Assessing the impact of a community-based psychodrama intervention on mental health promotion of adolescents and young adults in Mozambique

A mixed-methods study

Bibliographic Data

ID19550489
AuthorsRoberto Benoni (0000-0002-1144-8471, University of Verona), Chiara Malesani (University of Padua), Anna Sartorello (University of Verona), Hamilton Cardoso (Doctors with Africa Cuamm), Izilda Chaguruca (Doctors with Africa Cuamm), Chivite Alamo (Doctors with Africa Cuamm), G Putoto (0000-0003-0256-1744, Doctors with Africa Cuamm), Giulia Brigadoi (0009-0004-0600-7745, University of Padua), Annachiara Zin (University of Padua), Daniele Donà (0000-0001-7105-2105, University of Padua), Carlo Giaquinto (0000-0001-9365-0413, University of Padua), M Gatta (0000-0001-9050-6192, University of Padua)
Year2024
Volume14
Pages04182-04182
Publication date2024-07-26
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Global Health (JOURNAL)
Journal identifiersISSN: 2047-2978 • E-ISSN: 2047-2986
PublisherInternational Society of Global Health (PUBLISHER • GB)
DOI10.7189/jogh.14.04182
PMID39051689
OpenAlexW4400982656
LanguageEN
Citations received2
References cited34

Background: While mental health is an emerging issue in low-income countries, its promotion remains poor, with little context-oriented evidence available. Here we aimed to assess the impact and acceptability/feasibility of a community-based psychodrama intervention involving both adolescents and young adults (AYA) living with HIV (AYALHIV) and without HIV (AYAHIV-). Methods: We used a mixed-methods approach, where the quantitative part was based on pre/post questionnaires and the qualitative one on content analysis of semi-structured interviews. Trained community health care workers delivered psychodrama sessions involving AYAs aged 15-24 years once a week between July and August 2023 in Beira, Mozambique. The baseline assessment involved a sociodemographic and three mental health questionnaires: the Mental Health Knowledge Schedule (MAKS), Community Attitudes toward People with Mental Illness (CAMI27), and the Toronto Alexithymia Scale (TAS). We repeated all questionnaires after the intervention and conducted semi-structured interviews. Results: We enrolled 354 AYAs (50.8% female, 45.5% AYALHIV) at baseline; 315 (89.0%) attended the sessions, with a mean participation rate of 94.4%. Overall, 281 (89.2%) completed the post-intervention assessment. MAKS score improved from 44.5 (95% confidence interval (CI) = 44.0-45.0) to 47.1 (95% CI = 46.4-47.7, P < 0.001). Total CAMI27 score showed no significant variation (P = 0.855). Total TAS score decreased from 57.3 (95% CI = 56.1-58.5) to 54.3 (95% CI = 53.0-55.6, P < 0.001). We found no statistically significant interactions between time and sex, age, or HIV serostatus in all questionnaires. For the qualitative part of the study, we analysed 37 semi-structured interviews (43.2% with females, 40.5% with AYALHIV). We identified four areas of intervention impact: peer-to-peer support (30.3%), social empowerment (24.7%), resilience (23.0%), and emotional skills (21.9%). Regarding acceptability/feasibility, perceived scalability (37.2%) and affective attitude (34.5%) were the sub-areas most frequently retrieved in the SSIs. Conclusions: The community-based psychodrama intervention proved to be an effective tool in AYAs' mental health promotion, increasing knowledge and improving emotional awareness through group experience and interpersonal learning. The intervention also showed good acceptability and feasibility in the context of our study

Community-based participatory research · Environmental health · Health promotion · Mental health · Political science · Psychiatry · Psychodrama · Psychotherapist · Public health · Sociology · Young adult · Clinical Psychology · COVID-19 and Mental Health · Family Caregiving in Mental Illness · Medicine · Nursing · Psychology · Schizophrenia research and treatment · Gerontology