual populations and the various stigmas they may face. The concept of intersectionality highlights the interconnected nature of social categorisations and their ability to create interdependent systems of discrimination based on gender, race, sexuality and so on. Drawing from perspectives on intersectionality, intersectional stigma denotes the convergence of multiple marginalised identities within an individual or a group, the experiences of stigma associated with these identities as well as the synergistic impact of these experiences on health and well-being. With respect to HIV, public health scholars can examine the impacts of intersectional stigmas on HIV prevention and care utilisation.Methods and analysisReviewers will search systematically through MEDLINE, Global Health, Embase, Scopus, Web of Science Core Collection and Africa Index Medicus and citations for quantitative studies, qualitative studies and grey literature that include data on stigma and HIV among men who have sex with men and women who have sex with women in Sub-Saharan Africa. Eligible studies will include primary or secondary data on stigma related to HIV risk factors experienced by this population. Studies will be written in French or English and be published between January 1991 and November 2020. All screening and data extraction will be performed in duplicate, and if discrepancies arise, they will be settled by GM’RA, LEN, DD or AO. Findings from this study will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.Ethics and disseminationEthics approval is not required as there will be no human participants and no protected data will be used in this study. We will disseminate findings through peer-reviewed manuscripts, conferences and webinars.

Family Resemblances, Practical Interrelations and Material Extensions: Understanding Sexual Prohibitions, Production and Consumption in Kilimanjaro

Africa ◽  
2007 ◽  
Vol 77 (3) ◽  
pp. 307-330 ◽  
Author(s):  
Knut Christian Myhre
Keyword(s):  
Social Life ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Local Mode ◽  
Language Games ◽  
Beneficial Effects ◽  
Ex Post ◽  
Family Resemblances ◽  
Mode Of Life ◽  
Sub Saharan

AbstractThrough the ‘procreative paradigm’, sexuality and its relationships to other social practices have recently regained importance in the study of sub-Saharan Africa. Despite its apparent novelty, I argue that this paradigm invokes an anthropological approach that harks back to the discipline's beginnings. In an attempt at a fresh departure, I use Ludwig Wittgenstein's late philosophy to investigate the meaning of sexual prohibitions among the Chagga-speaking people of Rombo District, Kilimanjaro Region, Tanzania. Starting from local linguistic usage, I describe the multiple ‘language-games’ of the vernacular notion of ‘power’,horu. In this manner, I demonstrate how production, reproduction and consumption are conceptually, practically and materially intertwined through the ‘family resemblances’ of this local concept.Horuis expended through productive practices; in multiple ways it is converted, transferred and exchanged between adults and children in reproduction; and it is replenished through the consumption of specific ‘powerful’ foods. By means of different objects, the activities of work, sex and feeding enable ‘power’ to flow between persons. The multiple vernacular usages of the notion ofhoru, and its practical and material concomitants, interrelate diverse spheres of social life in such a manner that they constitute an overlapping network that extends laterally. Human capability and well-being are constituted through participation in these activities, and engagement in the mutual flows, conversions and exchanges of ‘power’ that encompass humans, livestock and vegetable matter. The sexual prohibitions of Rombo regulate and channel these flows and conversions, in order to ensure their beneficial effects for the parties concerned. I therefore argue that the sexual prohibitions are notex post factointerpretations or justifications that explain or control preceding experiences, but rather that they are constitutive of the local mode of life. An appreciation of lateral relationships between concepts, practices and objects enables an evasion of some of the problems that arise from the procreative paradigm.

“It’s better I’m dead”: oppression and suicidal ideation

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lisa Reber
Keyword(s):  
Suicidal Ideation ◽  
Host Country ◽  
Migrant Workers ◽  
Well Being ◽  
Environmental Context ◽  
Sub Saharan Africa ◽  
Content Type ◽  
Temporary Migrant ◽  
Sub Saharan ◽  
First Time

Purpose Anecdotal accounts of suicide among temporary low-wage migrant workers in the UAE are numerous, but unofficial and qualitative accounts remain unexplored. This study aims to examine how the socio-environmental context can lead some low-wage migrants, irrespective of their nationality or culture, to contemplate suicide for the first time after arriving in the host country. Design/methodology/approach The findings draw from ten months of qualitative fieldwork (2015–2016) and in-depth interviews conducted with 44 temporary migrant workers from sub-Saharan Africa and South Asia, earning in the lowest wage bracket in Dubai. The study used a non-probabilistic, purposive sampling approach to select participants. Three criteria drove eligibility: participants had to reside in the UAE, be non-national and earn Dh1500 (US$408) or less a month. Otherwise, diversity was sought in regard to nationality, occupation and employer. Findings Eight (18%) of the 44 study participants interviewed admitted to engaging in suicidal thoughts for the first time after arriving in the UAE. The findings suggest that for low-wage migrants working in certain socio-environmental contexts, the religious, gendered or other cultural or group characteristics or patterns that may be predictors of suicide in migrants’ country of origin may become secondary or possibly even irrelevant when one is forced to survive under conditions that by most objective standards would be deemed not only oppressive but extremely exploitative and abusive. Originality/value This study contributes to understandings of how the emotional and psychological well-being of temporary foreign low-wage migrant workers can be impacted by the socio-environmental context of the host country. It is a first step in understanding the intimate thoughts of low-wage migrant workers on the topic of suicidality, furthering our understanding of suicidal ideation and the factors that can contribute to it.

scholarly journals Depressive Symptoms and Associated Factors in Female Students in Fukushima Four Years after the Fukushima Nuclear Power Plant Disaster

