Browsing by Author "Khenti, Akwatu"

Now showing 1 - 8 of 8
  • No Thumbnail Available
    Item
    A Cluster Randomized Controlled Trial Exploring Stigmatization and Recovery-Based Perspectives on Mental Illness and Substance Use Problems Among Primary Healthcare Providers in Toronto, Ontario
    (2023) Khenti, Akwatu; Bobbili, Sireesha J.; Lentinello, Emily; Sapag, Jaime C.; van der Maas, Mark; Sanches, Marcos; Agic, Branka; Hamilton, Hayley; Patten, Scott; Stuart, Heather; Corrigan, Patrick
    Stigma toward mental health and substance use problems (MHSUP) represents a global public health challenge that undermines the quality of mental health care. This study looked at whether an anti-stigma intervention would result in a significant decrease in stigmatizing and discriminatory attitudes among Community Health Center (CHC) staff toward individuals with MHSUP, as well as clients' experiences of MHSUP stigma with CHC staff. A study in 6 CHCs in Toronto employed a cluster-randomized trial to determine the efficacy of an anti-stigma intervention toward people with MHSUP by CHC staff. Participants included 395 staff and 90 clients across 4 waves of the study. The study employed mixed effect models to test for differences between intervention sites and control sites over time. Mixed effects regressions show significantly better improvements in stigma scales among staff in the experimental sites, suggesting the intervention was successful in improving attitudes among CHC staff toward people with MHSUP. Three of the 6 interactions for staff and 2 of 4 interactions among clients indicated that the interventions beneficially affected stigma. The quantitative data with clients was not strong in finding a reduction in stigma. This tested innovative intervention may contribute to the development of effective anti-stigma initiatives for MHSUP in primary care worldwide.
  • No Thumbnail Available
    Item
    CHARACTERISTICS OF SIMULTANEOUS POLYDRUG USE AMONG UNDERGRADUATE STUDENTS OF HEALTH SCIENCES PROGRAMS OF ONE UNIVERSITY, SANTIAGO - CHILE
    (UNIV FEDERAL SANTA CATARINA, 2012) Riquelme Hernandez, Giselle; Simich, Laura; Strike, Carol; Brands, Bruna; Girsbrecht, Norman; Khenti, Akwatu
    Cross sectional study whose objective was to establish the patterns of simultaneous poly-drug use among students in undergraduate medical and nursing careers, at a university in Santiago - Chile. A sample of 188 students was studied. Results: 42.3% of students refered simultaneous poly-drug use, average age of onset of 16 years; most common combinations were alcohol + tobacco + marijuana and tobacco + alcohol with prescription drugs. They learn about drug combinations through friends, consume in mixed groups outside the university (nightclubs) and do it to relax or enjoy the company of friends. It is essential to develop comprehensive strategies in order to improve the health of this population of youngsters, who will be responsible for the health of future generations.
  • No Thumbnail Available
    Item
    Cost of implementing the Quality Rights programme in public hospitals in Gujarat providing mental healthcare
    (2023) Chatterjee, Susmita; Pathare, Soumitra; Funk, Michelle; Drew-Bold, Natalie; Das, Palash; Chauhan, Ajay; Kalha, Jasmine; Krishnamoorthy, Sadhvi; Sapag, Jaime C.; Bobbili, Sireesha J.; Shah, Sandip; Mehta, Ritambhara; Patel, Animesh; Gandhi, Upendra; Tilwani, Mahesh; Shah, Rakesh; Sheth, Hitesh; Vankar, Ganpat; Parikh, Minakshi; Parikh, Indravadan; Rangaswamy, Thara; Bakshy, Amritkumar; Khenti, Akwatu
    Background & objectives: Investment in mental health is quite meagre worldwide, including in India. The costs of new interventions must be clarified to ensure the appropriate utilization of available resources. The government of Gujarat implemented QualityRights intervention at six public mental health hospitals. This study was aimed to project the costs of scaling up of the Gujarat QualityRights intervention to understand the additional resources needed for a broader implementation.
