A qualitative pilot study exploring the acceptability of a peer provider delivered substance use brief intervention from the perspective of youth in Kenya

Substance Abuse Treatment Prevention and Policy, Journal Year: 2025, Volume and Issue: 20(1)

Published: Feb. 11, 2025

Substance use disorders are prevalent among youth in sub-Saharan Africa (SSA), yet treatment resources scarce. Peer provider delivered brief interventions (BIs) represent an affordable and potentially scalable strategy for addressing substance disorders. The goal of this study is to assess the acceptability a peer BI from perspective Kenya. We conducted qualitative semi-structured interviews with participants (n = 25) explore BI. Youth were two-arm mixed-methods pilot randomized controlled trial (RCT) investigating feasibility single-session aged 15–24 years moderate-risk use. three months after was guided by Theoretical Framework Acceptability (TFA). Qualitative data analyzed through thematic analysis. interviewed 25 38 arm, 18 males 7 females; 15 ages 18–24 years, 10 15–17 years. Affective attitude: Most reported that they enjoyed session content interacting provider. Burden: felt it easy understand participate it. Perceived effectiveness: perceived intervention be effective helping them reduce improve their well-being. Ethicality: All counselling fit goals values. Intervention coherence: understood overall intervention. They help stop use, bring about behavior change. Opportunity costs: Some had forgo other activities attend session, such as work, school, sports, gaming, visiting family, or house chores. Self-efficacy: confident being able cut down using substances following Our findings indicate acceptable youth. recommended follow-up sessions provided ensure sustained This supports utility TFA exploring young people. NCT05545904 Registration date 16/09/2022 Registry ClinicalTrials.gov https//clinicaltrials.gov/study/NCT05545904.

Language: Английский

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Empowering Young Adults: Reimagining Peritoneal Dialysis Support

Kidney Medicine, Journal Year: 2025, Volume and Issue: unknown, P. 100999 - 100999

Published: March 1, 2025

Language: Английский

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Kidney adolescent and young adult clinic: A transition model in Africa

Pediatric Transplantation, Journal Year: 2024, Volume and Issue: 28(2)

Published: March 1, 2024

Abstract Adolescents and Young Adults (AYAs) with chronic kidney disease (CKD) have challenges unique to this developmental period, increased rates of high‐risk behavior non‐adherence therapy which may impact the progression their requirement for replacement (KRT). Successful transition AYA patients are particularly important in low‐ middle‐income countries (LMICs) where KRT is limited, rationed or not available. Kidney clinics potential improve clinical outcomes but there a paucity data on translational these Africa. This review reflection 20‐year growth development first South African clinic. We describe model care CKD, irrespective etiology, aged 10–25 years, transitioning from pediatric adult nephrology services. service was established 2002 re‐designed 2015. multidisciplinary integrated has improved patient outcomes, created peer support groups formed training platform future nephrologists. In addition, an Adolescent Centre Excellence been compliment care. The pathway solutions explored article. clinic scope expanded over last two decades. With limited resources LMICs, such as KRT, structured AYAs only possible essential. It imperative preserve residual function, maximize allograft lifespan adherence, enable young individuals opportunity lead productive lives.

Language: Английский

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A Scoping Review on Peer-led Interventions to Improve Youth Mental Health in Low- and Middle-Income Countries

Cambridge Prisms Global Mental Health, Journal Year: 2024, Volume and Issue: 12

Published: Dec. 16, 2024

Abstract Youth living in low- and middle-income countries (LMICs) have an increased vulnerability to mental illnesses, with many lacking access adequate treatment. There has been a growing body of interventions using task sharing trained peer leaders address this health gap. This scoping review examines the characteristics, effectiveness, components delivery challenges peer-led for youth aged 10–24 LMICs. A key term search strategy was employed across MEDLINE, Embase, Web Science, Global Health Index Medicus. Eligibility criteria included young people component delivered any setting LMIC. Study selection extraction were conducted independently by first second authors, discrepancies resolved senior author. characteristics summarised presented descriptively. The identified 5,358 citations, 19 studies included. 14 quantitative, four qualitative one mixed methods study reporting outcomes. Types heterogenous but fell within three broad categories: (1) education psychoeducation, (2) psychotherapy counselling (3) support. All reported improved outcomes as result interventions. Peer-led are versatile terms both types mode delivery. Lived experience, mutual respect reduced stigma make method highly unique effective way engage age group. However, implementing is not without challenges. Adequate training, supervision, cultural appropriateness support from established institutions critical safeguarding ensuring sustainability such programs. Our findings suggest that models valuable intervention policymakers can leverage current future efforts Future areas research should expand include perspectives other stakeholders involved implementation interventions, focusing on factors including fidelity, feasibility acceptability enhance insights.

