03387nas a2200277   4500000000100000008004100001260004400042653003300086653005700119653001800176653003100194100001400225700001500239700001200254700001800266700001200284700001500296700001500311700001400326700002000340245017000360856007700530490000700607520248100614022001403095       2022                            d  bSpringer Science and Business Media LLC10aPsychiatry and Mental health10aPublic Health, Environmental and Occupational Health10aHealth Policy10aPshychiatric Mental Health1 aMabunda D1 aOliveira D1 aSidat M1 aCavalcanti MT1 aCumbe V1 aMandlate F1 aWainberg M1 aCournos F1 ade Jesus Mari J00aCultural adaptation of psychological interventions for people with mental disorders delivered by lay health workers in Africa: scoping review and expert consultation  uhttps://ijmhs.biomedcentral.com/track/pdf/10.1186/s13033-022-00526-x.pdf0 v163 a<p>Background</p>

<p>Lay Health Workers (LHW) are important providers of community mental health services and help mitigate access and treatment gaps in Africa. However, there is a paucity of knowledge about the role and performance of these workers, as well as about the extent to which the interventions delivered are culturally adapted to the African context.</p>

<p>Aims</p>

<p>This scoping review aimed to explore the content and aspects concerning the cultural adaptation and sustainability of psychological interventions delivered by LHW to people with mental disorders in Africa. Methods We conducted a scoping review of the peer-reviewed literature published from January 2000 to December 2018 to identify psychological interventions delivered by LHW for people with mental disorders in Africa. We systematically searched PubMed, Google scholar and Hinari to select relevant publications. The articles were evaluated for risk of bias according to study design with the National Heart, Lung, and Blood Institute’s (NHLBI) Quality Assessment Tools. Expert consultation was performed according to Arksey &amp; O’Malley framework and cultural adaptation analysis was performed according to Bernal framework.</p>

<p>Results</p>

<p>Out of 14,549 retrieved records, we identified ten peer-reviewed articles conducted in Zimbabwe, Uganda, South Africa and Zambia describing four distinct interventions. Six were randomized controlled trials; none addressed implementation outcomes. Group-based interpersonal therapy (n = 5), trauma-focused cognitive behaviour therapy (n = 1), problem solving therapy (n = 3) and narrative exposure therapy (n = 1) emerged as psychological interventions delivered by LHW for people with depression, anxiety, trauma and suicidal behavior. Psychological interventions delivered by LHW in Africa were all culturally adapted to meet the competence of LHW. All the interventions were associated with symptom improvement, but the quality of this evidence varied widely with study design.</p>

<p>Conclusion</p>

<p>Task-shifting psychological interventions delivered by LHW after appropriate cultural adaptation show promise for addressing unmet mental health care needs in Africa. More effectiveness and implementation evidence is needed, especially with regard to psychological interventions delivered by LHW for adolescence, older people and those with severe mental disorders and suicidal behaviors.</p>
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