1
|
Jaguga F, Mathai M, Ayuya C, Francisca O, Musyoka CM, Shah J, Atwoli L. 12-month substance use disorders among first-year university students in Kenya. PLoS One 2023; 18:e0294143. [PMID: 38011101 PMCID: PMC10681253 DOI: 10.1371/journal.pone.0294143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 10/25/2023] [Indexed: 11/29/2023] Open
Abstract
OBJECTIVES The period of entry into university represents one of vulnerability to substance use for university students. The goal of this study is to document the 12-month prevalence of substance use disorders among first year university students in Kenya, and to test whether there is an association between substance use disorders and mental disorders. METHODS This was a cross-sectional online survey conducted in 2019 and 2020 as part of the World Health Organization's World Mental Health International College Student (WMH-ICS) survey initiative. A total of 334 university students completed the survey. Descriptive statistics were used to summarize the demographic characteristics of the participants. Multivariate logistic regression was used to assess the association between substance use disorder and mental disorders after adjusting for age and gender. RESULTS The 12-month prevalence for alcohol use disorder was 3.3%, while the 12-month prevalence for other substance use disorder was 6.9%. Adjusting for age and gender, there was an association between any substance use disorder and major depression, generalized anxiety disorder, bipolar 1 disorder, intermittent explosive disorder, social anxiety disorder, suicidal ideation, suicide attempt, and non-suicidal self-injury. CONCLUSION These findings highlight the need to institute policies and interventions in universities in Kenya that address substance use disorders and comorbid mental disorders among first-year students.
Collapse
Affiliation(s)
- Florence Jaguga
- Department of Alcohol and Drug Abuse Rehabilitation Services, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Muthoni Mathai
- Department of Psychiatry, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Caroline Ayuya
- Department of Psychology & Counseling, Daystar University, Nairobi, Kenya
| | - Ongecha Francisca
- Department of Medicine, Therapeutics, Dermatology & Psychiatry, School of Medicine, Kenyatta University, Nairobi, Kenya
| | - Catherine Mawia Musyoka
- Department of Psychiatry, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Jasmit Shah
- Brain and Mind Institute and the Department of Internal Medicine, Medical College East Africa, Aga Khan University, Nairobi, Kenya
| | - Lukoye Atwoli
- Brain and Mind Institute and the Department of Internal Medicine, Medical College East Africa, Aga Khan University, Nairobi, Kenya
| |
Collapse
|
2
|
Harrington EK, Congo O, Kimanthi S, Dollah A, Onono M, Mugo N, Barnabas RV, Bukusi EA, Upadhyay UD. Adaptation of the sexual and reproductive empowerment scale for adolescents and young adults in Kenya. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001978. [PMID: 37883373 PMCID: PMC10602344 DOI: 10.1371/journal.pgph.0001978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023]
Abstract
Measuring empowerment is critical to understanding the level of control adolescents and young adults (AYA) have over their sexual and reproductive health (SRH) behaviors, and could provide a key window into addressing their unique SRH needs. We adapted the Sexual and Reproductive Empowerment (SRE) scale for AYA for use in an East African context. This multi-method qualitative study sampled 15-23 year-old female adolescents and young adults in Kisumu, Kenya. We conducted in-depth interviews (n = 30) and analyzed transcripts with an inductive, constant comparison approach. Empowerment domains were integrated with Kabeer's (1999) framework in a conceptual model, which we referenced to revise the original and develop new scale items. Items underwent expert review, and were condensed and translated through team-based consensus-building. We evaluated content validity in cognitive interviews (n = 25), during which item phrasing and word choice were revised to generate an adapted SRE scale. Participants (n = 55) had a median age of 18 (range 16-23), and 75% were under 19 years. We categorize three types of adaptations to the SRE scale: new item generation, item revision, and translation/linguistic considerations. We developed nine new items reflecting AYA's experiences and new domains of empowerment that emerged from the data; new domains relate to self-efficacy in accessing sexual and reproductive health care, and how material needs are met. All items were revised and translated to echo concepts and language relevant to participants, navigating the multilingualism common in many African countries. Centering the voices of female Kenyan AYA, this study provides insight into measuring the latent construct of adolescent sexual and reproductive empowerment in an East African setting, and supports the adapted SRE scale's content validity for Kenya. We detail our multi-method, theory-driven approach, contributing to limited methods guidance for measure adaptation across contexts and among diverse adolescent populations.