Language: Английский

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Achieving equity for children and adolescents with perinatal HIV exposure: an urgent need for a paradigm shift

Journal of the International AIDS Society, Journal Year: 2023, Volume and Issue: 26(S4)

Published: Oct. 1, 2023

One and a half million children (0–14 years) were estimated to be living with HIV globally in 2022 by the Joint United Nations Programme on HIV/AIDS (UNAIDS), 89% of these residing sub-Saharan Africa [1]. It was also that among HIV, only 57% accessing antiretroviral treatment (ART) compared 77% adults aged 15 years older [2]. The inequity access ART between can attributed disproportionately poor uptake testing, gaps timely initiation, low retention rates adherence paediatric population [3]. Fortunately, remarkable progress global scale-up for pregnant breastfeeding persons along improved risk-based options infant (ARV) prophylaxis, increasing availability pre-exposure prophylaxis at high risk acquisition, have led marked declines acquisition [4]. UNAIDS reported 58% reduction number new infections 2010 2022, offering hope achieving sustainable development goal 3.3, targeting an end AIDS as public health threat 2030 Concomitantly, recent data from highest burden settings demonstrate vertical transmission 3% South Africa, 2.4% Eswatini 1.8% Botswana[5]. However, over one women girls around world experience pregnancy annually, 82% [6]. Therefore, although infancy has continued decline, decline almost stalled years, 130,000 acquired 140,000 2021 [7]. In addition, who are HIV-exposed uninfected (CHEU) been steadily least annually. estimates cumulative CHEU approximately 16 90% reside [1, 8]. Eswatini, Botswana Lesotho, where prevalence is prioritised, 20% all infants born annually had utero exposure increasingly maternal [9, 10]. Several studies demonstrated outcome disparities without perinatal (children HIV-unexposed uninfected—CHUU), including mortality, morbidity, impaired growth poorer neurodevelopment outcomes [11-17]. These increase across child's life course, early into adulthood. Gaps remain understanding magnitude their underlying mechanisms, relative contributions biological, social and/or structural processes. Furthermore, there lack consensus effective interventions optimise wellbeing this growing children. Public commitment programming must go beyond prevention encompass holistic approach includes supporting course outcomes. Starting HIV-free not sufficiently enough bar. require support thrive fullest potential. This supplement Journal International Society features programmes highlight describe improve opportunities advocate mitigating presented. Collectively, motivate more robust policy climate response optimizing adolescents intent (1) identifying basic science research identify biological mechanistic pathways observed disparities; (2) informing design epidemiological investigating factors associated increased outcomes; (3) highlighting practical address (4) guiding educational policies programming; (5) ensuring parents caregivers affected knowledge needed suboptimal appropriate services. Failure diagnose manner increases infectious neurodevelopmental delays [18-22]. maturing epidemic, importance client-centred differentiated service delivery recognised necessary towards eliminating [23]. Following diagnoses initiation ART, care achievement viral suppression paramount HIV. Retention particularly challenging [24, 25]. Internalised stigma noted discontinuation [26]. Harrison colleagues report novel involving young peer groups comprised similarly individuals other chronic illnesses [27]. clinic-based pilot intervention called Better Together Program, leaders facilitating group sessions, youth value learning about challenges encountered peers conditions. Participation five or attending fewer higher self-reported individual-level resilience, positive attitude lower internalised self-concept, measured using standardised instruments. provides unique option improving mental may yield sustained suppression. de Beer evaluated trends hospitalisations due causes ≤3 age 2008 2021. They surrogate measure epidemic's impact child services Western Cape province [28]. authors analysed 50,000 eligible accounted decreasing proportion infectious-cause hospitalisations, comprising time. Importantly, Provincial Health Data Centre's successful automated linking identifiers various encounters serves powerful model how harmonised systems leveraged answer