In Their Own Words: Using Open-Ended Assessment to Identify Culturally Relevant Concerns among Kenyan Adolescents

Wasil, Akash R.; Venturo‐Conerly, Katherine E.; Gillespie, Sarah; Osborn, Tom L.; Weisz, John R.

doi:10.1007/s11013-020-09706-1

Cited by 8 publications

(4 citation statements)

References 72 publications

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“…However, such measures also have a variety of important limitations. Closed-ended questionnaires of coping strategies limit the potential range of responses, decreasing our ability to thoroughly characterize and describe the strategies that people naturally use (Wasil et al, 2021). Furthermore, in the context of stressful situations like the COVID pandemic, many people may be employing coping strategies that are not well-captured on existing questionnaires.…”

Section: Open-ended Assessmentmentioning

confidence: 99%

Commonly Reported Problems and Coping Strategies During the COVID-19 Crisis: A Survey of Graduate and Professional Students

et al. 2021

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BackgroundThe COVID-19 crisis has introduced a variety of stressors, while simultaneously decreasing the availability of strategies to cope with stress. In this context, it could be useful to understand issues that people find most concerning and ways in which they cope with stress. In this study, we explored these questions with a sample of graduate and professional students.MethodUsing open-ended assessments, we asked participants (n = 305) to identify their biggest challenge or concern (“top problem”), their most effective way of handling stress (“effective strategy”), and their most common way of handling stress (“common strategy”). We applied thematic analysis and evaluated whether participants’ strategies corresponded with evidence-based practices (EBPs).ResultsParticipants frequently reported top problems relating to productivity (27% of sample), physical health (26%), and emotional health (14%). Distraction was the most frequently classified common strategy (43%), whereas behavioral activation was the most frequently identified effective strategy (50%). Participants who reported a common strategy classified as an EBP reported lower depressive and anxiety symptoms. In contrast, there was no evidence of an association between symptom levels and whether or not participants’ effective strategy was an EBP. Participants who reported the same strategy as both their common and effective strategy (29%) reported lower depressive symptoms than those whose common and effective strategies were different.ConclusionOur findings highlight stressors that students are experiencing and ways they are coping during the COVID-19 crisis. We discuss how these findings can inform mental health promotion efforts and future research on coping with stressors.

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Section: Open-ended Assessmentmentioning

confidence: 99%

Commonly Reported Problems and Coping Strategies During the COVID-19 Crisis: A Survey of Graduate and Professional Students

et al. 2021

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“…There is an increase worldwide in recognition of the detrimental impact of social determinants on mental health, with calls for incorporating awareness of social determinants into mental health care ( Shields-Zeeman et al, 2019 ). In a recent qualitative study of top problems experienced by youth in Nairobi, Kenya, 35% reported an economic problem ( Wasil et al, 2021 ). As a field, we need options for addressing mental health problems that can also attend to social determinants.…”

Section: Discussionmentioning

confidence: 99%

Consumer perspectives on acceptability of trauma-focused cognitive behavioral therapy in Tanzania and Kenya: A mixed methods study

