Browsing by Author "Le, H."
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Item Co-Designing M-Healer: Supporting Lay Practitioner Mental Health Workers in Ghana(Springer, 2021) Albright, L.; Le, H.; Meller, S.; Atta, A.O.; Attah, D.A.; Asafo, S.M.; Collins, P.Y.; Zeev, D.B.; Snyder, J.. Mental health is a vast problem around the globe and is one of the key population health issues in the world today. At any given time, up to 6.8% of the world’s population suffers from a serious mental illness (SMI) such as schizophrenia or bipolar disorder. The impacts of SMI on a population are especially challenging in low and middle-income countries (LMIC). Mobile healthcare application research is a growing area of research aiming to ameliorate these challenging impacts. In Ghana, a LMIC in West Africa, mental healthcare systems are severely under resourced and people with SMI often receive care from lay practitioners such as traditional and faith healers rather than trained mental health clinicians. These challenges exist alongside developed wireless infrastructure. In these contexts, mobile applications can substantially increase access to health information. This is the basis for our work developing a mobile health (mHealth) application to support mental health lay practitioners in Ghana. We describe the ways that our principled design research practice is intersecting with local faith-based practices, vernacular expertise and values, and the practicalities of technology adoption in Ghana.Item A Digital Toolkit (M-Healer) to Improve Care and Reduce Human Rights Abuses Against People With Mental Illness in West Africa: User-Centered Design, Development, and Usability Study(JMIR, 2021) Ben-Zeev, D.; Meller, S.; Snyder, J.; Attah, D.A.; Albright, L.; Le, H.; Asafo, S.M.; Collins, P.Y.; Ofori-Atta, A.The resources of West African mental health care systems are severely constrained, which contributes to significant unmet mental health needs. Consequently, people with psychiatric conditions often receive care from traditional and faith healers. Healers may use practices that constitute human rights violations, such as flogging, caging, forced fasting, and chaining. The aim of this study is to partner with healers in Ghana to develop a smartphone toolkit designed to support the dissemination of evidence-based psychosocial interventions and the strengthening of human rights awareness in the healer community. Methods: We conducted on-site observations and qualitative interviews with healers, a group co-design session, content development and prototype system build-out, and usability testing. A total of 18 healers completed individual interviews. Participants reported on their understanding of the causes and treatments of mental illnesses. They identified situations in which they elect to use mechanical restraints and other coercive practices. Participants described an openness to using a smartphone-based app to help introduce them to alternative practices. A total of 12 healers participated in the co-design session. Of the 12 participants, 8 (67%) reported having a smartphone. Participants reported that they preferred spiritual guidance but that it was acceptable that M-Healer would provide mostly nonspiritual content. They provided suggestions for who should be depicted as the toolkit protagonist and ranked their preferred content delivery modality in the following order: live-action video, animated video, comic strip, and still images with text. Participants viewed mood board prototypes and rated their preferred visual design in the following order: religious theme, nature motif, community or medical, and Ghanaian culture. The content was organized into modules, including an introduction to the system, brief mental health interventions, verbal de-escalation strategies, guided relaxation techniques, and human rights training. Each module contained several scripted digital animation videos, with audio narration in English or Twi The module menu was represented by touchscreen icons and a single word or phrase to maximize accessibility to users with limited literacy. In total, 12 participants completed the M-Healer usability testing. Participants commented that they liked the look and functionality of the app and understood the content. The participants reported that the information and displays were clear. They successfully navigated the app but identified several areas where usability could be enhanced. Posttesting usability measures indicated that participants found M-Healer to be feasible, acceptable, and usable.The module menu was represented by touchscreen icons and a single word or phrase to maximize accessibility to users with limited literacy. In total, 12 participants completed the M-Healer usability testing. Participants commented that they liked the look and functionality of the app and understood the content. The participants reported that the information and displays were clear. They successfully navigated the app but identified several areas where usability could be enhanced. Posttesting usability measures indicated that participants found M-Healer to be feasible, acceptable, and usable.Item Multicentre studies of insecticide-treated durable wall lining in Africa and South-East Asia: Entomological efficacy and household acceptability during one year of field use(Malaria Journal, 2012-10) Messenger, L.A.; Matias, A.; Manana, A.N.; Stiles-Ocran, J.B.; Knowles, S.; Boakye, D.A.; Coulibaly, M.B.; Larsen, M.-L.; Traoré, A.S.; Diallo, B.; Konaté, M.; Guindo, A.; Traoré, S.F.; Mulder, C.E.G.; Le, H.; Kleinschmidt, I.; Rowland, M.Background: Indoor residual spraying (IRS) is a primary method of malaria vector control, but its potential impact is constrained by several inherent limitations: spraying must be repeated when insecticide residues decay, householders can tire of the annual imposition and campaign costs are recurrent. Durable lining (DL) can be considered an advanced form of long-lasting IRS where insecticide is gradually released from an aesthetically attractive wall lining material to provide vector control for several years. A multicentre trial was carried out in Equatorial Guinea, Ghana, Mali, South Africa and Vietnam to assess the feasibility, durability, bioefficacy and household acceptability of DL, compared to conventional IRS or insecticide-treated curtains (LLITCs), in a variety of operational settings. Methods. This study was conducted in 220 households in traditional rural villages over 12-15 months. In all sites, rolls of DL were cut to fit house dimensions and fixed to interior wall surfaces (usually with nails and caps) by trained teams. Acceptability was assessed using a standardized questionnaire covering such topics as installation, exposure reactions, entomology, indoor environment, aesthetics and durability. Bioefficacy of interventions was evaluated using WHO cone bioassay tests at regular intervals throughout the year. Results: The deltamethrin DL demonstrated little to no decline in bioefficacy over 12-15 months, supported by minimal loss of insecticide content. By contrast, IRS displayed a significant decrease in bioactivity by 6 months and full loss after 12 months. The majority of participants in DL households perceived reductions in mosquito density (93%) and biting (82%), but no changes in indoor temperature (83%). Among those households that wanted to retain the DL, 73% cited protective reasons, 20% expressed a desire to keep theirs for decoration and 7% valued both qualities equally. In Equatorial Guinea, when offered a choice of vector control product at the end of the trial (DL, IRS or LLITCs), DL consistently emerged as the most popular intervention regardless of the earlier household allocation. Conclusions: Just as long-lasting insecticidal nets overcame several of the technical and logistical constraints associated with conventionally treated nets and then went to scale, this study demonstrates the potential of DL to sustain user compliance and overcome the operational challenges associated with IRS. © 2012 Messenger et al.; licensee BioMed Central Ltd.