Mental health comorbidity in low-income and middle-income countries: a call for improved measurement and treatment

Kane, Jeremy C.; Vinikoor, Michael J.; Haroz, Emily E.; Al-Yasiri, Maytham; Bogdanov, Sergiy; Mayeya, John; Simenda, Francis; Murray, Laura

doi:10.1016/s2215-0366(18)30301-8

Cited by 25 publications

(24 citation statements)

References 10 publications

(11 reference statements)

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“…CETA is not conceptualized as a "new treatment" but rather an approach to teaching CBT skills that allows for more effective, efficient, and economic scale-up and sustainability. It specifically addresses the issue of comorbidity in mental and behavioral health, which is the rule, not the exception [29]. CETA comprises 9 evidence-based, widely used CBT elements: engagement, introduction/psychoeducation, safety, substance use reduction, cognitive coping and restructuring, problem solving, behavioral activation, relaxation, and exposure (live and imaginal).…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of the Common Elements Treatment Approach (CETA) in reducing intimate partner violence and hazardous alcohol use in Zambia (VATU): A randomized controlled trial

et al. 2020

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Background Both intimate partner violence (IPV) and alcohol misuse are highly prevalent, and partner alcohol misuse is a significant contributor to women's risk for IPV. There are few evidencebased interventions to address these problems in low-and middle-income countries (LMICs). We evaluated the effectiveness of an evidence-based, multi-problem, flexible, transdiagnostic intervention, the Common Elements Treatment Approach (CETA) in reducing (a) women's experience of IPV and (b) their male partner's alcohol misuse among couples in urban Zambia. Methods and findings This was a single-blind, parallel-assignment randomized controlled trial in Lusaka, Zambia. Women who reported moderate or higher levels of IPV and their male partners with hazardous alcohol use were enrolled as a couple and randomized to CETA or treatment as usual plus safety checks (TAU-Plus). The primary outcome, IPV, was assessed by the Severity of Violence Against Women Scale (SVAWS) physical/sexual violence subscale, and the secondary outcome, male alcohol misuse, by the Alcohol Use Disorders Identification Test (AUDIT). Assessors were blinded. Analyses were intent-to-treat. Primary outcome assessments were planned at post-treatment, 12 months post-baseline, and 24 months post-PLOS MEDICINE

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Section: Methodsmentioning

confidence: 99%

Effectiveness of the Common Elements Treatment Approach (CETA) in reducing intimate partner violence and hazardous alcohol use in Zambia (VATU): A randomized controlled trial

et al. 2020

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“…Eight out of ten individuals in Latin American countries live in cities, making it the most urbanized region in the world [4]. Latin American cities are characterized by high population density, disorganized and heavy tra c, air and noise pollution, rising crime rates, high-income inequality, high levels of poverty, and population aging, all of which might inhibit PA [5,6].…”

Section: Introductionmentioning

confidence: 99%

Is the perceived neighborhood built environment associated with domain-specific physical activity in Latin American adults? An eight-country observational study

Ferrari

Werneck

Silva

et al. 2020

Preprint

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Background: Characteristics of the neighborhood built environment are associated with physical activity (PA). However, few studies with representative samples have examined environmental correlates of domain-specific PA in Latin America. We examined the associations of the perceived neighborhood built environment with domain-specific PA in a large sample of adults from eight Latin American countries.Methods: This study examined data from 8185 adults (aged 18–65 years) from eight Latin American countries. The Neighbourhood Environment Walkability Survey - Abbreviated (NEWS-A) scale was used to assess perceptions of land use mix–diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic, and safety from crime. Perceived proximity from home to public open spaces (metropolitan parks, playgrounds, public squares) and to shopping centers was also measured. Transport-related and leisure-time PA were assessed using the long form of the International Physical Activity Questionnaire. Both logistic and linear regression models were estimated on pooled data.Results: Perceptions of higher land use mix-access (OR: 1.40; 95% CI: 1.22,1.61), the existence of many alternative routes in the neighbourhood (1.12; 1.04,1.20), slow speed of traffic (1.19; 1.03,1.35) and few drivers exceeding the speed limits (1.09; 1.03,1.15) were associated with greater odds of reporting at least 10 min/week of transport-related PA. Perceptions of higher levels of land use mix-diversity, better aesthetics and greater safety from crime, the presence of crosswalks and pedestrian signals, and greater proximity of shopping centers were associated with more min/week of transport-related PA. Perceptions of higher land use mix-diversity (1.12; 1.05,1.20), higher land use mix-access (1.27; 1.13,1.43), more walking/cycling facilities (1.18; 1.09,1.28), and better aesthetics (1.10; 1.02,1.18) were associated with greater odds of engaging in at least 10 min/week of leisure-time PA versus none. Perceptions of higher land use mix-diversity were associated with more min/week of leisure PA.Conclusions: Different perceived neighborhood built environment characteristics were associated with domain-specific PA among adults from Latin America countries. Interventions designed to modify perceptions of the neighbourhood built environment might influence initiation or maintenance of domain-specific PA.Trial registration: ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.

