Browsing by Author "Snyder, J."
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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.