Background Sub-Saharan Africa (SSA) has the largest care gap for common mental disorders (CMDs) globally, heralding the use of cost-cutting approaches such as task-shifting and digital technologies as viable approaches for expanding the mental health workforce. This study aims to evaluate the effectiveness of a problem-solving therapy (PST) intervention that is delivered by community health volunteers (CHVs) through a mobile application called ‘Inuka coaching’ in Kenya. Methods A pilot prospective cohort study recruited participants from 18 health centres in Kenya. People who self-screened were eligible if they scored 8 or higher on the Self-Reporting Questionnaire-20 (SRQ-20), were aged 18 years or older, conversant in written and spoken English, and familiar with the use of smart mobile devices. The intervention consisted of four PST mobile application chat-sessions delivered by CHVs. CMD measures were administered at baseline, 4-weeks (post-treatment), and at 3-months follow-up assessment. Results In all, 80 participants consented to the study, of which 60 participants (female, n = 38; male, n = 22) completed their 4-week assessments, and 52 participants completed their 3-month follow-up assessment. The results showed a significant improvement over time on the Self-Reporting Questionnaire-20 (SRQ-20). Higher-range income, not reporting suicidal ideation, being aged over 30 years, and being male were associated with higher CMD symptom reduction. Conclusion To our knowledge, this report is the first to pilot a PST intervention that is delivered by CHVs through a locally developed mobile application in Kenya, to which clinically meaningful improvements were found. However, a randomised-controlled trial is required to robustly evaluate this intervention.

中文翻译：

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一名社区健康志愿者在肯尼亚提供基于友谊长凳“伊努卡教练”的解决问题治疗移动应用程序：一项试点队列研究

背景 撒哈拉以南非洲地区 (SSA) 在全球常见精神障碍 (CMD) 方面的护理缺口最大，预示着使用任务转移和数字技术等成本削减方法作为扩大精神卫生劳动力的可行方法。本研究旨在评估社区健康志愿者 (CHV) 通过肯尼亚名为“Inuka coaching”的移动应用程序提供的问题解决疗法 (PST) 干预的有效性。方法 一项试点前瞻性队列研究招募了来自肯尼亚 18 个卫生中心的参与者。进行自我筛选的人如果在自我报告问卷-20 (SRQ-20) 中得分为 8 分或以上，年龄为 18 岁或以上，精通英语书面和口语，并熟悉智能移动设备的使用，则符合资格。干预包括由 CHV 提供的四场 PST 移动应用程序聊天会话。CMD 测量在基线、4 周（治疗后）和 3 个月随访评估时进行。结果 共有 80 名参与者同意本研究，其中 60 名参与者（女性、n= 38；男性，n= 22) 完成了为期 4 周的评估，52 名参与者完成了为期 3 个月的跟踪评估。结果显示，随着时间的推移，自我报告问卷 20 (SRQ-20) 有了显着改善。较高收入、未报告自杀意念、年龄超过 30 岁以及男性与 CMD 症状减轻程度较高相关。结论 据我们所知，本报告是第一个试点 PST 干预的报告，该干预由 CHV 通过肯尼亚本地开发的移动应用程序提供，并发现了具有临床意义的改进。然而，需要进行随机对照试验来强有力地评估这种干预措施。