Community perspectives of second-generation alcohol misuse and HIV risk in rural Kenya: A gendered syndemic lens

Kibicho, Jennifer; Campbell, Julie Kieffer

doi:10.1080/17441692.2019.1638958

Cited by 8 publications

(5 citation statements)

References 42 publications

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“…Second, the bidirectional relationship between specific dimensions of poverty and common mental health disorders and AUDs needs addressing. Research consistently demonstrates elevated risks for developing common mental health disorders and AUDs among individuals with limited access to material resources (Marmot et al, 2008 ; De Silva et al, 2011 ; Nadkarni et al, 2013 ; Allen et al, 2014 ; Lo et al, 2017b ; Kibicho and Campbell, 2019 ). A previous study in Uganda with refugees showed high prevalence of post-traumatic stress, major depressive, generalized anxiety and substance use disorders, all linked to unmet basic needs (Bapolisi et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Using Theory of Change to Plan for the Implementation of a Psychological Intervention Addressing Alcohol Use Disorder and Psychological Distress in Uganda

van der Boor,

Andersen,

Massazza

et al. 2024

Camb. prisms Glob. ment. health

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In conflict-affected settings, prevalence of alcohol use disorders (AUDs) can be high. However, limited practical information exists on AUD management in low-income settings. Using a theory of change (ToC) approach, we aimed to identify pathways influencing the implementation and maintenance of a new transdiagnostic psychological intervention ("CHANGE"), targeting both psychological distress and AUDs in humanitarian settings. Three half-day workshops in Uganda engaged 41 stakeholders to develop a ToC map. ToC is a participatory program theory approach aiming to create a visual representation of how and why an intervention leads to specific outcomes. Additionally, five semi-structured interviews were conducted to explore experiences of stakeholders that participated in the ToC workshops. Two necessary pathways influencing the implementation and maintenance of CHANGE were identified: policy impact, and mental health service delivery. Barriers identified included policy gaps, limited recognition of social determinants and the need for integrated follow-up care. Interviewed participants valued ToC's participatory approach and expressed concerns about its adaptability in continuously changing contexts (e.g., humanitarian settings). Our study underscores ToC's value in delineating context-specific outcomes and identifies areas requiring further attention. It emphasizes the importance of early planning and stakeholder engagement for sustainable implementation of psychological interventions in humanitarian settings. Impact statementBy using theory of change (ToC), we use a participatory approach to understand different pathways that can shape the implementation and maintenance of a new psychological intervention named "CHANGE" in a humanitarian setting in Uganda. The CHANGE intervention is designed to address both psychological distress and alcohol use disorders in conflict affected populations. The findings of this study reveal that there are two pathways that are important for the implementation of CHANGE in this context: policy impact, and mental health service delivery. We reflect on the utility of using a ToC methodology in this context and identify areas that require further attention. BackgroundOver the last 10 years, the number of forcibly displaced populations resulting from armed conflict, persecution and/or violence has grown by more than 50% (UNHCR, 2021). In 2021 alone, 23 countries faced high or medium intensity conflicts (World Bank, 2022), which have farreaching social, economic and health impacts (Milián et al., 2022; World Bank, 2022).Armed conflict can impact mental health both directly, for example, by exposing people to traumatic events, and indirectly, for example, by worsening known social determinants of mental health (i.e., impoverishment, poor access to healthcare, loss of social networks) (Lo et al., 2017a). In these contexts, alcohol use disorders (AUDs) may provide unhealthy ways to cope with Cambridge Prisms: Global Mental Health www.cambridge.org/gmh

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Section: Discussionmentioning

confidence: 99%

Using Theory of Change to Plan for the Implementation of a Psychological Intervention Addressing Alcohol Use Disorder and Psychological Distress in Uganda

van der Boor,

Andersen,

Massazza

et al. 2024

Camb. prisms Glob. ment. health

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“…The alignment of syndromic approaches with participatory surveillance plays an important role in understanding epidemiological settings at the community level [50], and even though there is a limitation in the implementation of more sophisticated tools, such as mobile apps, they are still strategic instruments for health surveillance systems. Nevertheless, the premise of the combination of not only information related to symptoms but also nutritional or developmental aspects has the possibility of deepening with the construction of syndemic models [51]. Even the observation of several factors that coexist in Malawi shows that they have been addressed as syndemics in similar contexts like Kenya or in similar social fabric related to food insecurity, maternal mental health, and domestic violence [52,53].…”

Section: Limitationsmentioning

confidence: 99%

Combining Wearable Devices and Mobile Surveys to Study Child and Youth Development in Malawi: Implementation Study of a Multimodal Approach