population-level [29]. Such real-world useful implementation regarding longer-term CHEU. Three offer further insights Bulterys findings Kenya-based observational cohort mother-infant pairs Malawi Developmental Assessment Tool administered mothers provided feedback 1-year-old infant's domains social, language, fine gross motor functioning [30]. study maternal−infant pairs, whom Interestingly, while comparable scores found HEU those (HUU), language scores. efavirenz dolutegravir, registries place monitor short- long-term ARV order safest most efficacious regimens use pregnancy. A trial conducted Ruff delivered mentor WHO's Nurturing Care Framework nurturing [31]. Mother-child took part experiment which standard activities viably integrated antenatal clinics reduce neurocognitive disparities. mechanisms driving children's occur through modifiable caregiving activities, reading provision positively influence optimal Powis present primary school Botswana-based FLOURISH [32]. prospective birth ages 8–12, 75% CHEU, odds academic performance, defined grade "C" less, HUU mathematics, science, English overall. association being performance attenuated after adjustment education, breastfeeding, weight sex. Biological socio-demographic factors, sex appeared contribute difference. To better understand possible points exposure, multifactorial elements considered. commentary offers insight behavioural milieu household caregiver-related [33]. disproportionate threaten ability achieve maturation brain, immune system, overall wellbeing. structured training healthcare workers, equipping gatekeepers conduct rapid screening tests need specialised promoting mitigate complex sub-optimal presents interventions. African-based Le Roux followed first year life, people 2013 2017, aim describing socio-economic adverse [34]. parental alcohol consumption, intimate partner violence food insecurity morbidity. HUU. our knowledge, systematically evaluate evidence HIV-related syndemic interactions, level within household, potentiate unexposed peers. field champion progressing thought, action capacity-building models reflect lived experiences, needs preferences communities [35]. cannot themselves. essential involved setting agenda exposure. Bukasa discusses engaging plans communication strategies, enabling inform behalf [36]. will equally important involve conversations. exposed uninfected, when less likely received disclosure status caregivers. Davtyan role willingness disclose derived participants States-based Surveillance Monitoring Toxicities (SMARTT) study, following [37]. Among uncommon disclose. demonstrates mitigated remove barrier uninfected. Research funders, US National Institutes (NIH), prioritizing Lee colleagues, NIH, share current investments outlining future areas focus [38]. recommend priorities could achieved rapidly sustainably focusing harmonisation shared efforts studies. Continued investment required expand commitments drivers Lastly, given large portion outcomes, stress exists urgent tools high-risk Viewpoint Evans et al. comprehensive package HIV-specific universal throughout 1000 days [39]. either mother include booking, healthy hygiene practices, others. July World Organisation, partnership UNICEF, announced Global Alliance End Children strategic vision, designed 2030, four pillars focus, calls optimised comprehensive, high-quality infants, While much foundation laid work presented highlights merely celebrating start short-sighted objective. Collective collaborative taken impactful research, multi-faceted transform monitoring evaluation components. declare they no competing interests. JNM, AR KMP jointly drafted editorial. All read approved final version. As Guest Editors—Jane Namangolwa Mutanga, Agnes Ronan Kathleen M. wish express appreciation prepared, submitted revised manuscripts request, even included. We would like thank reviewers invested time review respond, providing each manuscripts. grateful many volunteered represented supplement. Their participate highlighted informed exist health, developmental editors staff Society, specifically Marlène Bras, Annette Sohn, Chloé Zufferey Alberto Rossi, thoughtful guidance, rigorous encouragement process. Finally, we Collaborative Initiative Paediatric Education Research, initiated championed advancement Supplement. views expressed article personal understood quoted made reflecting position regulatory agency/agencies organisations employed/affiliated. sharing applicable datasets generated during study.

