A Narrative-Gamified Mental Health App (Kuamsha) for Adolescents in Uganda: Mixed Methods Feasibility and Acceptability Study.

Autor:	R Pozuelo J; Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, United States.; Department of Psychiatry, University of Oxford, Oxford, United Kingdom.; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Nabulumba C; BRAC, Kampala, Uganda., Sikoti D; BRAC, Kampala, Uganda., Davis M; Mind Ease, London, United Kingdom., Gumikiriza-Onoria JL; College of Health Sciences, Makerere University, Kampala, Uganda., Kinyanda E; Mental Health Project, Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Kampala, Uganda., Moffett B; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., van Heerden A; Centre for Community Based Research, Human Sciences Research Council, Pietermaritzburg, South Africa.; SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., O'Mahen HA; Mood Disorders Centre, Department of Psychology, University of Exeter, Exeter, United Kingdom., Craske M; Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States., Sulaiman M; BRAC University, Kampala, Uganda., Stein A; Department of Psychiatry, University of Oxford, Oxford, United Kingdom.; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.; Africa Health Research Institute, KwaZulu Natal, South Africa.; Blavatnik School of Government, University of Oxford, Oxford, United Kingdom.
Jazyk:	angličtina
Zdroj:	JMIR serious games [JMIR Serious Games] 2024 Dec 19; Vol. 12, pp. e59381. Date of Electronic Publication: 2024 Dec 19.
DOI:	10.2196/59381
Abstrakt:	Background: Many adolescents in Uganda are affected by common mental disorders, but only a few affordable treatment options are available. Digital mental health interventions offer promising opportunities to reduce these large treatment gaps, but interventions specifically tailored for Ugandan adolescents are limited. Objective: This study aimed to determine the feasibility and acceptability of the Kuamsha program, an intervention delivered through a gamified app with low-intensity telephonic guidance, as a way to promote mental health among adolescents from the general population in Uganda. Methods: A 3-month pre-post single-arm trial was conducted with adolescents aged between 15 and 19 years living in Wakiso District, Central Uganda. The intervention was coproduced with adolescents from the study site to ensure that it was culturally acceptable. The feasibility and acceptability of the intervention were evaluated using an explanatory sequential mixed methods approach. Feasibility was assessed by collecting data on trial retention rates and treatment adherence rates. Acceptability was assessed through a questionnaire and in-depth interviews with participants following the conclusion of the intervention period. As a secondary objective, we explored the changes in participants' mental health before and after the intervention. Results: A total of 31 adolescents were recruited for the study. Results from the study showed high levels of feasibility and acceptability. Trial retention rates exceeded 90%, and treatment adherence was ≥80%. These results, evaluated against our predefined trial progression criteria, indicate a successful feasibility study, with all criteria exceeding the thresholds necessary to progress to a larger trial. App engagement metrics, such as time spent on the app and modules completed, exceeded existing literature benchmarks, and many adolescents continued to use the app after the intervention. In-depth interviews and questionnaire responses revealed high acceptability levels. Depressive symptoms trended toward reduction (mean difference: 1.41, 95% CI -0.60 to 3.42, Cohen d=0.30), although this was not statistically significant (P=.16). Supporting this trend, we also observed a reduction in the proportion of participants with moderate depressive symptoms from 32% (10/31) to 17% (5/29) after the intervention, but this change was also not significant (P=.10). Conclusions: This study presents evidence to support the Kuamsha program as a feasible and acceptable digital mental health program for adolescents in Uganda. A fully powered randomized controlled trial is needed to assess its effectiveness in improving adolescents' mental health. (©Julia R Pozuelo, Christine Nabulumba, Doreen Sikoti, Meghan Davis, Joy Louise Gumikiriza-Onoria, Eugene Kinyanda, Bianca Moffett, Alastair van Heerden, Heather A O'Mahen, Michelle Craske, DoBAt & Ebikolwa Consortium, Munshi Sulaiman, Alan Stein. Originally published in JMIR Serious Games (https://games.jmir.org), 19.12.2024.)
Databáze:	MEDLINE
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