Neto

Haenni

Phuka

et al. 2021

JMIR Public Health Surveill

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Background Multimodal approaches have been shown to be a promising way to collect data on child development at high frequency, combining different data inputs (from phone surveys to signals from noninvasive biomarkers) to understand children’s health and development outcomes more integrally from multiple perspectives. Objective The aim of this work was to describe an implementation study using a multimodal approach combining noninvasive biomarkers, social contact patterns, mobile surveying, and face-to-face interviews in order to validate technologies that help us better understand child development in poor countries at a high frequency. Methods We carried out a mixed study based on a transversal descriptive analysis and a longitudinal prospective analysis in Malawi. In each village, children were sampled to participate in weekly sessions in which data signals were collected through wearable devices (electrocardiography [ECG] hand pads and electroencephalography [EEG] headbands). Additionally, wearable proximity sensors to elicit the social network were deployed among children and their caregivers. Mobile surveys using interactive voice response calls were also used as an additional layer of data collection. An end-line face-to-face survey was conducted at the end of the study. Results During the implementation, 82 EEG/ECG data entry points were collected across four villages. The sampled children for EEG/ECG were 0 to 5 years old. EEG/ECG data were collected once a week. In every session, children wore the EEG headband for 5 minutes and the ECG hand pad for 3 minutes. In total, 3531 calls were sent over 5 weeks, with 2291 participants picking up the calls and 984 of those answering the consent question. In total, 585 people completed the surveys over the course of 5 weeks. Conclusions This study achieved its objective of demonstrating the feasibility of generating data through the unprecedented use of a multimodal approach for tracking child development in Malawi, which is one of the poorest countries in the world. Above and beyond its multiple dimensions, the dynamics of child development are complex. It is the case not only that no data stream in isolation can accurately characterize it, but also that even if combined, infrequent data might miss critical inflection points and interactions between different conditions and behaviors. In turn, combining different modes at a sufficiently high frequency allows researchers to make progress by considering contact patterns, reported symptoms and behaviors, and critical biomarkers all at once. This application showcases that even in developing countries facing multiple constraints, complementary technologies can leverage and accelerate the digitalization of health, bringing benefits to populations that lack new tools for understanding child well-being and development.

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“…The studies were conducted between 2004 and 2020. Data was collected using several approaches including in-depth interviews (IDIs) only (n=6) (117)(118)(119)(120)(121), focus group discussions (FGDs) only (n=2) (122,123), a combination of FGDs and IDIs (n=10) (114,(124)(125)(126)(127)(128)(129)(130)(131)(132), a combination of observation and individual IDIs (120,133), a combination of observation, IDIs and FGDs (134), a combination of literature review, observation, IDIs and FGDs (132). One study utilized the participatory research and action approach (135).…”

Section: Studies Qualitatively Exploring Various Substance Use/sud Topics (Other Than Interventions)mentioning

confidence: 99%

“…The study populations for the qualitative studies included persons using heroin (129,133) Various themes were explored in these qualitative studies including risk and protective factors for substance use (120,127,131,134), health and or socioeconomic effects of substance use (119,122,123,130,132), perceptions on heroin use (133), transitions from heroin smoking to injection (117), and stages of change in participants enrolled in an intervention (121). Substance use was perceived as having a negative socio-economic and health impact (122,132). Speci cally, substance use was perceived to have a negative impact on contraceptive use (128), on utilization of antenatal and maternal & child health services ( 137), as well as on sexual and reproductive health (130).…”

Section: Studies Qualitatively Exploring Various Substance Use/sud Topics (Other Than Interventions)mentioning

confidence: 99%

A Systematic Review of Substance Use and Substance Use Disorder Research in Kenya

Jaguga

Kiburi

Temet

et al. 2021

Preprint

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Background: The burden of substance use in Kenya is significant. The objective of this study was to systematically summarize existing literature on substance use in Kenya, identify research gaps, and provide directions for future research. Methods: This systematic review was conducted in line with the PRISMA guidelines. We conducted a search of 5 bibliographic databases (PubMed, PsychINFO, Web of Science, Cumulative Index of Nursing and Allied Professionals (CINAHL) and Cochrane Library) until 20 August 2020. In addition we searched all the volumes of the official journal of the National Authority for the Campaign Against Alcohol & Drug Abuse (the African Journal of Alcohol and Drug Abuse). The results of eligible studies have been summarized descriptively and organized by the three broad categories: (1) Studies evaluating the epidemiology of substance use, (2) studies evaluating interventions and programs, and (3) qualitative studies exploring various themes on substance use. The quality of the included studies was assessed with the Quality Assessment Tool for Studies with Diverse Designs.Results: Of the 185 studies that were eligible for inclusion, 144 investigated the epidemiology of substance use, 23 qualitatively explored various substance use related themes, and 18 evaluated substance use interventions and programs. Key evidence gaps emerged. Firstly, vulnerable populations such as police officers, pregnant women, health care workers and persons with physical disability had been under-represented within the epidemiological and qualitative work. Secondly, no intervention study had been conducted among children and adolescents. Thirdly, most interventions had focused on alcohol to the exclusion of other prevalent substances such as tobacco and cannabis. Finally, little had been done to evaluate digital and population-level interventions. Conclusions: The results of this systematic review provide important directions for future substance use research in Kenya. Systematic review registration: PROSPERO: CRD42020203717

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Community perspectives of second-generation alcohol misuse and HIV risk in rural Kenya: A gendered syndemic lens

Cited by 8 publications

References 42 publications

Using Theory of Change to Plan for the Implementation of a Psychological Intervention Addressing Alcohol Use Disorder and Psychological Distress in Uganda

Using Theory of Change to Plan for the Implementation of a Psychological Intervention Addressing Alcohol Use Disorder and Psychological Distress in Uganda

Combining Wearable Devices and Mobile Surveys to Study Child and Youth Development in Malawi: Implementation Study of a Multimodal Approach

A Systematic Review of Substance Use and Substance Use Disorder Research in Kenya

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