Collapse
Affiliation(s)
- Elizabeth K. Harrington
- Department of Obstetrics & Gynecology, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Ouma Congo
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Syovata Kimanthi
- Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Maricianah Onono
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Nelly Mugo
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Ruanne V. Barnabas
- Division of Infectious Disease, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Elizabeth A. Bukusi
- Department of Obstetrics & Gynecology, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Ushma D. Upadhyay
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, California, United States of America
| |
Collapse
|
3
|
Dougherty K, Hobensack M, Bakken S. Scoping review of health information technology usability methods leveraged in Africa. J Am Med Inform Assoc 2023; 30:726-737. [PMID: 36458941 PMCID: PMC10018268 DOI: 10.1093/jamia/ocac236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/14/2022] [Accepted: 11/18/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to explore the state of health information technology (HIT) usability evaluation in Africa. MATERIALS AND METHODS We searched three electronic databases: PubMed, Embase, and Association for Computing Machinery. We categorized the stage of evaluations, the type of interactions assessed, and methods applied using Stead's System Development Life Cycle (SDLC) and Bennett and Shackel's usability models. RESULTS Analysis of 73 of 1002 articles that met inclusion criteria reveals that HIT usability evaluations in Africa have increased in recent years and mainly focused on later SDLC stage (stages 4 and 5) evaluations in sub-Saharan Africa. Forty percent of the articles examined system-user-task-environment (type 4) interactions. Most articles used mixed methods to measure usability. Interviews and surveys were often used at each development stage, while other methods, such as quality-adjusted life year analysis, were only found at stage 5. Sixty percent of articles did not include a theoretical model or framework. DISCUSSION The use of multistage evaluation and mixed methods approaches to obtain a comprehensive understanding HIT usability is critical to ensure that HIT meets user needs. CONCLUSIONS Developing and enhancing usable HIT is critical to promoting equitable health service delivery and high-quality care in Africa. Early-stage evaluations (stages 1 and 2) and interactions (types 0 and 1) should receive special attention to ensure HIT usability prior to implementing HIT in the field.
Collapse
Affiliation(s)
- Kylie Dougherty
- School of Nursing, Columbia University, New York, New York, USA
| | | | - Suzanne Bakken
- School of Nursing, Columbia University, New York, New York, USA
| |
Collapse
|
4
|
Laar AS, Harris ML, Shifti DM, Loxton D. Perspectives of health care professionals' on delivering mHealth sexual and reproductive health services in rural settings in low-and-middle-income countries: a qualitative systematic review. BMC Health Serv Res 2022; 22:1141. [PMID: 36085027 PMCID: PMC9461099 DOI: 10.1186/s12913-022-08512-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 08/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In low to middle income countries (LMICs) with limited health care providers (HCPs) and health infrastructure, digital technologies are rapidly being adopted to help augment service delivery. In this sphere, sexual and reproductive health (SRH) services are increasingly leveraging mobile health (mHealth) technologies to improve service and information provision in rural areas. This systematic review aimed to identify HCPs perspectives on barriers to, and facilitators of, mobile phone based SRH services and information in rural areas of LMICs from current literature. METHODS Searches were conducted using the following databases: Medline, Scopus, PsychINFO, CINAHL and Cochrane Library. Based on the inclusion and exclusion criteria, twelve full text qualitative studies published in English between January 2000 and December 2020 were included. The methodological quality of papers was assessed by two authors using the critical skills appraisal programme and synthesized using the narrative thematic analysis approach. RESULTS Positive HCPs experiences surrounding the provision of mHealth based SRH services in LMICs included saving consultation time, ability to shift tasks, reduction in travel costs, easy referrals and follow up on clients, convenience in communicating health information confidentially, and the ability to consult groups of clients remotely rather than face-to-face. Barriers to the provision of mHealth reported by HCPs included lack of technological infrastructure, unreliable networks, limited power, the cost of mobile airtime/data and mobile phones and limited technological literacy or skills. CONCLUSIONS Implementing innovative mHealth based SRH services could bridge a service provision and access gap of SRH information and services in rural areas of LMICs. Despite the advantages of this technology, several challenges associated with delivering mHealth SRH services need to be urgently addressed to enable scale-up and integration of sexual and reproductive mHealth into rural health systems.
Collapse
Affiliation(s)
- Alexander Suuk Laar
- The University of Newcastle, Australia, School of Public Health and Medicine, Centre for Women's Health Research, Faculty of Health and Medicine, Hunter Medical Research Institute, Callaghan, New South Wales, 2308, Australia.
