Background
Aim of the study
Methods
Design
Intervention
Ghana
Kenya
Data collection
Measures
Mental health-related knowledge (MAKS)
Mental health-related attitudes (CAMI)
Desire for social distance (RIBS)
Socio-economic status
Familiarity with mental health problems
Campaign awareness
Statistical analysis
Results
Sample demographics at each site
Variable, n(%) | Ghana (n = 810) | Kenya (n = 830) | |||
---|---|---|---|---|---|
Pre (n = 408) | Post (n = 402) | Pre (n = 419) | Post (n = 411) | ||
Gender | |||||
Male | 206 (50.5) | 201 (50.0) | 211 (50.4) | 210 (51.1) | |
Female | 202 (49.5) | 201 (50.0) | 208 (49.6) | 201 (48.9) | |
Age | |||||
18–25 | 276 (67.6) | 272 (67.7) | 144 (34.4) | 164 (39.9) | |
26–34 | 132 (32.4) | 130 (32.3) | 275 (65.6) | 247 (60.1) | |
Employment status | |||||
Working | 247 (60.5) | 228 (56.7) | 365 (87.1) | 338 (82.2) | |
Student | 117 (28.7) | 141 (35.1) | 41 (9.8) | 53 (12.9) | |
Not working | 44 (10.8) | 33 (8.2) | 13 (3.1) | 20 (4.9) | |
Level of education | |||||
Junior High or lower | 66 (16.2) | 61 (15.3) | 11 (2.6) | 11 (2.7) | |
Secondary | 227 (55.8) | 188 (47.1) | 160 (38.2) | 158 (38.4) | |
Post secondary education | 75 (18.4) | 84 (21.1) | 175 (41.8) | 179 (43.6) | |
University education | 39 (9.6) | 66 (16.5) | 73 (17.4) | 63 (15.3) | |
Religious denomination | |||||
Catholic/Anglican | 18 (4.4) | 38 (9.5) | 105 (25.1) | 115 (28.0) | |
Presbyterian, Baptist, Methodist | 60 (14.7) | 68 (16.9) | 90 (21.5) | 75 (18.2) | |
Seventh Day Adventist (SDA) | 9 (2.2) | 7 (1.7) | 56 (13.4) | 46 (11.2) | |
Pentecostal/Charismatic | 121 (29.7) | 141 (35.1) | 84 (20.1) | 85 (20.7) | |
Other Christians | 165 (40.4) | 67 (16.7) | 52 (12.4) | 59 (14.4) | |
Islam | 30 (7.4) | 63 (15.7) | 14 (3.3) | 14 (3.4) | |
No religion | 4 (1.0) | 9 (2.2) | 16 (3.8) | 14 (3.4) | |
Other religion | 1 (0.2) | 9 (2.2) | 1 (0.2) | 0 (0.0) | |
Marital status | |||||
Married | 50 (12.3) | 44 (10.9) | 204 (48.7) | 163 (39.7) | |
Living with someone in a stable relationship | 42 (10.3) | 22 (5.5) | 17 (4.1) | 20 (4.9) | |
Single | 316 (77.5) | 336 (83.6) | 198 (47.3) | 228 (55.5) | |
Living alone | |||||
Living with others | 338 (82.8) | 341 (84.8) | 338 (80.7) | 339 (82.5) | |
Living Alone | 70 (17.2) | 61 (15.2) | 81 (19.3) | 72 (17.5) | |
Living with children | |||||
No children | 206 (50.5) | 192 (47.8) | 123 (29.4) | 133 (32.4) | |
Living with children | 202 (49.5) | 210 (52.2) | 296 (70.6) | 278 (67.6) | |
Socio-economic class | |||||
AB | 31 (7.6) | 31 (7.7) | 12 (2.9) | 11 (2.7) | |
C1 | 227 (55.6) | 221 (55.0) | 31 (7.4) | 13 (3.2) | |
C2 | 150 (36.8) | 150 (37.3) | 136 (32.5) | 128 (31.1) | |
