The efficacy of a lay health workers – led physical activity counselling program in patients with HIV and mental health problems: a real-world intervention from Uganda

Vancampfort, Davy; Byansi, Peter; Namutebi, Hilda; Kinyanda, Eugene; Bbosa, Richard Serunkuma; Ward, Philip B.; Lukwata, Hafsa; Mugisha, James

doi:10.1080/09540121.2021.1874268

Cited by 13 publications

(13 citation statements)

References 27 publications

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“…The Mental Health Literacy Scale (MHLS) consists of 35 questions categorized into six dimensions: (1) ability to recognize disorders, (2), knowledge of risk factors and causes, (3) knowledge of self-treatment, (4) knowledge of available professional help, (5) knowledge of where to seek information, and (6) attitudes that promote recognition or appropriate help-seeking behavior. MHLS was initially developed by O'Connor and Casey (21).…”

Section: The Mental Health Literacy Scale (Mhls)mentioning

confidence: 99%

“…(1) the ability to recognize specific disorders or different types of psychological distress, (2), knowledge of risk factors and causes, (3) knowledge of self-treatment, (4) knowledge of professional help available, (5) knowledge of where to seek information, and (6) attitudes that promote recognition or appropriate help-seeking behavior. The theory was used as a framework within which to explain the unique needs and circumstances of early adults regarding their mental health problems.…”

Section: Introductionmentioning

confidence: 99%

“…In Uganda, several factors have been implicated in the development and sustenance of mental disorders such as depression. These factors include, inter alia , poverty ( 4 ), diseases ( 5 ), unemployment ( 6 ), and war ( 7 ). Depression also represents a risk factor for other mood disorders and substance abuse ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

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Barriers to treatment and care for depression among the youth in Uganda: The role of mental health literacy

Amone-P’Olak

Kakinda²,

Kibedi³

et al. 2023

Front. Public Health

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BackgroundDepression represents a significant mental health problem (MHP) in low- and middle-income countries (LMICs), especially among early adults. Nevertheless, most early adults with depression do not seek treatment. Failure to recognize depression and knowledge about mental health literacy (MHL) may contribute to poor help-seeking behavior. This study assessed MHL, access and barriers to mental health care for depression among early adults in Uganda.MethodsData were collected from students in two of the largest universities in Uganda. Participants completed questionnaires on depression, MHL, sources of barriers and opportunities for MH service. Regression analyses and parametric tests were used to assess depression, access, barriers and opportunities to promote MH.ResultsAbout 12 per cent (n = 56) of the respondents were at the level of moderately severe to severe depression. Mental health literacy (MHL) scores were generally low ranging from “Ability to recognize mental disorders” (mean = 19.32, SD 3.22, range 18–32), and “Knowledge of risk factors” (mean = 4.39, SD 1.17, range 2–8), and “Knowledge of available information” (mean = 9.59, SD 2.53, range 5–20). Respondents reported barriers such as “stigma/discrimination” (65.53%), “lack of knowledge of where to receive help” (65.15%), “lack of trust in health workers” (62.56%), and “distant health facilities” (19.70%) that impede access to treatment and care. MHL significantly predicted depression (based on a continuous scale) (β = 0.63, 95% confidence interval [CI]: [0.56, 0.70]) with the regression model yielding a significant fit [R2 = 0.40, F (2, 460) = 189.84, p < 0.001].ConclusionsMHL is low among university students amidst several barriers such as stigma, fear, and lack of trust. To attenuate the negative effects of MHPs on wellbeing and lower the increased risk of psychopathology into adulthood, it is critical to prioritize MHL, address barriers to treatment and care, and develop the requisite infrastructure to tackle depression among early adults.

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Section: The Mental Health Literacy Scale (Mhls)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Barriers to treatment and care for depression among the youth in Uganda: The role of mental health literacy

Amone-P’Olak

Kakinda²,

Kibedi³

et al. 2023

Front. Public Health

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“…In describing the experiences and perceived needs of stroke survivors, their caregivers, and CHWs in a context with limited access to and support from formal rehabilitation services, Sche er & Mash, (2020), reported CHWs providing home-based stroke rehabilitation and integration of stroke survivors in South Africa [40]. The Ugandan study by Vancampfort, et al (2021) explored the e cacy of an 8-week, once weekly, lay health worker-led physical activity counselling program on symptoms of anxiety, depression, HIV-related stress, and global disability in inactive people living with HIV and with mental health problems from a remote Ugandan farming community, showed that CHWs provided the study intervention in form of physical activity counselling at home [30].…”

