by Sharita Forrest, University of Illinois at Urbana-Champaign

A team led by, from left, social work professors Moses Okumu and Flora Cohen, with doctoral student Joshua Muzei explored the effectiveness of mental health interventions provided via mobile phones among refugee and displaced youths living in the slums of Kampala, Uganda. The study's findings highlighted the need to develop contextualized apps that enable these transient populations to access, understand and use online mental health information to enhance their well-being. Credit: Fred Zwicky

Mental health interventions provided through digital media to 445 displaced youths living in the slums of Kampala, Uganda, showed promise at broadening care to this high-risk, difficult-to-reach population, a new study found.

Led by Moses Okumu, a professor of social work at the University of Illinois Urbana-Champaign, the study included youths ages 16–24 who were living in five humanitarian settings. The goal of the study was to assess these young people's e-health literacy skills, defined in the study as those that are critical for users to access online resources and apply the knowledge they gain to addressing or resolving a health problem.

Published in the journal Computers in Human Behavior, the study is believed to be the first to validate the applicability of the eHEALS assessment—a widely used self-report survey that measures digital literacy—with displaced youths in Africa.

Refugee and displaced youths are a sizable population in Uganda. Because they are at risk of many mental health conditions such as anxiety, depression and PTSD, these young people could benefit significantly from e-health interventions provided remotely via their mobile phones, the team wrote.

"As mobile phone ownership continues to increase, so too have efforts to use these devices to connect out-of-sight populations to information and services that enhance their health outcomes, particularly in contexts that lack brick-and-mortar medical facilities," Okumu said.

"We need to develop contextualized digital health interventions that can help displaced young people better access, understand and use health information. By doing so, we are not just improving their ability to navigate digital health resources—we are potentially enhancing their resilience and mental health."

The eHEALS survey assesses users' familiarity with health resources that are available on the internet and their confidence in their ability to discern whether the information they access is accurate and reliable.

Those who participated in the study also completed surveys that assessed their levels of depressive symptoms and resilience, defined in the study as their ability to adaptively respond to difficult situations and bolster their well-being.

Contrary to previous work by other researchers, the team found no direct relationship between the youths' eHEALS scores and depressive symptoms. However, higher eHEALS scores were significantly related to greater resilience, and those who scored higher on resilience reported fewer depressive symptoms, the researchers found.

"Mental health isn't only about coping with the symptoms of depression, anxiety or post-traumatic stress disorder, it is also about the way we relate to others and foster both individual and community resilience," said co-author Flora Cohen, also a social work professor at Illinois whose research focuses on global mental health interventions for displaced people.

"It is not surprising that our results showed an association between resilience and digital literacy, especially within a sample of participants who are highly engaged with the digital world."

Peer navigators in the same age range as those in the study who also were refugees or displaced persons recruited the participants, administered the surveys on electronic tablets and provided social support, Okumu said.

"Our study takes a crucial step in addressing the knowledge gap about e-health literacy among displaced youths," he said.

"As we continue to see an increase in global displacement, understanding how to effectively support the mental health of displaced youths through digital means becomes increasingly important.

"Our findings provide a foundation for designing more effective digital health interventions that can enhance the psychosocial functioning of displaced youths living in urban slums and potentially other vulnerable adolescent populations globally."

The team is exploring the effectiveness of digital tools in various public health outreach projects to mobile and migrant populations. In a related study published earlier this year in International Health, the team found that a mobile health app significantly increased adherence to COVID-19 prevention practices such as hand washing and physical distancing among urban refugee youths, as well as their receptiveness to vaccines.

The intervention, called Kukaa Salama, a Swahili phrase that translates as "Staying Safe" in English, was part of a broader clinical trial on digital health interventions' effects on HIV self-testing in this population.

Carmen H. Logie, the Canada Research Chair in Global Health Equity and Social Justice with Marginalized Populations at the University of Toronto and a co-author of the current paper, was the first author of that study.

The co-authors of the current study included social work professors William Byansi of Boston College and Thabani Nyoni of Dalhousie University, and U. of I. graduate student Joshua Muzei.

More information: Moses Okumu et al, eHealth literacy and digital health interventions: Key ingredients for supporting the mental health of displaced youth living in the urban slums of kampala, Uganda, Computers in Human Behavior (2024). DOI: 10.1016/j.chb.2024.108434

Journal information: Computers in Human Behavior 

Provided by University of Illinois at Urbana-Champaign