D | 0 (0.0) | 0 (0.0) | 240 (57.3) | 259 (63.0) | |
Closest person with a mental illness | |||||
Self | 2 (0.5) | 0 (0.0) | 8 (1.9) | 8 (1.9) | |
Other | 176 (43.1) | 84 (20.9) | 137 (32.7) | 150 (36.5) | |
No-one known | 230 (56.4) | 318 (79.1) | 274 (65.4) | 253 (61.6) | |
Campaign aware | Yes | 263 (64.5) | 267 (66.4) | 125 (29.8) | 242 (58.9) |
No | 145 (35.5) | 135 (33.6) | 294 (70.2) | 169 (41.1) |
Knowledge of classification of conditions as mental health problems
Changes in stigma related outcome measures
Ghana
Predictors | Knowledge: standardised MAKS score (n = 806) | Knowledge: MAKS heredity item (n = 806) | Knowledge: MAKS curse item (n = 806) | Attitudes: standardised CAMI score (n = 806) | Intended behaviour: standardised RIBS IB score (n = 806) | |||||
---|---|---|---|---|---|---|---|---|---|---|
Standardised effect size (95% CI) | P value | Standardised effect size (95% CI) | P value | Standardised effect size (95% CI) | P value | Standardised effect size (95% CI) | P value | Standardised effect size (95% CI) | P value | |
Stage | ||||||||||
Post | −0.15 (− 0.30,0.00) | 0.050 | 0.88 (0.65, 1.21) | 0.432 | 0.56 (0.38, 0.82) | 0.003 | 0.11 (− 0.04, 0.27) | 0.134 | 0.29 (0.14, 0.43) | < 0.001 |
Pre (ref) | – | – | – | – | – | – | – | – | – | – |
Gender | ||||||||||
F | −0.03 (− 0.17, 0.11) | 0.699 | 1.26 (0.94, 1.71) | 0.128 | 1.20 (0.83, 1.73) | 0.331 | −0.02 (− 0.16, 0.13) | 0.801 | − 0.10 (− 0.24, 0.04) | 0.156 |
M (ref) | – | – | – | – | – | – | – | – | – | – |
Age | ||||||||||
18–25 | −0.29 (− 0.46, − 0.12) | 0.001 | 1.10 (0.76, 1.59) | 0.623 | 0.79 (0.51, 1.24) | 0.305 | 0.04 (−0.14, 0.21) | 0.682 | −0.09 (− 0.26, 0.08) | 0.290 |
26–34 (ref) | – | – | – | – | – | – | – | – | – | – |
Working | ||||||||||
Student | 0.28 (0.11, 0.45) | 0.002 | 0.99 (0.69, 1.43) | 0.964 | 1.23 (0.79, 1.91) | 0.357 | 0.00 (− 0.18, 0.18) | 0.999 | −0.12 (− 0.29, 0.05) | 0.172 |
Not working | 0.34 (0.08, 0.59) | 0.009 | 1.14 (0.67, 1.95) | 0.626 | 1.39 (0.70, 2.76) | 0.346 | −0.02 (− 0.28, 0.23) | 0.871 | 0.15 (− 0.10, 0.39) | 0.235 |
Working (ref) | – | – | – | – | – | – | – | – | – | – |
Living Alone | ||||||||||
Yes | −0.10 (− 0.31, 0.11) | 0.353 | 2.16 (1.37, 3.41) | 0.001 | 1.08 (0.64, 1.83) | 0.773 | 0.19 (−0.02, 0.40) | 0.079 | 0.09 (−0.11, 0.29) | 0.381 |
No (ref) | – | – | – | – | – | – | – | – | – | – |
Living with children | ||||||||||
Yes | −0.03 (− 0.18, 0.13) | 0.743 | 1.19 (0.86, 1.64) | 0.288 | 1.09 (0.74, 1.61) | 0.659 | −0.16 (− 0.31, 0.00) | 0.048 | 0.04 (− 0.11, 0.19) | 0.643 |
No (ref) | – | – | – | – | – | – | – | – | – | – |
Religion | ||||||||||