2018 ◽  
Vol 15 (11) ◽  
pp. 2411 ◽  
Author(s):  
Shinya Ito ◽  
Mie Sasaki ◽  
Satoko Okabe ◽  
Nobuhiro Konno ◽  
Aya Goto
Keyword(s):  
Depressive Symptoms ◽  
Risk Perceptions ◽  
Radiation Risk ◽  
Well Being ◽  
Female Students ◽  
World Health ◽  
Nuclear Radiation ◽  
Depression Symptoms ◽  
Cross Sectional Survey ◽  
Cross Sectional

Young women in their late teens and early 20s are at the highest risk for depression onset. The present study aimed to assess depressive symptoms among female college students in Fukushima. More specifically, it aimed to clarify factors predicting possible symptom profiles, with an emphasis on determining how nuclear radiation risks affect the reporting of depression symptoms. A cross-sectional survey was conducted of 310 female students at a college in the Fukushima prefecture, Japan, in December 2015, and 288 participants submitted valid questionnaires. In total, 222 (77.1%) participants lived in Fukushima at the time of the Great East Japan Earthquake. The measures included the World Health Organization-Five Well-Being Index, the Fukushima Future Parents Attitude Measure, and risk perception of radiation health effects. A total of 46.5% of participants reported depressive symptoms. Path analysis revealed that higher radiation risk perceptions and reduced efficacy with reproduction related to a decline in self-esteem and self-efficacy, which was subsequently associated with increased depressive symptoms. These findings highlight the importance of radiation education among children and young adults, both after a nuclear accident and during disaster preparation, particularly in the context of reproductive and mental health.

scholarly journals The reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) and PHQ-2 in patients with infertility

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Saman Maroufizadeh ◽  
Reza Omani-Samani ◽  
Amir Almasi-Hashiani ◽  
Payam Amini ◽  
Mahdi Sepidarkish
Keyword(s):  
Depressive Symptoms ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Univariate Analysis ◽  
Reliability And Validity ◽  
Well Being ◽  
Patient Health Questionnaire ◽  
Depression Symptoms ◽  
Health Questionnaire ◽  
Patient Health

Abstract Background Depression in patients with infertility often goes undiagnosed and untreated. The Patient Health Questionnaire-9 (PHQ-9) and its ultra-brief version (i.e. PHQ-2) are widely used measures of depressive symptoms. These scales have not been validated in patients with infertility. The aim of the present study was to examine the reliability and validity of the PHQ-9 and PHQ-2 in patients with infertility. Methods In this cross-sectional study, a total of 539 patients with infertility from a referral infertility clinic in Tehran, Iran completed the PHQ-9, along with other relevant scales: the WHO-five Well-being Index (WHO-5), the Hospital Anxiety and Depression Scale (HADS), and the Generalized Anxiety Disorder-7 (GAD-7). Factor structure and internal consistency of PHQ-9 were examined via confirmatory factor analysis (CFA) and Cronbach’s alpha, respectively. Convergent validity was evaluated by relationship with WHO-5, HADS and GAD-7. Results The mean total PHQ-9 and PHQ-2 scores were 8.47 ± 6.17 and 2.42 ± 1.86, respectively, and using a cut-off value of 10 (for PHQ-9) and 3 (for PHQ-2), the prevalence of depressive symptoms was 38.6 and 43.6%, respectively. The Cronbach’s alphas for PHQ-9 and PHQ-2 were, respectively, 0.851 and 0.767, indicating good internal consistency. The CFA results confirmed the one-factor model of the PHQ-9 (χ2/df = 4.29; CFI = 0.98; RMSEA = 0.078 and SRMR = 0.044). Both PHQ-9 and PHQ-2 showed moderate to strong correlation with the measures of WHO-5, HADS-depression, HADS-anxiety, and the GAD-7, confirming convergent validity. In univariate analysis, female sex, long infertility duration, and unsuccessful treatment were significantly associated with depression symptoms. Conclusion Both PHQ-9 and PHQ-2 are brief and easy to use measures of depressive symptoms with good psychometric properties that appear suitable for routine use in patients with infertility.

Features of Rural Communities in Latin America and Sub-Saharan Africa That Influence Well-Being of Older Persons

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 420-421
Author(s):  
Andrew Banda ◽  
Norah Keating ◽  
Jaco Hoffman ◽  
Jose Parodi ◽  
Nereide Curreri
Keyword(s):  
Older Adults ◽  
Latin America ◽  
Rural Communities ◽  
Older People ◽  
Scoping Review ◽  
Older Persons ◽  
Subjective Wellbeing ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Sub Saharan

Abstract In their recent volume, Critical Rural Gerontology, Skinner et al (2021) challenge us to set aside unidimensional notions of rural communities as bypassed vs very supportive; and to identify the elements of rurality that empower or exclude older people and how these differ across cultures and settings. Covid-19 has highlighted the need for safe and inclusive communities. Given that LMIC will be home to the majority of older adults (Gonzales et al. 2015), we undertook a scoping review of features of rural communities that influence wellbeing of older people in countries across Latin America and Sub-Saharan Africa. The review included literature in English, French, Spanish and Portuguese, using search engines MEDLINE, CINAHL Complete, PsycInfo, SocINDEX, SciELO, AJOL (Africa Journals Online), LILACS, Redalyc, LatinIndex and Clacso. Findings illustrate diversity in how community features including remoteness, infrastructure and belonging influence material, social and subjective wellbeing of older residents.

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