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Raeber F, Haldemann MI, Ray S, Huber J, Firima E, Fernandez LG, Amstutz A, Gerber F, Labhardt ND, Belus JM. Community-based models of care for adolescent and adult depression, suicidal behavior, anxiety, trauma, and substance use in Africa: a scoping review. Front Psychol 2024; 15:1241403. [PMID: 38406302 PMCID: PMC10885163 DOI: 10.3389/fpsyg.2024.1241403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024] Open
Abstract
Background Community-based care (CBC), where care is delivered outside of the traditional health facility setting, has been proposed to narrow the mental health (MH) and substance use (SU) treatment gap in Africa. Objective This scoping review aims to comprehensively summarize CBC models addressing adolescent and adult MH (depression, anxiety, trauma, suicidal behavior) and (non-tobacco) SU problems in Africa. Methods We searched PsycINFO, Embase, Scopus, CINAHL, and Medline Ovid. Studies and protocols were included if they reported on CBC intervention's effects on MH or SU symptoms/ diagnoses, acceptability, feasibility, or patient engagement in care, regardless of whether the intervention itself was designed specifically for MH or SU. Results Among 11,477 screened publications, 217 were eligible. Of the unique intervention studies (n = 206), CBC models were classified into the following approaches (non-mutually exclusive): psychotherapeutic (n = 144), social (n = 81), lifestyle/physical health (n = 55), economic (n = 26), and psychopharmacological (n = 2). While quantitative results suggest possible efficacy of CBC models, description of CBC location was often poor. Fewer interventions addressed suicidal behavior (n = 12), the needs of adolescents (n = 49), or used traditional healers or religious figures as providers (n = 3). Conclusion Many CBC models have been tested on MH and SU in Africa and should be critically appraised and meta-analyzed in subsequent reviews, where possible.
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Affiliation(s)
- Fabian Raeber
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
| | - Maria-Inés Haldemann
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
| | - Somidha Ray
- Research Consultant, International Center for Research on Women, New Delhi, India
| | - Jacqueline Huber
- Swiss TPH Library, Swiss Tropical and Public Health Institute, Allschwil, Basel, Switzerland
| | - Emmanuel Firima
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Lucia Gonzalez Fernandez
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Alain Amstutz
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
| | - Felix Gerber
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Niklaus D. Labhardt
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
| | - Jennifer M. Belus
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
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Martinez AB, Lau JYF, Morillo HM, Brown JSL. 'C'mon, let's talk: a pilot study of mental health literacy program for Filipino migrant domestic workers in the United Kingdom. Soc Psychiatry Psychiatr Epidemiol 2024; 59:385-401. [PMID: 36575338 PMCID: PMC9794465 DOI: 10.1007/s00127-022-02405-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 12/12/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE This pilot study of a culturally adapted online mental health literacy (MHL) program called 'Tara, Usap Tayo!' (C'mon, Let's Talk) aims to assess the acceptability, appropriateness, feasibility, and potential effectiveness in improving the help-seeking behavior of Filipino migrant domestic workers in the United Kingdom (UK). METHODS Using mixed methods, we conducted a non-randomized single-group study of the online MHL program with 21 participants. The development of this intervention was guided by the Medical Research Council Framework for developing complex interventions and utilized Heim & Kohrt's (2019) framework for cultural adaptation. Content materials from the WHO Mental Health Gap Action Program (mhGAP), WHO Problem Management Plus (PM +) and Adult Improving Access to Psychological Therapies (IAPT) were modified and translated into the Filipino language. The MHL program was delivered online in three sessions for two hours each session. Data were collected at three time points: (T1) pretest; (T2) posttest; and (3) follow-up test. Quantitative data on participants' attitudes towards help-seeking and level of mental health literacy as outcome measures of potential intervention effectiveness were collected at T1, T2 and T3, while focus group discussions (FGDs) to assess participants' feedback on the acceptability, feasibility, and appropriateness of the online MHL program were conducted immediately at T2. Data analysis was done using a thematic approach for qualitative data from the FGDs and descriptive statistics and repeated-measures ANOVA were used to assess the difference in the T1, T2, and T3 tests. Both quantitative and qualitative results were then integrated and triangulated to answer the research questions. RESULTS The online MHL program is generally acceptable, appropriate, and feasible for use among Filipino migrant domestic workers. Preliminary findings lend support for its possible effectiveness in improving mental health literacy and help-seeking propensity. The cultural adaptation made in the content, form, and delivery methods of the intervention was acceptable and feasible for this target subcultural group. CONCLUSION By improving their mental health literacy and help-seeking propensity, this online MHL program has the potential to provide support to the mental health and well-being of Filipino migrant domestic workers in the UK. Further feasibility study or large-scale randomized controlled trial is needed to confirm the preliminary findings of this study.