  • Thumbnail Image
    Item
    Evaluation of a Pilot Intervention to Reduce Mental Health and Addiction Stigma in Primary Care Settings
    (2019) Khenti, Akwatu; Bobbili, Sireesha; Sapag Muñoz de la Peña, Jaime
  • Thumbnail Image
    Item
    Global mental health: transformative capacity building in Nicaragua
    (2013) Sapag Muñoz de la Peña, Jaime; Herrera, Andrés; Trainor, Ruth; Caldera, Trinidad; Khenti, Akwatu
  • No Thumbnail Available
    Item
    Including culture in programs to reduce stigma toward people with mental disorders in low- and middle-income countries
    (2020) Mascayano, Franco; Toso-Salman, Josefina; Ho, Yu Chak Sunny; Dev, Saloni; Tapia, Thamara; Thornicroft, Graham; Cabassa, Leopoldo J.; Khenti, Akwatu; Sapag, Jaime; Bobbili, Sireesha J.; Alvarado, Ruben; Yang, Lawrence Hsin; Susser, Ezra
    Stigma is one of the main barriers for the full implementation of mental health services in low- and middle-income countries (LMICs). Recently, many initiatives to reduce stigma have been launched in these settings. Nevertheless, the extent to which these interventions are effective and culturally sensitive remains largely unknown. The present review addresses these two issues by conducting a comprehensive evaluation of interventions to reduce stigma toward mental illness that have been implemented in LMICs. We conducted a scoping review of scientific papers in the following databases: PubMed, Google Scholar, EBSCO, OVID, Embase, and SciELO. Keywords in English, Spanish, and Portuguese were included. Articles published from January 1990 to December 2017 were incorporated into this article. Overall, the studies were of low-to-medium methodological quality-most only included evaluations after intervention or short follow-up periods (1-3 months). The majority of programs focused on improving knowledge and attitudes through the education of healthcare professionals, community members, or consumers. Only 20% (5/25) of the interventions considered cultural values, meanings, and practices. This gap is discussed in the light of evidence from cultural studies conducted in both low and high income countries. Considering the methodological shortcomings and the absence of cultural adaptation, future efforts should consider better research designs, with longer follow-up periods, and more suitable strategies to incorporate relevant cultural features of each community.
  • No Thumbnail Available
    Item
    Reducing stigma toward mental illness and substance use issues in primary health care in Chile: Protocol of a cluster controlled trial study
    (2022) Sapag, Jaime C.; Traub, Carolina; Velasco, Paola R.; Arratia, Tamara; Alvarado, Ruben; Aracena, Marcela; Poblete, Fernando C.; Villarroel, Luis; Bravo, Paulina; Alvarez-Huenchulaf, Cinthia; Jofre Escalona, Ana; Vargas-Malebran, Nelson; Bobbili, Sireesha; Bustamante, Ines; Khenti, Akwatu; Corrigan, Patrick W.
    Background: Chile is implementing a Community Mental Health Model with a strong role of primary health care (PHC). PHC has great potential to early detection and provision of accessible and coordinated services to people who present mental illness and/or substance use issues (MISUI). However, stigma toward people with MISUI among PHC professionals is a significant barrier to accessing good quality of care. A wealth of literature supports the importance of reducing stigma for this population. The main goal of this research project is to determine the effectiveness of a comprehensive anti-stigma intervention in reducing stigmatizing attitudes and behaviors among PHC providers toward individuals with MISUI in the Chilean context, using Centros de Salud Familiar (CESFAMs) as the point of intervention. Methods: The intervention is based on an initiative that was previously developed in Canada and then also pilot-tested in Lima, Peru, with the Center for Addiction and Mental Health (Ontario, Canada). The model will be culturally adapted with CESFAM PHC provider and user inputs to be relevant and valid to Chile. The 18-month intervention includes five (5) components that are simultaneously implemented in CESFAMs: (1) Develop a Team of Local Champions in each intervention CESFAM, comprising PHC providers and users; (2) Analysis of Internal CESFAM Policies, Procedures, and Protocols to determine areas of improvement in service delivery for individuals with MISUI; (3) Raising Awareness of stigma toward MISUI using various forms of media within the CESFAM; (4) Innovative Contact-Based Education workshops on anti-stigma and recovery principles, co-lead by academic/clinical trainers and a person with lived experience of MISUI; and (5) Recovery-Based Arts, a multi-week arts workshop for PHC providers and users to produce artwork related to MISUI and recovery, culminating in an exhibition to showcase artwork for the CESFAM providers, users, and community. The expected intervention outcomes are the following: Participation in the experimental group will result in a significant decrease in stigmatizing attitudes among PHC providers toward individuals with MISUI compared with the control group as measured by the Chilean version of the Opening Minds Scale for Health Care Providers Scale (OMS-HC); Participation in the experimental group will result in a significant decrease of PHC users experiences of stigma conveyed by PHC providers compared with the control group as measured by the Internalized Stigma of Mental Illness (ISMI) scale, validated for the Chilean population. The changes in attitudes and behaviors within the experimental group will be sustained over time as measured at 6 months-follow-up. To evaluate the effectiveness of this 18-month intervention, a 4-year, two-arm, cluster-randomized controlled trial is proposed, with CESFAMs being the unit of randomization (or "cluster "). Implementation Science approach will be taken to measure relevant implementation outcomes for each component of the intervention, and through qualitative data collection with CESFAM providers and authorities. Data analysis will be carried out using SAS 9.4 (specifically, using POC MIXED and PROC GENMOD) and R 3.5. Mixed-effect modeling will used for both PHC provider and user data, which will include individuals and CESFAMs as random effects and group (intervention/control) as fixed effects.
  • Thumbnail Image
    Item
    Stigma towards mental illness and substance use issues in primary health care : challenges and opportunities for Latin America
    (2018) Sapag Muñoz de la Peña, Jaime; Sena, Brena N.; Bustamante, Inés V.; Bobbili, Sireesha J.; Velasco, Paola R.|Mascayano, Franco; Alvarado, Rubén; Khenti, Akwatu