Improving access to evidence‐based interventions for trauma‐exposed adults in low‐ and middle‐income countries

Journal of Traumatic Stress, Journal Year: 2024, Volume and Issue: 37(4), P. 563 - 573

Published: March 8, 2024

In low- and middle-income countries (LMICs), the mental health consequences of trauma exposure pose a substantial personal, societal, economic burden. Yet, significant need for evidence-based treatment remains largely unmet. To unlock potential care survivors in lower-resource contexts, it is critical to map barriers identify strategies improve access evidence-based, culturally appropriate, scalable interventions. This review, based on an International Society Traumatic Stress (ISTSS) briefing paper, describes gap facing adults with traumatic stress LMICs identifies that contribute this gap. We then highlight enhancing effective treatments these populations, including task-sharing, use adapted multiproblem interventions, digital tools scale appropriate care. Finally, we offer recommendations policymakers, researchers, service providers guide agenda action close LMICs.

Language: Английский

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Why People with Overweight and Obesity Are Seeking Care Through Digital Obesity Services: A Qualitative Analysis of Patients from Australia’s Largest Digital Obesity Provider

Telemedicine Reports, Journal Year: 2024, Volume and Issue: 5(1), P. 187 - 194

Published: April 1, 2024

Language: Английский

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Global trends in antidepressant, atypical antipsychotic, and benzodiazepine use: A cross-sectional analysis of 64 countries

PLoS ONE, Journal Year: 2023, Volume and Issue: 18(4), P. e0284389 - e0284389

Published: April 26, 2023

To describe the trends in use of antidepressants (ADs), atypical antipsychotics (AAPs), and benzodiazepines (BZDs) among high-, middle-, low-income countries.A cross-sectional time-series analysis by country from July 2014 to December 2019 utilizing IQVIA's Multinational Integrated Data Analysis database was conducted. Population-controlled rates were calculated number standard units medications per drug class population size. The United Nations' 2020 World Economic Situation Prospects used group countries into low-income. Percent change 2019. Linear regression analyses conducted assess predictability percent a country's baseline rate economic status as predictor variables.A total 64 included: 33 6 25 Average for ADs 2.15, 0.35, 0.38 size, respectively. For AAPs, 0.69, 0.15, 0.13, BZDs, 1.66, 1.46, 0.33, changes 20%, 69%, 42%, they 27%, 78%, -13%, 4%, -5%, Some associations found demonstrating that increases, AD (p = 0.916), AAP 0.23), BZD 0.027) decreases. Similarly, AAPs decreases with p-values 0.026 0.054, increases 0.038).High-income have higher treatment utilization compared low- middle-income (LMICs) increasing all interest.

Language: Английский

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A WHO digital intervention to address depression among young Chinese adults: a type 1 effectiveness-implementation randomized controlled trial

Translational Psychiatry, Journal Year: 2024, Volume and Issue: 14(1)

Published: Feb. 20, 2024

Abstract Common mental disorders among young people are rising globally. Current university-based interventions inadequate to address the need for evidence-based interventions. We investigated effectiveness and implementation of Step-by-Step (SbS), a WHO digital intervention depression, Chinese university students with depressive symptoms. In this paper, we report type 1 hybrid effectiveness-implementation randomized controlled trial conducted between September 2021 2022. The control condition was enhanced treatment as usual (ETAU, psychoeducation). primary outcome improvement in depression Secondary outcomes were improvements psychological well-being, anxiety symptoms, self-identified psychosocial problems. Effectiveness evaluated using generalized linear mixed models. Implementation by thematic analysis participant interviews. A total 371 participants enrolled two conditions 1:1 ratio. SbS resulted greater reduction symptoms at posttreatment ( p = 0.004, Hedges’ g 0.35), but no significant difference ETAU observed three-month follow-up 0.179, 0.16). effect larger those who adhered (Hedges’ s 0.59 0.30). Subjective well-being also improved both time points 0.31 addition, more 0.029, 0.26), not 0.265, 0.13). qualitative results demonstrated that well-implemented self-help health service, minimal support from peer supporters. conclusion, Step-by-Step, developed WHO, effective reducing short term improving longer term. sustained on needs further investigation. Improving uptake engagement program is needed its scale-up service adults. Trial registration: ChiCTR2100050214.

Language: Английский

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“Anxiety is not cute” analysis of twitter users’ discourses on romanticizing mental illness

BMC Psychiatry, Journal Year: 2024, Volume and Issue: 24(1)

Published: March 21, 2024

Abstract Background The proliferation of social media platforms has provided a unique space for discourse on mental health, originally intended to destigmatize illness. However, recent discourses these have shown concerning shift towards the romanticization health issues. This research focuses Twitter (now called X) users’ authentic discussions phenomenon romanticizing aiming uncover perspectives, themes, and language used by users when engaging with this complex topic. Methods A comprehensive content analysis was conducted 600 relevant tweets, application topic modeling techniques. methodology allowed identification exploration six primary themes that emerged from discussions. Statistical tests were not applied in qualitative analysis. Results study identified resulting health. These include rejecting/critiquing glamorization monetization corporate organizations, societal misconceptions role traditional media, unfiltered realities depression, emphasis Conclusions provides valuable insights into multifaceted surrounding Twitter. It highlights critiques, concerns, calls change, emphasizing potential harm caused findings underscore importance fostering responsible empathetic about platforms. By examining how interact respond advances our understanding emerging perspectives issues among users, particularly young adolescents. also underscores effects individuals, society, community. Overall, emphasizes need more knowledgeable around digital age.