Dorsey

Akiba

Triplett

et al. 2022

Implementation Research and Practice

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Background There is a substantial mental health treatment gap globally. Increasingly, mental health treatments with evidence of effectiveness in western countries have been adapted and tested in culturally and contextually distinct countries. Findings from these studies have been promising, but to better understand treatment outcome results and consider broader scale up, treatment acceptability needs to be assessed and better understood. This mixed methods study aimed to examine child and guardian acceptability of trauma-focused cognitive behavioral therapy (TF-CBT) in two regions in Tanzania and Kenya and to better understand how TF-CBT was perceived as helpful for children and guardians. Methods Participants were 315 children (7–13), who experienced the death of one or both parents and 315 guardians, both of whom participated in TF-CBT as part of a randomized controlled trial conducted in Tanzania and Kenya. The study used mixed methods, with quantitative evaluation from guardian perspective ( N=315) using the Treatment Acceptability Questionnaire (TAQ) and the Client Satisfaction Questionnaire-8 (CSQ-8). Acceptability was assessed qualitatively from both guardian and child perspectives. Qualitative evaluation involved analysis using stratified selection to identify 160 child and 160 guardian interviews, to allow exploration of potential differences in acceptability by country, setting (urban/rural), and youth age (younger/older). Results Guardians reported high acceptability on the TAQ and, using an interpretation guide from U.S.-based work, medium acceptability on the CSQ-8. Guardians and children noted high acceptability in the qualitative analysis, noting benefits that correspond to TF-CBT’s therapeutic goals. Analyses exploring differences in acceptability yielded few differences by setting or child age but suggested some potential differences by country. Conclusion Quantitative and qualitative data converged to suggest high acceptability of TF-CBT from guardian and child perspectives in Tanzania and Kenya. Findings add to accumulating evidence of high TF-CBT acceptability from Zambia and other countries (United States, Norway, Australia). Plain Language Summary: Evidence-based treatments have been shown to be effective in countries and regions that are contextually and culturally distinct from where they were developed. But, perspectives of consumers on these treatments have not been assessed regularly or thoroughly. We used open-ended questions and rating scales to assess guardian and youth perspectives on a group-based, cognitive behavioral treatment for children impacted by parental death, in regions within Tanzania and Kenya. Our findings indicate that both guardians and youth found the treatment to be very acceptable. Nearly all guardians talked about specific benefits for the child, followed by benefits for the family and themselves. Eighty percent of youth mentioned benefits for themselves and all youth said they would recommend the program to others. Benefits mentioned by guardians and youth corresponded to treatment goals (improved mood/feelings or behavior, less distress when thinking about the parent/s’ death). Both guardians and children named specific aspects of the treatment that they liked and found useful. Dislikes and challenges of the treatment were less frequently mentioned, but point to areas where acceptability could be further improved. Recommendations from participants also offer areas where acceptability could be improved, namely guardians’ recommendation that the treatment also address non-mental health needs and offer some follow-up or opportunity to participate in the program again. Our study provides an example of how to assess acceptability and identify places to further enhance acceptability.

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“…A conversation about symptoms would enable clinicians to evaluate the models' performance systematically and provide a richer ground truth for the model. This approach also allows people to discuss their depression symptoms in culturally (Harrington et al, 2021;Wasil et al, 2022) and personally (Haroz et al, 2017) relevant ways that would be missed by a standard speech sample or a fixed self-report form. Further, while attempts to change or personalize fixed self-report forms can decrease their validity (Flake et al, 2017), changing an AI model by giving it more data will often improve its performance (Junqué de Fortuny et al, 2013).…”

mentioning

confidence: 99%

Conversational Assessment Using Artificial Intelligence is as Clinically Useful as Depression Scales and Preferred by Users

Weisenburger,

Mullarkey,

Labrada

et al. 2023

Preprint

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Background: Depression is prevalent, chronic, and burdensome. Due to limited screening access, depression often remains undiagnosed. Artificial intelligence (AI) models based on spoken responses to interview questions may offer an effective, efficient alternative to other screening methods.Objective: The primary aim was to use a demographically diverse sample to validate an AI model, previously trained on human-administered interviews, on novel bot-administered interviews, and to check for algorithmic biases related to age, sex, race, and ethnicity.Methods: Using the Aiberry app, adults recruited via social media (N = 393) completed a brief bot-administered interview and a depression self-report form. An AI model was used to predict form scores based on interview responses alone. For all meaningful discrepancies between model inference and form score, clinicians performed a masked review to determine which one they preferred.Results: There was strong concurrent validity between the model predictions and raw self-report scores (r = 0.73, MAE = 3.3). 90% of AI predictions either agreed with self-report or with clinical expert opinion when AI contradicted self-report. There was no differential model performance across age, sex, race, or ethnicity.Limitations: Limitations include access restrictions (English-speaking ability and access to smartphone or computer with broadband internet) and potential self-selection of participants more favorably predisposed toward AI technology.Conclusion: The Aiberry model made accurate predictions of depression severity based on remotely collected spoken responses to a bot-administered interview. This study shows promising results for the use of AI as a mental health screening tool.

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In Their Own Words: Using Open-Ended Assessment to Identify Culturally Relevant Concerns among Kenyan Adolescents

Cited by 8 publications

References 72 publications

Commonly Reported Problems and Coping Strategies During the COVID-19 Crisis: A Survey of Graduate and Professional Students

Commonly Reported Problems and Coping Strategies During the COVID-19 Crisis: A Survey of Graduate and Professional Students

Consumer perspectives on acceptability of trauma-focused cognitive behavioral therapy in Tanzania and Kenya: A mixed methods study

Conversational Assessment Using Artificial Intelligence is as Clinically Useful as Depression Scales and Preferred by Users

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