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. 2022 Aug 24;8(5):e161.
doi: 10.1192/bjo.2022.564.

Adaptation, acceptability and feasibility of Problem Management Plus (PM+) intervention to promote the mental health of young people living with HIV in Kenya: formative mixed-methods research

Moses Kachama Nyongesa  1 , Eva Mwangome  2 , Paul Mwangi  2 , Carophine Nasambu  2 , Judy Wanjiru Mbuthia  3 , Hans M Koot  4 , Pim Cuijpers  4 , Charles R J C Newton  5 , Amina Abubakar  5
Affiliations

Adaptation, acceptability and feasibility of Problem Management Plus (PM+) intervention to promote the mental health of young people living with HIV in Kenya: formative mixed-methods research

Moses Kachama Nyongesa et al. BJPsych Open. .

Abstract

Background: Problem Management Plus (PM+) is a psychological intervention that seeks to address common mental disorders among individuals exposed to adversity. Thus far, the potential for delivering PM+ by mobile phones has not been evaluated.

Aims: To adapt PM+ for telephone delivery (ten weekly sessions of about 45 min each) and preliminarily evaluate its acceptability and feasibility with young people living with HIV (YLWH) in coastal Kenya.

Method: This was a mixed-method formative research. Qualitative data collection included consultations with stakeholders, conducting key informant interviews with HIV care providers and focus group discussions with potential end-users, i.e. YLWH. Moreover, brief exit interviews with recipients of the adapted PM+ were conducted. Quantitative acceptability and feasibility indicators and outcome measures were tracked/assessed during PM+ preliminary implementation involving 70 YLWH.

Results: From the qualitative inquiries, the adapted PM+ emerged as contextually appropriate, acceptable and feasible for mobile phone delivery, despite some concerns around missing nonverbal cues and poor network connectivity. High recruitment (85%) and fair programme retention (69%) were observed. Intervention sessions over the telephone lasted 46 min on average (range 42-55 min). Preliminary feasibility data indicated that the adapted PM+ has the potential of reducing common mental disorders among YLWH from the Kenyan coast.

Conclusions: PM+ is acceptable and can feasibly be delivered via mobile phone to YLWH in coastal Kenya. This study sets the stage for a future fully powered, randomised controlled trial assessing the efficacy of the adapted PM+ in this or a similar setting.

Keywords: Common mental disorders; HIV infections; Problem Management Plus; acceptability and feasibility; young people.

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Figures

Fig. 1
Fig. 1
PM+ adaptation and preliminary implementation process. Workshop participants were stakeholders in HIV/mental health from Kilifi and Mombasa Counties. *These young people were identified from similar peer groupings at the HIV clinics to avoid accidental disclosure. #These young people were identified and recruited from a larger cross-sectional study that was ongoing at that time recruiting from the HIV clinics in Kilifi and Mombasa Counties. FGD, focus group discussion; HCP, healthcare provider at the HIV clinic; PM+, Problem Management Plus; YLWH, young person living with HIV (aged 18–24 years).
Fig. 2
Fig. 2
Participant flowchart. PM+, Problem Management Plus.
See this image and copyright information in PMC

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