Mental Health
Conditions
Brief summary
From our previous studies, we know that urban refugee youth commonly report depressive symptoms. The primary aim of this study is to compare the effectiveness of youth-tailored interventions to improve mental health literacy and reduce mental health stigma among urban refugee youth in Kampala, Uganda. There will be two intervention arms and one control arm. The first intervention arm will involve a VR experience that focuses on mental health literacy and coping strategies, as well as SMS check-ins from peer navigators (PN) trained in psychological first aid. The second intervention arm will involve an adapted version of the WHO's Group Problem Management Plus. The primary outcomes are to a) increase mental health literacy (knowledge and understanding of mental health generally and of specific disorders; b) increase attitudes towards mental health help-seeking, c) reduce depression, d) increase adaptive coping strategies; e) reduce mental health stigma, f) improve mental wellbeing, and g) increase level of functioning. Participants will complete a pre- and post-intervention survey as well as a follow-up survey.
Interventions
BEHAVIORALVR + MHL intervention
The intervention will include: 1) a Virtual Reality (VR) interactive and immersive 30-minute session viewed using a low cost VR headset; and 2) an 8-week program of weekly WelTel SMS check-ins managed by Peer Navigators (PNs), weekly WelTel SMS blasts informed by Psychological First Aid (PFA) with mental health literacy (MHL) messages developed with PN, and weekly WelTel web-based secure platform social group discussions on MHL, stress coping, and stigma moderated by PN alongside a trained Coordinator. Weekly MHL WelTel platform moderated discussion foci will address MHL, stigma and stress coping strategies, including self-compassion and other strategies that emerge from the urban refugee youth interviews and focus groups, through diverse methods, including: 'scenarios' mimicking real life situations; a 'question box'; sharing photos demonstrating stress coping strategies; memes; songs; and ways participants interrupted stigma in their daily lives.
BEHAVIORALGroup PM+
Participants will attend small groups (5-6 participants with a PN and a coordinator supporting) outdoors with physically distancing, for Group PM+ sessions following the adapted WHO Group-PM+ manual (adaptations made in Phase 1 explain above) 5 weekly 3-hour sessions delivered by PN who will co-facilitate sessions with the Coordinator. Each session has a mechanism of action: 1. Managing stress: mechanism of action-identify goals, learn deep breathing and techniques for stress management 2. Managing problems: mechanism of action-identify 1 solvable practical problem, brainstorm possible solutions together 3. Get going, keep doing: mechanism of action-learn about depression and inactivity, identify and plan small enjoyable activities 4. Strengthen social support: mechanism of action-discuss a range of social support resources, make plan to increase social support 5. Staying well: mechanism of action- this session reviews all of the mechanisms of action in the prior 4 sessions
Sponsors
Young African Refugees for Integral Development
University of Toronto
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
The two intervention arms will be compared to the control arm of the study using a pre- and post-intervention survey. There will also be a follow-up survey 8 weeks after the study is complete.
Eligibility
Sex/Gender
ALL
Age
16 Years to 25 Years
Healthy volunteers
Yes
Inclusion criteria
1. living in one of the 5 informal settlements in Kampala we already work with (Nsambya, Katwe, Rubaga, Kabalagala, Kansanga); 2. self identify as a woman or man (transgender inclusive); 3. identify as a refugee/displaced person/having refugee parents; 4. aged 16-25; 5. own a mobile phone; 6. speak Swahili, Luganda, Kirundi, Kinyarwanda, French or English and can provide informed consent.
Exclusion criteria
\-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mental health literacy | change from baseline at 16 weeks | Measured using a modified depression literacy scale validated in Low- and Middle- Income Countries (LMICs) |
| Attitudes towards mental health help seeking | change from baseline at 16 weeks | Measured using the Inventory of Attitudes towards Seeking Mental Health Services |
| Depression | change from baseline at 16 weeks | Measured using the PHQ-9 |
| Adaptive coping strategies | change from baseline at 16 weeks | Measured by the Kidcope and Self-Compassion Scale for Youth |
| Mental Health Stigma | change from baseline at 16 weeks | Measured using the Brief Version of the Internalized Stigma of Mental Illness (ISMI) Scale |
| Mental wellbeing | change from baseline at 16 weeks | Measured using the WHO-Five Wellbeing Scale |
| Level of functioning | change from baseline at 16 weeks | Measured usingWHO Disability Assessment Schedule |
Contacts
Primary ContactCarmen Logie, PhD
Backup ContactMoses Okumu, PhD
Outcome results
None listed