- REJ Institute, Research and ICT Consultancy Services, Tamale, Ghana.
| | - Melissa L Harris
- The University of Newcastle, Australia, School of Public Health and Medicine, Centre for Women's Health Research, Faculty of Health and Medicine, Hunter Medical Research Institute, Callaghan, New South Wales, 2308, Australia
| | - Desalegn Markos Shifti
- The University of Newcastle, Australia, School of Public Health and Medicine, Centre for Women's Health Research, Faculty of Health and Medicine, Hunter Medical Research Institute, Callaghan, New South Wales, 2308, Australia
| | - Deborah Loxton
- The University of Newcastle, Australia, School of Public Health and Medicine, Centre for Women's Health Research, Faculty of Health and Medicine, Hunter Medical Research Institute, Callaghan, New South Wales, 2308, Australia
| |
Collapse
|
5
|
Macharia P, Pérez-Navarro A, Inwani I, Nduati R, Carrion C. Developing an Unstructured Supplementary Service Data-based mobile phone app to provide adolescents with sexual reproductive health information: a human-centered design approach. BMC Med Res Methodol 2022; 22:213. [PMID: 35927636 PMCID: PMC9351084 DOI: 10.1186/s12874-022-01689-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescent pregnancies and sexually-transmitted infections continue to impact 15 - 19-year-olds across the globe. The lack of sexual reproductive health information (SRH) in resource-limited settings due to cultural and societal attitudes towards adolescent SRH could be contributing to the negative outcomes. Innovative approaches, including mobile phone technologies, are needed to address the need for reliable adolescent SRH information. OBJECTIVE The study aimed to co-design a Unstructured Supplementary Service Data (USSD) based mobile app prototype to provide confidential adolescent SRH information on-demand and evaluate the mobile app's usability and user experience. METHODS A human-centered design methodology was applied. This practice framework allowed the perspectives and feedback of adolescent users to be included in the iterative design process. To participate, an adolescent must have been 15 to 19 years old, resided in Kibra and would be able to access a mobile phone. Adolescents were enrolled for the alpha and field testing of the app prototype at different time-points. The Mobile Application Rating Scale (MARS) a multidimensional mobile phone evaluation tool was used to access the functionality, engagement, aesthetics and quality of information in the app. Responses from the MARS were reported as mean scores for each category and a mean of the aggregate scores making the app's quality score. The MARS data was also evaluated as categorical data, A Chi square test of independence was carried out to show significance of any observed differences using cumulative and inverse cumulative distribution functions. RESULTS During the usability test, 62/109 (54.9%) of the adolescents that were followed-up had used the app at least once, 30/62 (48.4%) of these were male participants and 32/62 (51.6%) female. On engagement, the app had a mean score of 4.3/5 (SD 0.44), 4.6/5 (SD 0.38) on functionality, 4.3/5 (SD 0.57) on aesthetics and 4.4/5 (SD 0.60) on the quality of information. The overall app quality mean score was 4.4/5 (SD 0.31). The app was described as 'very interesting' to use by 44/62 (70.9%) of the participants, 20/44 males and 24/44 females. The content was deemed to be either 'perfectly' or 'well targeted' on sexual reproductive health by 60/62 (96.7%) adolescents, and the app was rated 'best app' by 45/62 (72.6%) adolescents, 27/45 females and 18/45 males, with a p-value = 0.011. CONCLUSIONS Adolescents need on-demand, accurate and trusted SRH information. A mobile phone app is a feasible and acceptable way to deliver adolescent SRH information in resource-limited settings. The USSD mobile phone technology shows promise in the delivery of much needed adolescent SRH information on-demand..
Collapse
Affiliation(s)
- Paul Macharia
- Faculty of Computer Sciences, Multimedia and Telecommunication, Universitat Oberta de Catalunya, Barcelona, Spain
- Consulting in Health Informatics, P.O Box 3966, Nairobi, 00100 Kenya
- eHealth Lab Research Group, School of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Antoni Pérez-Navarro
- Faculty of Computer Sciences, Multimedia and Telecommunication, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Irene Inwani
- Kenyatta National Hospital, Hospital Rd, Nairobi, Kenya
| | - Ruth Nduati
- University of Nairobi, University Way, Nairobi, Kenya
| | - Carme Carrion
- eHealth Lab Research Group, School of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
- eHealth Center, Universitat Oberta de Catalunya, Barcelona, Spain
| |
Collapse
|