The effectiveness of a psycho-education intervention on mental health literacy in communities affected by the COVID-19 pandemic—a cluster randomized trial of 24 villages in central Uganda—a research protocol

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Abstract

Background

Literature shows a high prevalence of psychological distress (PD) as well as common mental disorders (CMD) such as major depressive disorders (MDD), generalized anxiety disorders (GAD), post-traumatic stress disorders (PTSD), and substance misuse disorders (SUD) among people exposed to disasters and pandemics like the COVID-19. Moreover, CMD are associated with increased mortality (mainly through suicide) and morbidity (loss of productivity). A number of countries have made deliberate efforts to identify and manage CMD in light of COVID-19. However, low levels of mental health literacy (MHL) manifested by the individual’s unawareness of CMD symptoms, limited human and mental health infrastructure resources, and high levels of mental illness stigma (MIS) are barriers to integration of mental health care in general health care during pandemics and epidemics such as the COVID-19.

Objectives

For the proposed study, we will determine effectiveness of a psycho-education intervention delivered by village health team (VHT) members.

Methods

We will employ a cluster randomized trial design in 24 villages in central Uganda. We will collect baseline data to and document the prevalence of MHL, PD, MDD, PTSD, GAD, and SUD. We will distribute information education and communication materials (IEC) aimed at improving MHL to 420 adult individuals in the intervention arm ( n = 12 villages). In the control arm ( n = 12 villages), VHTs will distribute ministry of health COVID-19 information leaflets to 420 participants. Within 7 days of distributing the materials, research assistants will conduct a follow-up interview and assess for the same parameters (MHL, PD, MDD, PTSD, GAD, and SUD). We will use an intention to treat analysis to estimate the effectiveness of the psycho-education intervention.

Discussion

Findings from this research will guide policy and practice regarding the integration of mental health services in the community in the context of epidemic preparedness and response.

Trial registration

ClinicalTrials.gov NCT04616989. Registered on 05 November 2020

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Most cited references 34

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A brief measure for assessing generalized anxiety disorder: the GAD-7.

Robert L Spitzer, Kurt Kroenke, Janet B W Williams … (2006)

Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.

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A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations

Jianyin Qiu, Bin Shen, Min Zhao … (2020)

The Coronavirus Disease 2019 (COVID-19) epidemic emerged in Wuhan, China, spread nationwide and then onto half a dozen other countries between December 2019 and early 2020. The implementation of unprecedented strict quarantine measures in China has kept a large number of people in isolation and affected many aspects of people’s lives. It has also triggered a wide variety of psychological problems, such as panic disorder, anxiety and depression. This study is the first nationwide large-scale survey of psychological distress in the general population of China during the COVID-19 epidemic.

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A Nationwide Survey of Psychological Distress among Italian People during the COVID-19 Pandemic: Immediate Psychological Responses and Associated Factors

Cristina Mazza, Eleonora Ricci, Sílvia Biondi … (2020)

The uncontrolled spread of the coronavirus disease 2019 (COVID-19) has called for unprecedented measures, to the extent that the Italian government has imposed a quarantine on the entire country. Quarantine has a huge impact and can cause considerable psychological strain. The present study aims to establish the prevalence of psychiatric symptoms and identify risk and protective factors for psychological distress in the general population. An online survey was administered from 18–22 March 2020 to 2766 participants. Multivariate ordinal logistic regression models were constructed to examine the associations between sociodemographic variables; personality traits; depression, anxiety, and stress. Female gender, negative affect, and detachment were associated with higher levels of depression, anxiety, and stress. Having an acquaintance infected was associated with increased levels of both depression and stress, whereas a history of stressful situations and medical problems was associated with higher levels of depression and anxiety. Finally, those with a family member infected and young person who had to work outside their domicile presented higher levels of anxiety and stress, respectively. This epidemiological picture is an important benchmark for identifying persons at greater risk of suffering from psychological distress and the results are useful for tailoring psychological interventions targeting the post-traumatic nature of the distress.

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Author and article information

Contributors

Dickens Akena: akendickens@yahoo.co.uk

Ronald Kiguba: kiguba@gmail.com

Wilson W. Muhwezi: winstons.muhwezi@gmail.com

Brendan Kwesiga: brendan.kwesiga@gmail.com

Gwendolyne Kigozi: gwendolyn.kigozi@gmail.com

Noeline Nakasujja: drnoeline@yahoo.com

Hafsa Lukwata: hafluk@yahoo.com

Journal

Journal ID (nlm-ta): Trials

Journal ID (iso-abbrev): Trials

Title: Trials

Publisher: BioMed Central (London )

ISSN (Electronic): 1745-6215

Publication date (Electronic): 13 July 2021

Publication date PMC-release: 13 July 2021

Publication date Collection: 2021

Volume: 22

Electronic Location Identifier: 446

Affiliations

[1 ]GRID grid.11194.3c, ISNI 0000 0004 0620 0548, Department of Psychiatry, , Makerere University College of Health Sciences, ; Kampala, Uganda

[2 ]GRID grid.11194.3c, ISNI 0000 0004 0620 0548, Department of Pharmacology, , Makerere University College of Health Sciences, ; Kampala, Uganda

[3 ]Health Systems Strengthening Cluster, World Health Organization, Kenya Country Office, Nairobi, Kenya

[4 ]GRID grid.11194.3c, ISNI 0000 0004 0620 0548, Grants office, , Makerere University College of Health Sciences, ; Kampala, Uganda

[5 ]GRID grid.415705.2, Department of Mental Health, , Ministry of Health of Uganda, ; Kampala, Uganda

Article

Publisher ID: 5391

DOI: 10.1186/s13063-021-05391-6

PMC ID: 8276200

PubMed ID: 34256810

SO-VID: 6c0107e8-7621-4ecf-9e75-c8806ad663d8

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 8 December 2020

Date accepted : 22 June 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100009914, Makerere University;

Award ID: MAK/DVCFA/113/20

Award Recipient : Dickens Akena

Custom metadata

ScienceOpen disciplines: Medicine

Keywords: mental health literacy,common mental disorders,sub-saharan africa

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ScienceOpen disciplines: Medicine

Keywords: mental health literacy, common mental disorders, sub-saharan africa

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The effectiveness of a psycho-education intervention on mental health literacy in communities affected by the COVID-19 pandemic—a cluster randomized trial of 24 villages in central Uganda—a research protocol

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Abstract

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Objectives

Methods

Discussion

Trial registration

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Novel Coronavirus Disease COVID-19

Most cited references 34

A brief measure for assessing generalized anxiety disorder: the GAD-7.

A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations

A Nationwide Survey of Psychological Distress among Italian People during the COVID-19 Pandemic: Immediate Psychological Responses and Associated Factors

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Cited by 5

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