Section: Home-basedmentioning

confidence: 99%

“…A community-based rehabilitation evaluation report for the Norwegian Association of the Disabled byClaussen et al (2005), shows that CHWs provide physical rehabilitation by assisting the disabled through training in activities of daily living, using rehabilitation programme providing basic physical rehabilitation, education of in-home caregivers around physical rehabilitation, emotional support, and counselling, access to resources and assistive devices, and increased integration into the local community for people living with HIV/AIDS[17]. In the cohort study of people living with HIV on antiretroviral therapy to explore the e cacy physical activity counselling program in Uganda byVancampfort et al (2021), CHWs provided the physical activity counselling intervention[30].Cobbing et al (2017) describe community care workers working as rehabilitation assistants providing basic rehabilitation to people living with HIV as an intervention in a randomised trial[36]. In another study,Cobbing et al (2017) found lay health workers providing basic rehabilitation services in KwaZulu-Natal, South Africa[37].…”

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Community health workers’ provision of physical rehabilitation services in sub-Saharan Africa: a scoping review

Mapulanga

Kgarosi

Maluleke

et al. 2023

Preprint

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Background The increase in the prevalence of non-communicable diseases as a result of increasing life expectancy and changing lifestyles from active to sedentary has increased the demand for physical rehabilitation. Due to this increased demand, services are required as close to people as possible through task-shifting physical rehabilitation services thereby strengthening services at primary health care level. We systematically mapped evidence and described the scope of physical rehabilitation services delivered by CHWs, their mode of physical rehabilitation services delivery, and the barriers and facilitators experienced by CHWs in delivering physical rehabilitation services in SSA.Methods We used the framework of Arksey and O'Malley and Levac et al’s to guide this scoping review. We searched PubMed, Scopus, Cochrane Central, and databases within the EBSCOhost platform using a mix of Medical Subject Heading terms and a combination of keywords for relevant literature without applying language restrictions. We included articles presenting evidence on CHWs’ provision of physical rehabilitation services in SSA from January 1978 to December 2022. Two independent reviewers screened articles at the abstract and full-text screening guided by the inclusion or exclusion criteria and the PCC elements. All relevant data were extracted using a google form and organized into themes and a summary of the results was reported narratively. The methodological quality of included studies was assessed using the mixed methods appraisal tool.Results A total of 6996 were identified through database search and other sources of which 29 met the included criteria and were included for data extraction. The included 29 studies were conducted in eight countries with the majority 16/29 from South Africa followed by 5/29 from Malawi, 3/29 from Uganda and 2/29 from Ethiopia. Of the 29 articles, each one was conducted in Eritrea, Kenya, Namibia and Mauritius. The review revealed the scope of practice for CHWs to be palliative care, disability, non-communicable diseases, HIV/AIDS, assistive devices, neurology, community-based rehabilitation, speech and language, and general rehabilitation while the modes of delivery are community-based, home-based, health facilities, community with health facilities and community with home-based. The review also revealed that the barriers experienced by CHWs in the delivery of physical rehabilitation services are transport and distance, societal and community attitudes, supplies, finance, weather, delivery capacity and governance while the facilitators were proximity to the community, personal attitude, knowledge and technology.Conclusion The review shows that CHWs are involved in physical rehabilitation service delivery in sub-Saharan Africa. It is therefore necessary to develop a training model for CHWs in physical rehabilitation services. Moreover, the review shows that there is need for the integration of CHWs into the national healthcare system as a sustainable solution to curb the chronic human resources for health shortage in SSA.

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Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

Purgato,

Prina,

Ceccarelli

et al. 2023

Cochrane Database of Systematic Reviews

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Background There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma. Objectives To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low‐ and middle‐income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs. Search methods We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021. Selection criteria Randomized controlled trials (RCTs) of primary‐level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs. Data collection and analysis Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random‐effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post‐intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2. Main results Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta‐analyses) for inclusion. Nineteen RCTs were conducted in low‐income countries, 27 in low‐middle‐income countries, 2 in middle‐income countries, 58 in upper‐middle‐income countries and 7 in mixed settings. Eighty‐three RCTs included adults and 30 RCTs included children. Cadres of primary‐level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate‐', 'low‐', or 'very low‐'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post‐intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared...

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The efficacy of a lay health workers – led physical activity counselling program in patients with HIV and mental health problems: a real-world intervention from Uganda

Cited by 13 publications

References 27 publications

Barriers to treatment and care for depression among the youth in Uganda: The role of mental health literacy

Barriers to treatment and care for depression among the youth in Uganda: The role of mental health literacy

Community health workers’ provision of physical rehabilitation services in sub-Saharan Africa: a scoping review

Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

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