Cross-sectional study of Digital MindSKILLZ among mobile phone users in six sub-Saharan African countries

DETAILED SUMMARY

Importance

• Mental health conditions affect many young people in sub-Saharan Africa (SSA), but stigma is high and care is limited. There is little evidence of digital mental health interventions (DMHIs) as a method to promote mental health in SSA.

Objective

• Understand the reach, feasibility, and acceptability of the digital intervention by country and user demographics;
• Assess knowledge of mental health topics during users’ engagement with the intervention.

Study details

• Study design: Cross-sectional
• Data collection tools: Real-time capture of user interaction with platform, including demographic, behavioral, and technical data; voluntary post-intervention questions shown as prompts during the intervention
• Participants: Anyone in one of the six sub-Saharan African countries who called the platform
• Implementation setting: 6 sub-Saharan African countries: Democratic Republic of Congo, Ghana, Nigeria, Rwanda, Uganda, and Zambia
• Study period: September 1, 2024 – March 20, 2025 (7 month period)

Intervention

• Digital MindSKILLZ: an Interactive Voice Response mental health intervention with gamified soccer-related material adapted from Grassroot Soccer’s in-person MindSKILLZ program. Consists of 3 branches with guided learning on Viamo’s automated telephone system: 1) mental health information (~20 min); 2) mental health skills (~10–15 min); 3) soccer-themed trivia (~5–10 min).

Results

• Very high reach: 700,138 people called the platform, and 425,395 (61%) listened to ≥ 1 voice-recorded message. Of these, 63.6% were under 25 years and 68.3% were from rural areas.
• High attrition: 34–69% of users disengaged before listening to a mental health message
• The proportion of users accessing each branch included 36.5% for mental health information, 46.4% for mental health skills, and 50.9% for soccer quizzes. Among users who accessed the mental health section:
  • Mean number of messages completed: 7.6 out of 18 messages (42%)
  • Average knowledge score at baseline: 62% correct, which indicates moderate awareness
  • According to a follow-up survey, 91% of users understood some or all of the content, 85% would recommend the intervention, and 38% found mental health content most helpful.

Conclusions and implications

• Digital MindSKILLZ shows promise as a scalable DMHI, and its IVR platform may be a critical delivery channel for populations with low connectivity and limited utilization of web-enabled phones.
• Future studies should use a mixed-methods and longitudinal approach to understand effectiveness and implementation outcomes.
• Results will inform an upcoming study of Digital MindSKILLZ in Malawi.