Language: Английский

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Patient Adherence to a Real-World Digital, Asynchronous Weight Loss Program in Australia That Combines Behavioural and GLP-1 RA Therapy: A Mixed Methods Study

Behavioral Sciences, Journal Year: 2024, Volume and Issue: 14(6), P. 480 - 480

Published: June 6, 2024

Increasingly large numbers of people are using digital weight loss services (DWLSs) to treat being overweight and obesity. Although it is widely agreed that modalities improve access care in general, obesity stakeholders remain concerned many DWLSs not comprehensive or sustainable enough deliver meaningful health outcomes. This study adopted a mixed methods approach assess why after how long patients tend discontinue Australia’s largest DWLS, program combines behavioural pharmacological therapy under the guidance multidisciplinary team. We found cohort who commenced Eucalyptus DWLS between January June 2022 (n = 5604), mean adherence was 171.2 (±158.2) days. Inadequate supplying patient’s desired glucose-like peptide-1 receptor agonist medication most common reason for discontinuation (43.7%), followed by cost (26.2%), result dissatisfaction (9.9%), service (7.2%). Statistical tests revealed ethnicity age both had significant effect on patient adherence. These findings suggest have potential comprehensive, continuous care, but models need upon one observed Australia mitigate real-world attrition factors.

Language: Английский

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Indirect social contact interventions to reduce mental health-related stigma in low- and middle-income countries: systematic review

Epidemiology and Psychiatric Sciences, Journal Year: 2022, Volume and Issue: 31

Published: Jan. 1, 2022

Abstract Aims Mental health-related stigma and discrimination are a complex widespread issue with negative effects on numerous aspects of life people lived experience mental health conditions. Research shows that social contact is the best evidence-based intervention to reduce stigma. Within context rapid development remote technology, COVID-19-related restrictions for face-to-face contact, aim this paper categorise, compare define indirect (ISC) interventions in low- middle-income countries (LMICs). Methods MEDLINE, Global Health, EMBASE, PsychINFO, Cochrane Central Register Control Trials (CENTRAL), Cumulative Index Nursing Allied Health Literature (CINAHL) were searched using strategy including terms related ‘stigma discrimination’, ‘intervention’, ‘indirect contact’, ‘mental health’ ‘low- countries’. Relevant information ISC was extracted from included articles, quality assessment conducted. Emerging themes coded thematic synthesis method, narrative undertaken present results. Results Nine studies review overall. One study ineffective; not considered categorisation interventions, it separately comparison interventions. Of eight effective synthesis, categorised by content, combination stigma-reducing strategies, medium delivery, delivery agents, target condition population, as well active or passive interaction follow-up. Most used education ISC. Recovery personal important content components all either one both. Cultural adaptation local relevance also considerations. Conclusions overall both general public healthcare providers, medical students. A new definition LMICs proposed. More research better reporting details needed explore effectiveness strategies LMICs, especially regions where little relevant has been

Language: Английский

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Mental illness stigma in Bangladesh: Findings from a cross-sectional survey

Cambridge Prisms Global Mental Health, Journal Year: 2023, Volume and Issue: 10

Published: Jan. 1, 2023

Abstract Background Mental illness stigma is universally prevalent and a significant barrier to achieving global mental health goals. in Bangladesh has gained little attention despite its widespread impact on seeking care rural urban areas. This study aimed investigate the associated factors areas of Bangladesh. Methods The were divided into several clusters from which 325 participants (≥18 years) recruited with systematic random sampling. Bangla version Days’ Illness Stigma Scale was used collect data. Independent-samples t -test, ANOVA, multiple regression performed. Results suggest that gender, age, geographical location, socioeconomic status, occupation significantly differed across subscales stigma. Age, treatment illness, having knowledge health, status predictive results also showed high gap both Conclusion supports Bangladesh, requiring coordinated efforts. can inform development contextually tailored strategies reduce contribute promotion individuals communities

Language: Английский

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The Role of Moderators in Facilitating and Encouraging Peer-to-Peer Support in an Online Mental Health Community: A Qualitative Exploratory Study

Journal of Technology in Behavioral Science, Journal Year: 2023, Volume and Issue: 8(2), P. 128 - 139

Published: Feb. 16, 2023

Language: Английский

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The Effects of Internet-Based Storytelling Programs (Amazing Adventure Against Stigma) in Reducing Mental Illness Stigma With Mediation by Interactivity and Stigma Content: Randomized Controlled Trial

Journal of Medical Internet Research, Journal Year: 2022, Volume and Issue: 24(8), P. e37973 - e37973

Published: July 18, 2022

Mental illness stigma has been a global concern, owing to its adverse effects on the recovery of people with mental illness, and may delay help-seeking for health because concern being stigmatized. With technological advancement, internet-based interventions reduction have developed, these promising.This study aimed examine differential storytelling programs, which varied in levels interactivity content, reducing stigma.Using an experimental design, this compared 4 websites that content. Specifically, conditions included interactive website stigma-related content (combo condition), noninteractive (stigma without (interact (control condition). Participants were recruited via mass emails all students staff public university social networking sites. Eligible participants randomized into following four conditions: combo (n=67), (n=65), interact (n=64), or control (n=67). The each group viewed respective web pages at their own pace. Public stigma, microaggression, distance measured before experiment, after 1-week follow-up. Perceived autonomy immersiveness, as mediators, assessed experiment.Both (n=66) (n=65) effective microaggression toward experiment However, none had significant time×condition from illness. condition (n=64) significantly reduced (P=.02) but not follow-up (P=.22). (n=67) did reduce outcomes associated stigma. was found mediate effect (P=.56), immersiveness mediated (P=.99).Internet-based programs elicited largest reduction, including reductions although only difference statistically significant. In other words, could strengthen effect, more critical than Future efforts should prioritize production pages, followed by considering value incorporating future programs.ClinicalTrials.gov NCT05333848; https://clinicaltrials.gov/ct2/show/NCT05333848.

Language: Английский

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