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“…While previous studies have found inconsistent associations between safety and transport-related PA we observed positive associations between transport PA and safety from crime and tra c [11,36]. Perhaps, the degree of danger from both crime and tra c in Latin American cities accounts for these observations [5,6]. These relationships may be especially challenging to tease out in Latin America where crime, tra c, and access to public transport vary greatly by neighborhood and where lower income residents must engage in active transport regardless of safety issues because they have no other choice [42,43].…”

Section: Discussionmentioning

confidence: 44%

“…Alternatively, the actual level of access to various destinations might have been so high that many respondents could reach destinations with minimal walking In fact, recent studies have observed negative effects of extreme levels of access to destinations on transport-related walking [38,39]. These patterns are more likely to occur in locations with high population and destination densities as in many Latin American cities [6,7]. Unexpected relationships between the built environment, parks and transport PA were also observed in Cuernavaca, Mexico and attributed to the local context [16].…”

Section: Discussionmentioning

confidence: 99%

“…Eight out of ten individuals in Latin American countries live in cities, making it the most urbanized region in the world [4]. Latin American countries are characterized by high population density, disorganized and heavy tra c, air and noise pollution, rising crime rates, high-income inequality, high levels of poverty, and population aging which might inibith PA [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Is the Perceived Neighborhood Built Environment Associated With Domain-Specific Physical Activity in Latin American Adults? An Eight-Country Observational Study

Ferrari

Werneck

Silva

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Characteristics of the neighborhood built environment are associated with physical activity (PA). However, few studies with representative samples have examined environmental correlates of domain-specific PA in Latin America. We examined the associations of the perceived neighborhood built environment with domain-specific PA in a large sample of adults from eight Latin American countries. Methods: This study examined data from 8185 adults (aged 18–65 years) from eight Latin American countries. The Neighbourhood Environment Walkability Survey - Abbreviated (NEWS-A) scale was used to assess perceptions of land use mix–diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic, and safety from crime. Perceived proximity from home to public open spaces (metropolitan parks, playgrounds, public squares) and to shopping centers was also assessed. Transport-related and leisure-time PA were assessed using the long form of the International Physical Activity Questionnaire. Both logistic and linear regression models were estimated on pooled data. Results: Perceptions of higher land use mix-access (OR: 1.40; 95% CI: 1.22,1.61), the existence of many alternative routes in the neighbourhood (1.12; 1.04,1.20), slow speed of traffic (1.19; 1.03,1.35) and few drivers exceeding the speed limits (1.09; 1.03,1.15) were associated with greater odds of reporting at least 10 min/week of transport-related PA. Perceptions of higher levels of land use mix-diversity, better aesthetics and greater safety from crime, the presence of crosswalks and pedestrian signals, and greater proximity of shopping centers were associated with more min/week of transport-related PA. Perceptions of higher land use mix-diversity (1.12; 1.05,1.20), higher land use mix-access (1.27; 1.13,1.43), more walking/cycling facilities (1.18; 1.09,1.28), and better aesthetics (1.10; 1.02,1.18) were associated with greater odds of engaging in at least 10 min/week of leisure-time PA versus none. Perceptions of higher land use mix-diversity were associated with more min/week of leisure PA. Conclusions: Different perceived neighborhood built environment characteristics were associated with domain-specific PA among adults from Latin America countries. Interventions designed to modify perceptions of the neighbourhood built environment might influence initiation or maintenance of domain-specific PA.Trial registration: ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.

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Mental health comorbidity in low-income and middle-income countries: a call for improved measurement and treatment

Cited by 25 publications

References 10 publications

Effectiveness of the Common Elements Treatment Approach (CETA) in reducing intimate partner violence and hazardous alcohol use in Zambia (VATU): A randomized controlled trial

Effectiveness of the Common Elements Treatment Approach (CETA) in reducing intimate partner violence and hazardous alcohol use in Zambia (VATU): A randomized controlled trial

Is the perceived neighborhood built environment associated with domain-specific physical activity in Latin American adults? An eight-country observational study

Is the Perceived Neighborhood Built Environment Associated With Domain-Specific Physical Activity in Latin American Adults? An Eight-Country Observational Study

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