Department of Occupational Therapy

Permanent URI for this collectionhttp://197.255.125.131:4000/handle/123456789/23057

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    Editorial: Contextualizing psychological assessment in Africa: COVID-19 and beyond
    (Frontiers in Psychology, 2023) Oppong, S.; Appiah, R.; Hapunda, G.; Kheswa, J.G.
    Historically, the science of Psychology and the practice of psychological assessment have in Africa have been influenced by Western ideologies and practices (Nsamenang, 2007; Oppong et al., 2022). However, there are vast cultural differences among people of different social structures and value orientations. Therefore, there is a growing need for locally generated and validated tools to assess the strengths, capacities, and mental health of the African people (Oppong, 2017; Laher, 2019; Appiah et al., 2020; Oppong et al., 2022), who are often under-represented in global psychological research (Nielsen et al., 2017; Rad et al., 2018; Thalmayer et al., 2021). The overarching importance of generating and administering context-appropriate measures is that it strengthens the drive toward ensuring valid, reliable, and context-worthy assessment of mental health and psychological wellbeing among individuals, groups, and communities in the context of research and practice.
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    A look back, a path forward: Revisiting the mental health and well-being research and practice models and priorities in sub-Saharan Africa
    (New Ideas in Psychology, 2022) Appiah, R.
    Despite the enthusiasm to promote mental health in Ghana and sub-Saharan Africa more generally, the models and frameworks that underpin research and practice in these settings have focused exclusively on understanding and treating mental disorders, to the neglect of the mental health needs of the general, non-clinical population. We discuss the limitations of the bipolar and biomedical models as frameworks for mental health research and practice in the current paradigm. Using Ghana as a case example, we identify gaps in the mental health research priorities in sub-Saharan Africa, and discuss the limitations of the revised Mental Health Policy of Ghana in ensuring a mentally healthy population. Drawing on a consilience of evidence from the literature, we contend that, although important and laudatory, the current research approach and priorities, which remain overwhelmingly fixated on alleviating and treating symptoms of mental disorders, are insufficient to buffer against psychopathology and bolster positive mental health. We argue for the adoption of more global and empirically tested frameworks and population-based approaches to complement clinical approaches to reduce the population burden of mental health problems.
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    Measuring Positive Mental Health and Depression in Africa: A Variable-Based and Person-Centred Analysis of the Dual-Continua Model
    (Frontiers in Psychology, 2022) Khumalo, I.P.; Appiah, R.; Fadiji, A.W.
    The dual-continua model of mental health provides a contemporary framework for conceptualising and operationalizing mental health. According to this model, mental health is distinct from but related to mental illness, and not the opposite or merely the absence of psychopathology symptoms. To examine the validity of the dual-continua model, previous studies have either applied variable-based analysis or confirmatory factor analysis (CFA), or used predetermined cut-off points for subgroup division. The present study extends this contribution by subjecting data from an African sample to both CFA and latent class analysis (LCA) to test the dual-continua model in Africa. We applied CFA separately for the Mental Health Continuum—Short Form (MHC-SF) and Patient Health Questionnaire—9 (PHQ-9); and LCA on combined item responses. College students (N = 892; average age = 22.74, SD = 4.92; female = 58%) from Ghana (n = 309), Kenya (n = 262), and Mozambique (n = 232), and South Africa (n = 89) completed the MHC-SF and PHQ-9. With minor modifications to the measurement models, the CFA results of this study confirm the three-factor structure of the MHC-SF and a unidimensional solution for the PHQ-9. LCA results show the presence of three distinct latent classes: languishing with moderate endorsement of depressive symptoms (25.9%), flourishing with low endorsement of depressive symptoms (63.7%), and moderate mental health with high endorsement of depressive symptoms (10.4%). These findings further contribute to affirming the evidence for the dual- continuum model of mental health, with implications for the assessment of mental health, to inform policy, practice, and future research in community and clinical settings in Africa.
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    The Inspired Life Program: Development of a multicomponent positive psychology intervention for rural adults in Ghana
    (Journal Community Psychology, 2021) Appiah, R.; Fadiji, A.W.; Wissing, M.P.; Schutte, L.
