Using theory of change to plan for the implementation of a psychological intervention addressing alcohol use disorder and psychological distress in Uganda.

Journal: Global mental health (Cambridge, England)

Volume: 11

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK. Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. HealthRight International, Kampala, Uganda. Mental Health Focus Area, MRC/UVRI & LSHTM Uganda Research Unit/MRC Investigator, Entebbe, Uganda. Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.

Abstract summary 

In conflict-affected settings, prevalence of alcohol use disorders (AUDs) can be high. However, limited practical information exists on AUD management in low-income settings. Using a theory of change (ToC) approach, we aimed to identify pathways influencing the implementation and maintenance of a new transdiagnostic psychological intervention ("CHANGE"), targeting both psychological distress and AUDs in humanitarian settings. Three half-day workshops in Uganda engaged 41 stakeholders to develop a ToC map. ToC is a participatory program theory approach aiming to create a visual representation of how and why an intervention leads to specific outcomes. Additionally, five semi-structured interviews were conducted to explore experiences of stakeholders that participated in the ToC workshops. Two necessary pathways influencing the implementation and maintenance of CHANGE were identified: and Barriers identified included policy gaps, limited recognition of social determinants and the need for integrated follow-up care. Interviewed participants valued ToC's participatory approach and expressed concerns about its adaptability in continuously changing contexts (e.g., humanitarian settings). Our study underscores ToC's value in delineating context-specific outcomes and identifies areas requiring further attention. It emphasizes the importance of early planning and stakeholder engagement for sustainable implementation of psychological interventions in humanitarian settings.

Authors & Co-authors:  van der Boor Catharina C Andersen Lena S LS Massazza Alessandro A Tol Wietse A WA Taban Dalili D Roberts Bayard B Ssebunnya Joshua J Kinyanda Eugene E May Carl C Nadkarni Abhijit A Fuhr Daniela D

Study Outcome 

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Citations :  Aaraj E, Haddad P, Khalife S, Fawaz M and Van Hout MC (2021) Understanding and Responding to Substance Use and Abuse in the Palestinian Refugee Camps in Lebanon Prior to and During COVID-19 Times | SpringerLink. Available at https://link.springer.com/article/10.1007/s11469-021-00714-9 (accessed 11 May 2023).
Authors :  11
Identifiers
Doi : e6
SSN : 2054-4251
Study Population
Male,Female
Mesh Terms
Other Terms
alcohol use disorders;brief psychological interventions;conflict-affected populations;mental health;theory of change
Study Design
Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
England