Language: Английский

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Peer support as pressure ulcer prevention strategy in special school learners with paraplegia

South African Journal of Physiotherapy, Journal Year: 2024, Volume and Issue: 80(1)

Published: July 30, 2024

Background: Adults with spinal cord injuries perceived peer support as beneficial in preventing secondary health conditions, but the role of among adolescent learners paraplegia special schools is still unknown. Objectives: To explore perspectives current and previous on to prevent pressure ulcers a school. Method: A qualitative, exploratory, descriptive study design was used. The authors conducted 12 semi-structured telephonic, audio-recorded interviews focus group discussion attending were transcribed verbatim translated, data organised using Nvivo-12 Pro program. Through conducting an inductive thematic analysis categories, sub-themes themes identified from participants' narratives. Results: included positive challenging aspects reflected four sub-themes: group-based support, individual mentoring, challenges roles school physiotherapist regarding support. Conclusion: Learners saw crucial strategy reducing ulcers. Establishing system components could be game-changer end ensure better educational outcomes. Clinical implications: Physiotherapists should initiatives successful ulcer prevention.

Language: Английский

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Research on child and adolescent health in low- and middle-income countries in 2023–2024

Archives of Disease in Childhood, Journal Year: 2024, Volume and Issue: unknown, P. archdischild - 327876

Published: Sept. 19, 2024

Between July 2023 and June 2024, there were 540 publications from randomised controlled trials (RCTs) in child adolescent health low- middle-income countries (LMICs), identified using a standardised process that has been use for 21 years. This year, addressed wide range of diseases conditions impacting the health, development well-being children, newborns, adolescents mothers. The RCTs reflected old, new neglected problems, rapidly changing epidemiology evolving social economic circumstances many countries. They also highlighted local global priorities LMICs, as well environmental factors contributing to poor inequities. tested refined treatments, diagnostics, vaccines, holistic management prevention approaches, explored outcomes, including mortality, nutrition, psychosocial measures development. studies conducted hospitals primary healthcare clinics, schools communities. Some are highest quality, while others fall short. implications many, need greater capacity discriminating synthesis translation evidence at national level LMICs. involves resourcing educational components, with worker training research translation, quality improvement learning systems. Paediatricians nurses everywhere have role play.

Language: Английский

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Dissecting the Role of Donors in Capacity Building for HIV/AIDS Treatment, Care and Support: A Case Study of an Antiretroviral Therapy Programme in Zimbabwe

Journal of Asian and African Studies, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 16, 2024

Donor involvement in development activities the Global South has been questioned for failing to capacitate communities recipient country. Therefore, need establish whether Médecins Sans Frontières (MSF) antiretroviral treatment (ART) programme Zimbabwe contributed capacity building HIV and AIDS support, care triggered this study. A qualitative methodology involving semi-structured interviews with purposively selected participants was adopted. As a result of MSF programme, community-based clinics created ART support groups which facilitated easy access medication health-related information. Dispensing testing could also be done these clinics, were previously district hospitals. These interventions reduced waiting periods long-distance travel care, treatment, thus improving healthcare quality. Community-influenced strategies are recommended sustain improvements.

Language: Английский

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Using creativity and the arts to promote mental health in youth living with HIV in South Africa

Southern African Journal of HIV Medicine, Journal Year: 2024, Volume and Issue: 25(1)

Published: Dec. 20, 2024

Access to adolescent-friendly, culturally relevant and stigma-free mental health support is essential for reducing the long-term psychological, social economic challenges of illness youth living with HIV (YLWH). Now more than ever, innovative task-shifting interventions, through which non-mental professionals provide YLWH, need be explored supported. While many these have considered shifting tasks nurses, tapping into wisdom inspiration from artists in community where YLWH are could represent a novel potentially powerful strategy.In this opinion piece, we propose that arts future studies as promising avenue interventions South Africa. Better Together peer-support intervention chronic illness, has been published previously by our team.As part discussion, share feedback about creative component groups provided participants themselves.Overall, yielded several key insights further underscore idea providing opportunities engage group setting may platform addressing Africa.Specifically, learned (1) enjoyed opportunity creatively, (2) experiences helped them connect others, (3) they gained new perspectives themselves their lives, (4) experienced positive impact on mood well-being.

Language: Английский

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Digital Health Interventions for Adolescents with Long-Term Health Conditions in South Africa: A Scoping Review

International Journal of Environmental Research and Public Health, Journal Year: 2024, Volume and Issue: 22(1), P. 2 - 2

Published: Dec. 24, 2024

Adolescents with long-term health conditions may benefit from digital interventions (DHIs) to support self-management. The study aimed map the current research on DHIs for adolescents in South Africa, focusing types of interventions, targeted chronic conditions, and reported outcomes. scoping review was conducted following Joanna Briggs Institute (JBI) guidelines Preferred Reporting Items Systematic Reviews Meta-Analyses Extension Scoping (PRISMA-ScR) checklist. Searches were electronic databases such as EBSCOHost (CINAHL, MEDLINE, Academic Search Ultimate, APA PSycArticles), Wiley Online Library, PubMed articles published between 2014 2024. Studies that (1) involved a condition (aged 15-24) residing (2) use technology, (3) provided empirical evidence included. Nine studies included analysis, primarily HIV, depression/anxiety, diabetes. Most utilized WhatsApp, SMS, or social media provide peer healthcare worker support. Process outcomes like acceptability feasibility dominated, limited data effectiveness. show potential supporting adolescent but cover number face barriers effective implementation. Affordable, context-specific solutions co-designed are crucial enhance engagement ensure scalability African context. Registration: protocol registered Open Science Framework.

Language: Английский

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