van der Boor, Catharina; Andersen, Lena S; Massazza, Alessandro; Tol, Wietse A; Taban, Dalili; Roberts, Bayard; Ssebunnya, Joshua; Kinyanda, Eugene; May, Carl; Nadkarni, Abhijit; +1 more... Fuhr, Daniela; (2024) Using theory of change to plan for the implementation of a psychological intervention addressing alcohol use disorder and psychological distress in Uganda. Cambridge Prisms: Global Mental Health, 11. e6-. ISSN 2054-4251 DOI: https://doi.org/10.1017/gmh.2023.93
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Abstract
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: policy impact, and mental health service delivery. 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.
Item Type | Article |
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Faculty and Department |
Faculty of Public Health and Policy > Dept of Health Services Research and Policy MRC Uganda > UG-HIV Care Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) |
PubMed ID | 38283880 |
Elements ID | 213073 |
Official URL | http://dx.doi.org/10.1017/gmh.2023.93 |
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