Browsing by Author "Puffer, Eve S"
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Item Embargo Feasibility of Kanasina Gulabi, a Pilot Peer Support Intervention for Young Adults with Type 2 Diabetes in Mysore District, South India(2024) Gopisetty, Nikhita RaniBackground: The global rise in early-onset type 2 diabetes (T2D) is impacting the lives of millions of young individuals around the world. To address the knowledge gap and emotional burden in young adults with T2D, the research team designed a four-week education and goal-based peer support intervention, Kanasina Gulabi (Kannada: My Dream Rose), implemented in Mysore, India between June and July 2023. Methods: The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework was used to assess feasibility. Peer navigators (n=3, mean age: 33 years) were recruited from the community and trained to deliver the intervention. Twenty-eight adults ≤ 40 years of age with T2D were recruited and quasi-randomly allocated to the intervention group (n=14, mean age: 33 years) or the control group (n=14, mean age: 33 years). Hemoglobin A1c, T2D knowledge, diabetes distress, diabetes-related stigma, depression severity, and optimism were assessed at baseline, immediately after the intervention, and at the 2-month follow-up. Attendance, fidelity, and acceptability were also assessed. Results: Intervention participants expressed high satisfaction with Kanasina Gulabi and gratitude for the guided knowledge and mentorship from their peer navigators. Participants displayed excellent attendance and adherence, with an average of 5 hours of Kanasina Gulabi exposure over 4 weeks. Peer navigators delivered the intervention with 100% fidelity. Results immediately following the intervention showed reductions in diabetes distress (Intervention: 30.9%, Control: 6.5%), diabetes-related stigma (Intervention: 25.3%, Control: 14.5%), and depression severity (Intervention: 58.3%, Control: 38.5%). Both groups presented an increase in T2D knowledge (Intervention: 19.7%, Control: 25.2%). Conclusion: Implementing Kanasina Gulabi in Mysore is feasible and acceptable, with intervention participants showing more positive changes on multiple psychosocial outcomes compared to the control group. Results support a full trial to evaluate its effectiveness and sustainability in young adults with T2D.
Item Open Access The protective role of religious coping in adolescents' responses to poverty and sexual decision-making in rural Kenya.(J Res Adolesc, 2012-03-01) Puffer, Eve S; Watt, Melissa H; Sikkema, Kathleen J; Ogwang-Odhiambo, Rose A; Broverman, Sherryl AIn this study, we explored how adolescents in rural Kenya apply religious coping in sexual decision-making in the context of high rates of poverty and Human Immunodeficiency Virus (HIV). Semi-structured interviews were conducted with 34 adolescents. One-third (13) reported religious coping related to economic stress, HIV, or sexual decision-making; the majority (29) reported religious coping with these or other stressors. Adolescents reported praying for God to partner with them to engage in positive behaviors, praying for strength to resist unwanted behaviors, and passive strategies characterized by waiting for God to provide resources or protection from HIV. Adolescents in Sub-Saharan Africa may benefit from HIV prevention interventions that integrate and build upon their use of religious coping.Item Embargo Voices of Families: Evaluating the Implementation of Tuko Pamoja, a Two-Tiered Family Therapy Intervention, through Participant Perspectives in Western Kenya..(2024) Birgen, Elcy JeptooAbstractBackground: Mental health significantly affects overall well-being, with childhood identified as a critical period for intervention. The family unit plays a pivotal role in shaping children's mental health, serving as both a source of support and, potentially, stress. In low and middle-income countries (LMICs) like Kenya, where access to mental health services is limited, the impact of family dynamics on children's mental health underscores the need for effective, culturally tailored interventions. The Tuko Pamoja program in Kenya offers a novel approach by integrating community-based prevention with targeted family counseling, addressing the gap in family-based mental health interventions within a community-embedded framework. Objective: This study aims to explore the factors influencing family participation in the Tuko Pamoja program, examining the experiences of families who engaged with the program and those who did not. It seeks to understand the interplay between the program's two components –group-based prevention (Tuko Pamoja Family Days) and individual family counseling (Tuko Pamoja Home) and participants' perceptions of their collective influence on family dynamics and mental health. Methods: Employing a qualitative research design, this study included in-depth interviews with 14 caregivers from families identified within the community with high levels of family distress. Thematic content analysis was conducted to identify themes related to participation decisions, program impact, and recommendations for improvement. Results: Findings reveal that non-attenders had positive perceptions of the program but were still unable to attend due to logistical barriers. Among attenders, effective recruitment strategies, clear communication, and logistical support facilitated participation in both tiers of the program. Attenders expressed that participation in TP Family Days played a crucial role in reducing stigma and encouraging participation in the more intensive TP Home counseling tier. Participants who engaged with both tiers reported significant improvements in family communication, parenting practices, and overall family dynamics, with both tiers reinforcing each other's content to enhance the overall impact. Conclusion: The Tuko Pamoja program demonstrates the potential to improve family dynamics and mental health awareness in LMIC settings by synergistically combining prevention and treatment tiers. Attenders felt that the program's prevention component played a crucial role in reducing stigma, improving family communication, and strengthening family relationships. This study contributes to the understanding of implementing family-based mental health interventions in LMICs, offering valuable insights into how integrated approaches can effectively address complex psychosocial needs within family systems. Addressing barriers to participation and enhancing program accessibility will be important for broadening the program's reach and efficacy. Keywords: Family-based interventions, Mental health, LMIC, Community-embedded model, Tuko Pamoja, Tuko Pamoja Home, Tuko Pamoja Family Days, Kenya, Qualitative research.