Evidence map›Paper›PMID 39700489›Full record

ArticleJMIR serious games2024

A Narrative-Gamified Mental Health App (Kuamsha) for Adolescents in Uganda: Mixed Methods Feasibility and Acceptability Study.

Julia R Pozuelo, Christine Nabulumba, Doreen Sikoti, Meghan Davis, Joy Louise Gumikiriza-Onoria, Eugene Kinyanda, Bianca Moffett, Alastair van Heerden, Heather A O'Mahen, Michelle Craske and 3 more

Abstract read
In one paragraph

Article in JMIR serious games, 2024. 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. Article
  2. Article
  3. Article
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

13 authors.

Julia R PozueloDepartment of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, United States.ORCID https://orcid.org/0000-0002-3058-0371
Christine NabulumbaBRAC, Kampala, Uganda.ORCID https://orcid.org/0000-0003-2845-0380
Doreen SikotiBRAC, Kampala, Uganda.ORCID https://orcid.org/0009-0005-5846-0573
Meghan DavisMind Ease, London, United Kingdom.ORCID https://orcid.org/0009-0007-8497-2171
Joy Louise Gumikiriza-OnoriaCollege of Health Sciences, Makerere University, Kampala, Uganda.ORCID https://orcid.org/0000-0003-4915-5356
Eugene KinyandaMental Health Project, Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Kampala, Uganda.ORCID https://orcid.org/0000-0001-7068-9294
Bianca MoffettMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.ORCID https://orcid.org/0000-0002-8887-1374
Alastair van HeerdenCentre for Community Based Research, Human Sciences Research Council, Pietermaritzburg, South Africa.ORCID https://orcid.org/0000-0003-2530-6885
Heather A O'MahenMood Disorders Centre, Department of Psychology, University of Exeter, Exeter, United Kingdom.ORCID https://orcid.org/0000-0003-3458-430X
Michelle CraskeDepartment of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.ORCID https://orcid.org/0000-0002-3704-5240
DoBAt & Ebikolwa Consortium *See Acknowledgments, Oxford, United Kingdom.
Munshi Sulaiman *BRAC University, Kampala, Uganda.ORCID https://orcid.org/0000-0001-6061-933X
Alan Stein *Department of Psychiatry, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0001-8207-2822

Funding

Improving Outcomes in Depression in Primary Care in a Low Resource SettingR01MH121632 · NIMH · HARVARD MEDICAL SCHOOL · PI HOLLON, STEVEN DENNIS, PATEL, VIKRAM H · 2022 to 2025
$5.0M
NIMH NIH HHS R01 MH121632
6 · The paper itself

Abstract

backgroundMany adolescents in Uganda are affected by common mental disorders, but only a few affordable treatment options are available. Digital mental health interventions offer promising opportunities to reduce these large treatment gaps, but interventions specifically tailored for Ugandan adolescents are limited.

objectiveThis study aimed to determine the feasibility and acceptability of the Kuamsha program, an intervention delivered through a gamified app with low-intensity telephonic guidance, as a way to promote mental health among adolescents from the general population in Uganda.

methodsA 3-month pre-post single-arm trial was conducted with adolescents aged between 15 and 19 years living in Wakiso District, Central Uganda. The intervention was coproduced with adolescents from the study site to ensure that it was culturally acceptable. The feasibility and acceptability of the intervention were evaluated using an explanatory sequential mixed methods approach. Feasibility was assessed by collecting data on trial retention rates and treatment adherence rates. Acceptability was assessed through a questionnaire and in-depth interviews with participants following the conclusion of the intervention period. As a secondary objective, we explored the changes in participants' mental health before and after the intervention.

resultsA total of 31 adolescents were recruited for the study. Results from the study showed high levels of feasibility and acceptability. Trial retention rates exceeded 90%, and treatment adherence was ≥80%. These results, evaluated against our predefined trial progression criteria, indicate a successful feasibility study, with all criteria exceeding the thresholds necessary to progress to a larger trial. App engagement metrics, such as time spent on the app and modules completed, exceeded existing literature benchmarks, and many adolescents continued to use the app after the intervention. In-depth interviews and questionnaire responses revealed high acceptability levels. Depressive symptoms trended toward reduction (mean difference: 1.41, 95% CI -0.60 to 3.42, Cohen d=0.30), although this was not statistically significant (P=.16). Supporting this trend, we also observed a reduction in the proportion of participants with moderate depressive symptoms from 32% (10/31) to 17% (5/29) after the intervention, but this change was also not significant (P=.10).

conclusionsThis study presents evidence to support the Kuamsha program as a feasible and acceptable digital mental health program for adolescents in Uganda. A fully powered randomized controlled trial is needed to assess its effectiveness in improving adolescents' mental health.

Indexed as

adolescentsdigital interventionsgamified applow- and middle-income countriesmental healthmobile phoneUgandauser-centered design

Identifiers

PMID39700489
PMCPMC11695961

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.