Evidence map›Paper›PMID 36283239›Full record

ArticleBehaviour research and therapy2022

Mechanisms of change for a family intervention in Kenya: An Integrated Clinical and Implementation Mapping approach.

Ali Giusto, Elsa A Friis-Healy, Bonnie N Kaiser, David Ayuku, Wilter Rono, Eve S Puffer

Abstract read
In one paragraph

Article in Behaviour research and therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ali GiustoNew York State Psychiatric Institute, Columbia University, Department of Psychiatry, New York, NY, 10032, USA; Duke Global Health Institute, Durham, NC, USA. Electronic address: ali.giusto@nyspi.columbia.edu.
Elsa A Friis-HealyDuke Global Health Institute, Durham, NC, USA; Department of Psychiatry Duke University School of Medicine, Durham, NC, USA. Electronic address: esla.friis@duke.edu.
Bonnie N KaiserDuke Global Health Institute, Durham, NC, USA; University of California San Diego, Anthropology Department and Global Health Program, La Jolla, CA, USA. Electronic address: bfullard@gmail.com.
David AyukuMoi University, Academic Highway, Eldoret, Usain Gishu County, Kenya. Electronic address: david.ayuku@gmail.com.
Wilter RonoMoi Teaching & Referral Hospital, Eldoret, Rift Valley, Kenya. Electronic address: wilterrono4@gmail.com.
Eve S PufferDuke Global Health Institute, Durham, NC, USA; Department of Neuroscience and Psychology, Duke University, Durham, NC, USA. Electronic address: eve.puffer@duke.edu.

Funding

Global Mental Health Research Fellowship: Interventions That Make a DifferenceT32MH096724 · NIMH · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI MILTON L WAINBERG · 2012 to 2026
$4.4M
A brief, task-shifted treatment to improve father depression and child outcomes in Kenya: A pilot effectiveness-implementation trialK23MH128742 · NIMH · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI Ali Giusto · 2022 to 2026
$841k
Community-sourced Interventions for Global Mental HealthF32MH113288 · NIMH · DUKE UNIVERSITY · PI KAISER, BONNIE NICOLE · 2017 to 2017
$58k
NIMH NIH HHS F32 MH113288NIMH NIH HHS K23 MH128742NIMH NIH HHS T32 MH096724
6 · The paper itself

Abstract

To increase cultural relevance and maximize access for historically underserved populations, there is a need to explore mechanisms underlying treatment outcomes during piloting. We developed a mixed-method approach, Integrated Clinical and Implementation Mapping (ICIM), to explore clinical and implementation mechanisms to inform improvements in content and delivery. We applied ICIM in a pilot of Tuko Pamoja, a lay counselor-delivered family intervention in Kenya (10 families with adolescents ages 12-17). ICIM is a 3-phase process to triangulate data sources to analyze how and why change occurs within individual cases and across cases. We synthesized data from session and supervision transcripts, fidelity and clinical skills ratings, surveys, and interviews. Outputs included a comprehensive narrative and visual map depicting how content and implementation factors influenced change. For Tuko Pamoja, ICIM results showed common presenting problems, including financial strain and caregivers' distress, triggering negative interactions and adolescent distress. ICIM demonstrated that active treatment ingredients included communication skills and facilitated, prescribed time together. Families improved communication, empathy, and hope, facilitated improved family functioning and mental health. Key implementation mechanisms included provider clinical competencies, alliance-building, treatment-aligned adaptations, and consistent attendance. Results guided manual and training refinements and generated hypotheses about mechanisms to test in larger trials.

Indexed as

CaregiversMental HealthAdolescentChildCommunicationHumansKenyaSurveys and QuestionnairesFamily therapyGlobal mental healthImplementation scienceMechanismsMixed methods

Identifiers

PMID36283239
PMCPMC10155602

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.