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Affiliation(s)
- Andrea B Martinez
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Department of Behavioral Science, College of Arts and Sciences, University of the Philippines Manila, Manila, Philippines.
| | - Jennifer Y F Lau
- Youth Resilience Unit, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Hannah Misha Morillo
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - June S L Brown
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Bokolo NP, Van Niekerk RL, Mathews V, Leach L. A Systematic Review Protocol for the Effectiveness of Psycho-Educational Intervention Programmes in Addressing the Psychological Risk Factors Associated with Non-Communicable Diseases among Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6467. [PMID: 37569009 PMCID: PMC10418932 DOI: 10.3390/ijerph20156467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/16/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023]
Abstract
The psychological health concerns and risk factors associated with non-communicable disease among adolescents have been prioritized on the agenda of international health institutions globally. The aims of this systematic review are to determine the various types of psycho-educational intervention programmes developed to address the psychological risk factors associated with non-communicable diseases among adolescents, and to assess the effectiveness of the psycho-educational intervention programmes. The systematic review will include case-control and randomized controlled studies. The review will be conducted using the following electronic databases, PubMed, CINAHL, Science Direct, Cochrane Library, SCOPUS, and ERIC, as well as the grey literature for the thesis repository from 2012 to 2022. The key search terms will include intervention programme, adolescents (aged 10-19 years), psychological risk factors and non-communicable diseases. The studies identified by the search strategy will be downloaded into Mendeley and exported to Covidence software for screening, quality assessment and data extraction. The quality assessment tool that will be utilized is the Joanna Briggs Institute critical appraisal checklists to ensure relevance and quality of the articles. This systematic review will use two types of data analysis: narrative synthesis of qualitative studies and meta-analysis of quantitative studies. The findings from this systematic review will provide evidence-based tools for the management of psychological risk factors associated with non-communicable diseases, as well as present key insights for future intervention programmes on the management of psychological risk factors associated with NCDs among adolescents.
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Affiliation(s)
- Nokwanda P. Bokolo
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa
| | - Rudolph Leon Van Niekerk
- Department of Psychology, Faculty of Social Sciences and Humanities, University of Fort Hare, Private Bag X9083, 50 Church Street, East London 5201, South Africa
| | - Verona Mathews
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, University of the Western Cape, Bellville 7535, South Africa
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Zemni I, Gara A, Nasraoui H, Kacem M, Maatouk A, Trimeche O, Abroug H, Fredj MB, Bennasrallah C, Dhouib W, Bouanene I, Belguith AS. The effectiveness of a health education intervention to reduce anxiety in quarantined COVID-19 patients: a randomized controlled trial. BMC Public Health 2023; 23:1188. [PMID: 37340300 DOI: 10.1186/s12889-023-16104-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/11/2023] [Indexed: 06/22/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic is regarded as a serious public health concern that boosts levels of stress and anxiety which could be explained by several reasons, including social isolation. In this regard, we aimed to assess the impact of health education on the anxiety level of COVID-19 patients during the isolation period. METHODS This is a randomized controlled trial conducted between February 2021 and June 2021. Patients tested positive for Covid-19 with mild to moderate forms were randomized to Education (n = 267) or control (n = 269). The education group received a phone health education session on day 1 (D1) following the diagnosis. The three components of the health education intervention were an explanation of the coronavirus disease, what to do in the event of complications, and the recommended preventive measures. The two groups received a telephone evaluation of their Hospital Anxiety and Depression scores on D1 and day seven D7 following the positive diagnosis. The primary outcome was the rate of anxiety reduction in each group on D7 based on a HAD-A score ≥ 8. Secondary outcomes were the rate of anxiety reduction on D7 based on a HAD-A score ≥ 11, the percentage of people complying with isolation and the scores of adherences to preventive measures during the isolation in each group. RESULTS Hundred and ninety-six patients in the intervention group and 206 patients in the control group completed the study. The sociodemographic, clinical, and initial anxiety level features of the intervention and control groups were comparable at baseline (p ≥ 0.05). On D7, the education group's anxiety level (HAD-A ≥ 8) decreased from 26 to 16.3% (p = 0.013) while in the control group it increased from 19.4 to 22.8% (p = 0.37). Thus, the percentage change in anxiety between D1 and D7 (delta D7 - D1) was - 9.7% in the Education group and + 3.4% in the Control group. Using the HAD-A ≥ 11 thresholds, the percentage of anxiety decreased from 15.3 to 11.2% (p = 0.26) between D1 and D7, while it increased in the control group from 9.7 to 15.7% (p = 0.045). Thus, the education group's change in anxiety (delta D7 - D1) was - 4.1%, while the control group's change was + 6%. CONCLUSION During an outbreak, providing health education to quarantined patients may be beneficial to reduce the psychological impact of the disease. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Identifier: NCT05715593, retrospectively registered on 8/02/2023 https://clinicaltrials.gov/ct2/results?term=NCT05715593&Search=Search .