Catholic/Anglican | 0.13 (−0.16, 0.41) | 0.387 | 1.26 (0.69, 2.29) | 0.450 | 1.23 (0.58, 2.58) | 0.591 | 0.20 (−0.09, 0.49) | 0.184 | 0.26 (−0.02, 0.55) | 0.066 |
Presbyterian, Baptist, Methodist | 0.11 (− 0.10, 0.32) | 0.301 | 1.19 (0.77, 1.84) | 0.434 | 0.98 (0.58, 1.67) | 0.939 | −0.14 (− 0.35, 0.07) | 0.190 | 0.23 (0.03, 0.44) | 0.027 |
Seventh-Day Adventist (SDA) | −0.16 (− 0.67, 0.34) | 0.528 | 1.12 (0.39, 3.20) | 0.835 | 1.68 (0.36, 7.88) | 0.513 | 0.05 (−0.46, 0.56) | 0.856 | −0.21 (− 0.71, 0.28) | 0.394 |
Other Christians | 0.09 (−0.09, 0.27) | 0.312 | 1.53 (1.04, 2.24) | 0.029 | 0.80 (0.50, 1.27) | 0.343 | −0.07 (− 0.25, 0.12) | 0.479 | 0.31 (0.13, 0.49) | 0.001 |
Islam | 0.12 (−0.12, 0.35) | 0.337 | 1.81 (1.08, 3.04) | 0.023 | 1.10 (0.59, 2.06) | 0.766 | −0.09 (− 0.33, 0.15) | 0.481 | 0.10 (− 0.13, 0.33) | 0.409 |
No religion | −0.24 (− 0.80, 0.31) | 0.393 | 0.43 (0.13, 1.48) | 0.183 | 0.32 (0.10, 1.04) | 0.058 | −0.01 (− 0.57, 0.55) | 0.973 | 0.54 (− 0.00, 1.08) | 0.051 |
Other religion | 0.13 (−0.50, 0.76) | 0.682 | 1.06 (0.29, 3.92) | 0.933 | 1.43 (0.28, 7.17) | 0.666 | −0.23 (− 0.86, 0.41) | 0.485 | 0.07 (− 0.55, 0.68) | 0.833 |
Pentecostal/Charismatic (ref) | – | – | – | – | – | – | – | – | – | – |
Education | ||||||||||
Junior High or lower | 0.02 (−0.27, 0.31) | 0.894 | 1.29 (0.70, 2.40) | 0.414 | 1.58 (0.74, 3.39) | 0.240 | −0.13 (− 0.42, 0.17) | 0.395 | − 0.08 (− 0.36, 0.20) | 0.577 |
Secondary | − 0.19 (− 0.43, 0.04) | 0.101 | 1.03 (0.63, 1.67) | 0.919 | 1.20 (0.68, 2.14) | 0.530 | −0.15 (− 0.38, 0.09) | 0.214 | − 0.24 (− 0.46, − 0.01) | 0.040 |
Post secondary education | −0.07 (− 0.32, 0.18) | 0.598 | 0.78 (0.46, 1.32) | 0.365 | 0.73 (0.40, 1.33) | 0.305 | 0.03 (−0.22, 0.29) | 0.796 | −0.14 (− 0.39, 0.10) | 0.254 |
University education (ref) | – | – | – | – | – | – | – | – | – | – |
Marriage status | ||||||||||
Married | 0.001 (−0.25, 0.25) | 0.995 | 1.39 (0.81, 2.37) | 0.231 | 1.09 (0.56, 2.11) | 0.802 | 0.02 (−0.23, 0.27) | 0.869 | 0.04 (−0.21, 0.28) | 0.769 |
Cohabiting | −0.24 (− 0.51, 0.02) | 0.073 | 0.89 (0.51, 1.56) | 0.693 | 0.52 (0.28, 0.98) | 0.044 | 0.00 (−0.26, 0.27) | 0.974 | −.011 (− 0.37, 0.14) | 0.380 |
Single (ref) | – | – | – | – | – | – | – | – | – | – |
Socio-economic status | ||||||||||
AB | −0.03 (− 0.32, 0.26) | 0.842 | 1.12 (0.61, 2.07) | 0.712 | 0.76 (0.37, 1.59) | 0.471 | 0.06 (−0.24, 0.36) | 0.699 | 0.48 (0.20, 0.77) | 0.001 |
C1 | −0.09 (− 0.24, 0.07) | 0.253 | 1.19 (0.85, 1.66) | 0.307 | 0.82 (0.54, 1.24) | 0.345 | 0.11 (− 0.05, 0.27) | 0.183 | 0.21 (0.06, 0.37) | 0.006 |
C2 (ref) | – | – | – | – | – | – | – | – | – | – |
Familiarity with mental health problems | ||||||||||