    Although several theories and studies have explored human strengths and mental well-being at the global level, these insights are rarely tested and translated into practice in sub-Saharan Africa. This study aims to describe the development of a 10-session multicomponent positive psychology intervention, the Inspired Life Program (ILP). designed to promote mental health and reduce symptoms of depression and negative affect in rural adults in Ghana. Guided by the Medical Research Council's framework for developing complex interventions, a seven-step iterative community-based participatory research approach was adopted to develop the ILP, based on constructs and principles of positive psychology and cognitive-behavioral model. The final intervention components included a 10-session, two-hourly, once-weekly manualized program designed to promote meaningful and purposeful living, self-acceptance, personal growth, goal-setting, and problem-solving solving skills, and positive thinking through group discussion and activity sessions. We describe the program theory and implementation strategy of the final intervention, and reflect on the challenges and lessons learned from applying this framework in the study context. The development of strengths-based interventions and practicality of methods to promote positive mental health in rural adults is feasible and has important policy implications for mental health and social care in sub-Saharan Africa.
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    Exploring Students' Experiences In Occupational Therapy Education: A Phenomenological Study Of Professional Identity Development
    (The Qualitative Report, 2022) Ndaa, P.O.; Bello, A.I.; Wimpenny, K.; et al.
    The existing literature on professional identity enactment and development subscribes to students’ socializing in a learning environment, where they regularly encounter practicing professionals throughout their education period. However, in most countries with less resourced occupational therapists, like In Ghana, education in occupational therapy is fraught with inadequate number of same professionals. mentor undergraduate occupational therapy students. The students are thus faced with serious dilemma regarding their professional identity, which tends to elicit a bleak perception of their chosen career. The present study was therefore envisaged to interpret and analyse the students’ lived experiences, with the view to capture the process of constructing and developing professional identity. The study focused on purposively sampled group of nine undergraduate occupational therapy students during their practice placement education, and their learning styles on didactic lectures. A hermeneutic phenomenological approach was adopted for the study. The students were followed up throughout their four-year study program for data collection, using one-to-one semi-structured interviews each year. With reference to the threshold concepts, transcribed interview data were analyzed using interpretative phenomenological procedures. The study established a transformational development of professional identity from the novice stage into graduate professionals, amidst complex interaction of co-constructed themes, included: personal knowing, professional knowing and experiential knowing.
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    Balancing Ethics and Culture: A Scoping Review of Ethico-Cultural and Implementation Challenges of the Individual-Based Consent Model in African Research
    (Journal of Empirical Research on Human Research Ethics, 2024) Appiah, R.; Raviola, G.; Weobong, B.
    Objective: This review explores the ethical, cultural and implementation challenges associated with the individual-based informed consent (IC) model in the relatively collectivistic African context and examines suggested approaches to managing them. Methods: We searched four databases for peer-reviewed studies published in English between 2000 and 2023 that examined the ethico-cultural and implementation challenges associated with the IC model in Africa. Results: Findings suggest that the individual-based IC model largely misaligns with certain African social values and ethos and subverts the authority and functions of community gatekeepers. Three recommendations were proffered to manage these challenges: that researchers should: adopt a multi-step approach to IC, conduct a rapid ethical assessment, and generate an African-centered IC model. Conclusions: A pluriversal, context-specific, multi-step IC model that critically harmonizes the cultural values of the local population and the general principles of IC can minimize ethical dumping, safeguard the integrity of the research process, and promote respectful engagement
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    Facilitating change processes in group-based behaviour change interventions in rural African contexts: practical lessons from Ghana
    (International Journal of Mental Health Systems, 2023) Appiah, R.
    Evidence from implementation research suggests that group-based behaviour change interventions (GBCIs) can encourage the development of peer support, promote psychosocial skills, and facilitate collaborative therapeutic relationships. However, although the mechanisms of action that mediate the behavior change process have been extensively described in other settings, less is known about the implementation strategies and contextual factors that actuate the reported behaviour changes among programme participants in Ghana and sub-Saharan Africa, more generally. We draw on insights from the literature and field experiences from designing, implementing, and evaluating GBCIs across several rural and peri-urban communities in Ghana to discuss a range of theoretical, methodological, and contextual factors that facilitate the behaviour change process in programme participants. We offer suggestions to guide researchers to envision and manage potential challenges with the programme development and implementation processes. We propose that intervention programmes designed to facilitate health behaviour change in the defined context should (i) have a context-relevant focus, (ii) be coherent and well-structured, (iii) have explicit techniques to facilitate inter-personal and intra-personal change processes, (iv) include appropriate mechanisms to monitor and assess the progress of the interventional sessions; and (v) be implemented by trained facilitators with a deep knowledge of the sociocultural values and norms of the target group and of the principles and theories underlying the intervention programme. We envisage that these insights could serve to guide the design, implementation, and evaluation of contextually-tailored and potentially effective GBCIs that align with the needs, capacities, and circumstances of the local population.