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Affiliation(s)
- Imen Zemni
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia.
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia.
| | - Amel Gara
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Hadhba Nasraoui
- Department of Emergency Medicine, Taher Sfar University Hospital, Mahdia, Tunisia
| | - Meriem Kacem
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia
| | - Amani Maatouk
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Oumeyma Trimeche
- Department of Endocrinology, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Hela Abroug
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia
| | - Manel Ben Fredj
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia
| | - Cyrine Bennasrallah
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia
| | - Wafa Dhouib
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia
| | - Ines Bouanene
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Asma Sriha Belguith
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia
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Abstract
IMPORTANCE Although the suicide rate in Japan increased during the COVID-19 pandemic, the reasons for suicide have yet to be comprehensively investigated. OBJECTIVE To assess which reasons for suicide had rates that exceeded the expected number of suicide deaths for that reason during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS This national, population-based cross-sectional study of data on suicides gathered by the Ministry of Health, Labor, and Welfare from January 2020 to May 2021 used a times-series analysis on the numbers of reason-identified suicides. Data of decedents were recorded by the National Police Agency and compiled by the Ministry of Health, Labor, and Welfare. EXPOSURE For category analysis, we compared data from January 2020 to May 2021 with data from December 2014 to June 2020. For subcategory analysis, data from January 2020 to May 2021 were compared with data from January 2019 to June 2020. MAIN OUTCOMES AND MEASURES The main outcome was the monthly excess suicide rate, ie, the difference between the observed number of monthly suicide deaths and the upper bound of the 1-sided 95% CI for the expected number of suicide deaths in that month. Reasons for suicide were categorized into family, health, economy, work, relationships, school, and others, which were further divided into 52 subcategories. A quasi-Poisson regression model was used to estimate the expected number of monthly suicides. Individual regression models were used for each of the 7 categories, 52 subcategories, men, women, and both genders. RESULTS From the 29 938 suicides (9984 [33.3%] women; 1093 [3.7%] aged <20 years; 3147 [10.5%] aged >80 years), there were 21 027 reason-identified suicides (7415 [35.3%] women). For both genders, all categories indicated monthly excess suicide rates, except for school in men. October 2020 had the highest excess suicide rates for all cases (observed, 1577; upper bound of 95% CI for expected number of suicides, 1254; 25.8% greater). In men, the highest monthly excess suicide rate was 24.3% for the other category in August 2020 (observed, 87; upper bound of 95% CI for expected number, 70); in women, it was 85.7% for school in August 2020 (observed, 26; upper bound of 95% CI for expected number, 14). CONCLUSIONS AND RELEVANCE In this study, observed suicides corresponding to all 7 categories of reasons exceeded the monthly estimates (based on data from before or during the COVID-19 pandemic), except for school-related reasons in men. This study can be used as a basis for developing intervention programs for suicide prevention.
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Affiliation(s)
- Masahide Koda
- Department of Psychiatry, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Nahoko Harada
- Department of Psychiatric and Mental Health Nursing, School of Nursing, University of Miyazaki, Miyazaki, Japan
| | - Akifumi Eguchi
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Yasushi Ishida
- Department of Psychiatry, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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