Self or other | 0.20 (0.04, 0.35) | 0.012 | 1.61 (1.16, 2.23) | 0.004 | 1.54 (1.02, 2.33) | 0.041 | 0.12 (−0.04, 0.27) | 0.136 | 0.33 (0.18, 0.48) | < 0.001 |
None (ref) | – | – | – | – | – | – | – | – | – | – |
Kenya
Predictors | Knowledge: standardised MAKS score (n = 829) | Knowledge: MAKS heredity item (n = 829) | Knowledge: MAKS curse item (n = 829) | Attitudes: standardised CAMI score (n = 829) | Intended behaviour: standardised RIBS IB score (n = 829) | |||||
---|---|---|---|---|---|---|---|---|---|---|
Standardised effect size (95% CI) | P value | Standardised effect size (95% CI) | P value | Standardised effect size (95% CI) | P value | Standardised effect size (95% CI) | P value | Standardised effect size (95% CI) | P value | |
Stage | ||||||||||
Post | 0.21 (0.07, 0.34) | 0.003 | 1.11 (0.83, 1.49) | 0.491 | 0.67 (0.49, 0.91) | 0.010 | 0.04 (− 0.10, 0.17) | 0.583 | − 0.04 (− 0.17, 0.08) | 0.511 |
Pre (ref) | – | – | – | – | – | – | – | – | – | – |
Gender | ||||||||||
F | −0.09 (− 0.23, 0.06) | 0.247 | 0.89 (0.64, 1.23) | 0.475 | 0.67 (0.48, 0.93) | 0.018 | −0.03 (− 0.18, 0.11) | 0.665 | − 0.11 (− 0.24, 0.03) | 0.122 |
M (ref) | – | – | – | – | – | – | – | – | – | – |
Age | ||||||||||
18–25 | 0.17 (− 0.001, 0.34) | 0.051 | 0.83 (0.57, 1.21) | 0.343 | 0.83 (0.56, 1.24) | 0.366 | 0.03 (−0.14, 0.20) | 0.758 | 0.07 (− 0.09, 0.23) | 0.363 |
26–34 (ref) | – | – | – | – | – | – | – | – | – | – |
Working | ||||||||||
Student | −0.11 (− 0.36, 0.13) | 0.366 | 1.35 (0.79, 2.32) | 0.274 | 1.14 (0.65, 2.00) | 0.652 | −0.21 (− 0.45, 0.04) | 0.094 | − 0.17 (− 0.40, 0.05) | 0.133 |
Not working | 0.11 (− 0.24, 0.47) | 0.542 | 0.39 (0.15, 0.99) | 0.048 | 0.55 (0.23, 1.34) | 0.190 | −0.01 (− 0.36, 0.35) | 0.976 | 0.19 (− 0.14, 0.52) | 0.252 |
Working (ref) | – | – | – | – | – | – | – | – | – | – |
Living Alone | ||||||||||
Yes | 0.01 (− 0.24, 0.26) | 0.934 | 1.28 (0.72, 2.28) | 0.407 | 1.04 (0.57, 1.90) | 0.907 | −0.17 (− 0.42, 0.08) | 0.193 | − 0.19 (− 0.42, 0.05) | 0.118 |
No (ref) | – | – | – | – | – | – | – | – | – | – |
Living with children | ||||||||||
Yes | 0.12 (−0.11, 0.35) | 0.290 | 1.35 (0.80, 2.29) | 0.261 | 1.53 (0.89, 2.64) | 0.127 | −0.20 (− 0.43, 0.03) | 0.090 | − 0.03 (− 0.24, 0.18) | 0.767 |
No (ref) | – | – | – | – | – | – | – | – | – | – |
Religion | ||||||||||
Catholic/Anglican | 0.08 (−0.11, 0.28) | 0.406 | 0.88 (0.57, 1.36) | 0.576 | 0.93 (0.59, 1.47) | 0.754 | 0.24 (0.04, 0.44) | 0.017 | 0.25 (0.06, 0.43) | 0.008 |
Presbyterian, Baptist, Methodist | 0.24 (0.02, 0.45) | 0.029 | 0.77 (0.48, 1.22) | 0.269 | 1.16 (0.72, 1.87) | 0.549 | 0.33 (0.12, 0.55) | 0.002 | 0.40 (0.21, 0.60) | < 0.001 |