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    Facilitating change processes in group-based behaviour change interventions in rural African contexts: practical lessons from Ghana
    (International Journal of Mental Health Systems, 2023) Appiah, R.
    Evidence from implementation research suggests that group-based behaviour change interventions (GBCIs) can encourage the development of peer support, promote psychosocial skills, and facilitate collaborative therapeutic relationships. However, although the mechanisms of action that mediate the behaviour change process have been extensively described in other settings, less is known about the implementation strategies and contextual factors that actuate the reported behaviour changes among programme participants in Ghana and sub-Saharan Africa, more generally. We draw on insights from the literature and field experiences from designing, implementing, and evaluating GBCIs across several rural and peri-urban communities in Ghana to discuss a range of theoretical, methodological, and contextual factors that facilitate the behaviour change process in programme participants. We offer suggestions to guide researchers to envision and manage potential challenges with the programme development and implementation processes. We propose that intervention programmes designed to facilitate health behaviour change in the defined context should (i) have a context-relevant focus, (ii) be coherent and well-structured, (iii) have explicit techniques to facilitate inter-personal and intra-personal change processes, (iv) include appropriate mechanisms to monitor and assess the progress of the interventional sessions; and (v) be implemented by trained facilitators with a deep knowledge of the sociocultural values and norms of the target group and of the principles and theories underlying the intervention programme. We envisage that these insights could serve to guide the design, implementation, and evaluation of contextually-tailored and potentially effective GBCIs that align with the needs, capacities, and circumstances of the local population.
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    Context matters: Sociocultural considerations in the design and implementation of community-based positive psychology interventions in sub-Saharan Africa
    (Culture & Psychology, 2022) Appiah, R.
    Abstract Scholars conducting cross-cultural research in mental health often import intervention programs found to be efficacious in one social context (e.g., Western) and directly implement them in other contexts (e.g., African and Asian) without recourse to the sociocultural disparities between the target populations and the theoretical foundations of the constructs and principles underpinning the intervention programs. Such efforts mistakenly assume that positive psychology interventions (PPIs), most of which were developed from Western perspectives and assumed individualistic cultural orientation and value systems, operate equally across all contexts. Drawing on the extant literature and on insights from designing, implementing, and evaluating group-based (mental) health behavior change intervention programs across several communities in Ghana, we discuss some sociocultural, theoretical, and methodological issues that can significantly constrain the design, uptake, and effectiveness of PPIs in the rural, low literate, socioeconomically disadvantaged, highly collectivistic context of Ghana, and sub-Saharan Africa more generally. In all illustrations, we offer suggestions to guide the design and implementation processes to ensure culturally appropriate, highly acceptable, and potentially effective intervention programs. We argue that PPIs can be potentially fructuous in the sub-region when adapted to, or embedded in, the cultural values of the target population and tailored to the needs, capacities, and circumstances of participants.
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    Participants’ experiences and impressions of a group-based positive psychology intervention programme for rural adults in Ghana
    (Taylor & Francis Group, 2021) Appiah, R.; Fadiji, A.W.; Wissing, M.P.; Schutte, L.
    Introduction: There is growing evidence that group-based mental health intervention programmes can encourage the development of peer support, psychosocial skills, and collaborative therapeutic relationships with longer lasting effects. This study explored participants’ experiences of, perceived benefits of, and recommendations to improve a 10-session group based multicomponent positive psychology intervention (mPPI)—the Inspired Life Programme (ILP)—designed to promote positive mental health and reduce symptoms of depression and negative affect in a sample of rural Ghanaian adults. Method: Face-to-face semi-structured individual interviews were conducted with 18 randomly selected programme participants three months after their participation in the ILP. Data were analysed thematically with an inductive approach. Results: Participants described their experience of the ILP as a forum for growth that granted them the opportunity to introspect, practicalise and situate everyday life challenges, connect with others, and to develop a sense of mutual accountability. Results indicate that the ILP led participants to develop a stronger sense of positivity and well-being, fructify their ideas, and to cultivate stronger social networks and relationships that led to increased vocational productiveness. Participants recommended that researchers include facets of physical health promotion in the programme and invite close relations of participants to participate in the programme. Conclusion: This study provides the first insight into participants’ experiences of a group based mPPI in Ghana. These findings may provide useful information to inform the design of context-appropriate community-based mental health interventions to fit participants’ specific needs, capacities, and circumstances.