Seventh-Day Adventist (SDA) | 0.03 (− 0.21, 0.28) | 0.779 | 1.04 (0.62, 1.76) | 0.871 | 1.10 (0.64, 1.91) | 0.726 | 0.11 (−0.13, 0.36) | 0.352 | 0.16 (− 0.07, 0.38) | 0.166 |
Other Christians | 0.08 (− 0.16, 0.32) | 0.516 | 1.12 (0.67, 1.86) | 0.669 | 1.96 (1.17, 3.29) | 0.011 | 0.14 (−0.09, 0.38) | 0.232 | 0.42 (0.20, 0.64) | < 0.001 |
Islam | 0.79 (0.39, 1.18) | < 0.001 | 1.41 (0.60, 3.33) | 0.430 | 4.44 (1.84, 10.75) | 0.001 | −0.13 (−0.52, 0.27) | 0.527 | 0.14 (−0.22, 0.51) | 0.445 |
No religion | 0.68 (0.29, 1.06) | 0.001 | 0.76 (0.32, 1.83) | 0.543 | 6.04 (2.44, 14.94) | < 0.001 | 0.74 (0.35, 1.12) | < 0.001 | 0.95 (0.59, 1.31) | < 0.001 |
Other religion | 0.62 (−0.36, 1.60) | 0.216 | 1.82 (0.23, 14.31) | 0.568 | 2.25 (0.28, 17.92) | 0.443 | −0.48 (−1.45, 0.50) | 0.337 | −0.09 (−1.00, 0.82) | 0.853 |
Pentecostal/Charismatic (ref) | – | – | – | – | – | – | – | – | – | – |
Education | ||||||||||
Junior High or lower | −0.31 (− 0.77, 0.16) | 0.199 | 1.98 (0.71, 5.53) | 0.193 | 4.18 (1.46, 11.91) | 0.007 | −0.29 (− 0.75, 0.18) | 0.226 | − 0.16 (− 0.60, 0.27) | 0.463 |
Secondary | 0.09 (− 0.14, 0.32) | 0.455 | 2.19 (1.26, 3.80) | 0.005 | 2.84 (1.57, 5.14) | 0.001 | 0.00 (−0.23, 0.24) | 0.968 | 0.28 (0.06, 0.49) | 0.012 |
Post secondary education | −0.08 (− 0.29, 0.13) | 0.447 | 2.78 (1.67, 4.63) | < 0.001 | 3.04 (1.74, 5.30) | < 0.001 | −0.16 (− 0.37, 0.05) | 0.145 | 0.00 (− 0.20, 0.19) | 0.966 |
University education (ref) | – | – | – | – | – | – | – | – | – | – |
Marriage status | ||||||||||
Married | 0.04 (−0.14, 0.21) | 0.683 | 1.40 (0.96, 2.04) | 0.082 | 0.97 (0.66, 1.44) | 0.887 | 0.07 (−0.10, 0.24) | 0.433 | −0.01 (− 0.17, 0.15) | 0.860 |
Cohabiting | 0.26 (−0.08, 0.60) | 0.132 | 0.77 (0.35, 1.69) | 0.518 | 0.99 (0.45, 2.20) | 0.987 | 0.08 (−0.26, 0.42) | 0.643 | −0.10 (− 0.42, 0.22) | 0.530 |
Single (ref) | – | – | – | – | – | – | – | – | – | – |
Socio-economic status | ||||||||||
AB | 0.16 (−0.27, 0.58) | 0.467 | 1.36 (0.55, 3.38) | 0.508 | 1.10 (0.43, 2.84) | 0.839 | −0.36 (− 0.78, 0.06) | 0.092 | 0.12 (− 0.27, 0.51) | 0.551 |
C1 | 0.12 (−0.20, 0.44) | 0.451 | 1.24 (0.61, 2.51) | 0.556 | 0.71 (0.33, 1.53) | 0.381 | −0.38 (− 0.70, − 0.07) | 0.018 | −0.16 (− 0.45, 0.14) | 0.303 |
C2 | 0.12 (−0.04, 0.29) | 0.129 | 0.63 (0.44, 0.90) | 0.011 | 0.70 (0.48, 1.01) | 0.055 | −0.06 (− 0.22, 0.10) | 0.479 | − 0.01 (− 0.16, 0.14) | 0.879 |
D (ref) | – | – | – | – | – | – | – | – | – | – |
Familiarity with mental health problems | ||||||||||
Self or other | 0.24 (0.10, 0.38) | 0.001 | 0.99 (0.73, 1.35) | 0.967 | 0.93 (0.67, 1.28) | 0.650 | 0.40 (0.26, 0.54) | < 0.001 | 0.78 (0.64, 0.91) | < 0.001 |
None (ref) | – | – | – | – | – | – | – | – | – | – |