Mixed methods study of the MindSKILLZ Magazine among youth living with HIV in Zambia

DETAILED SUMMARY

Importance

• Youth living with HIV experience high rates of mental health challenges, with 1 in 4 experiencing depression. There is a critical gap in mental health education and young people’s family engagement in positive mental health promotion in Zambia.

Objective

• To use the MindSKILLZ Magazine as a simple, take-home resource to fill the gap in mental health education and familial engagement among youth living with HIV in Zambia.
• To evaluate the effectiveness and relevance of the Magazine to promote mental well-being.

Study details

• Study design: Mixed methods evaluation
• Data collection tools: Matched pre/post surveys (n = 269), focus group discussions (n = 4 with participants; n = 2 with Coaches), interviews including capturing photos of participants’ writing and drawing in Magazines (n = 22), interviews (n = 12 with parents/guardians; n = 15 with health service providers and volunteer antiretroviral therapy caregivers)
• Participants: Coaches (n = 44), youth living with HIV (n = 2,344), parents/guardians, volunteer antiretroviral therapy caregivers, and health service providers from 17 health facilities
• Implementation setting: Chipata and Lusaka, Zambia
• Study period: Evaluation conducted July to December of 2022

Intervention

• MindSKILLZ Magazine: A fun, comic book-style resource to promote mental well-being of youth living with HIV. It includes youth-friendly mental health content, soccer-based activities, and relatable images, including lived experiences from Grassroot Soccer Coaches who serve as role models for youth. Participants were already connected to Grassroot Soccer through their participation in SKILLZ Plus, which is Grassroot Soccer’s curriculum-based program for youth living with HIV.

Results

• Effective in promoting the mental well-being of adolescent participants
• Pre/post change of 9% in mental health knowledge, attitudes, and behaviors
• 13% increase in participants’ willingness to share mental health information (biggest relative % increase)
• 3% increase in mental health attitudes (smallest relative % increase)
• Negative wording of 2 survey items appears to have confused participants and negatively impacted quantitative results on mental health attitudes
• 15 out of 23 pre/post items showed statistically significant positive change (p<0.05)
• Acceptable and relevant to young people and adult stakeholders
• 93% of participants viewed the Magazine as a good tool for positive mental health promotion

Conclusions and implications

• The MindSKILLZ Magazine is a promising supplementary tool for reinforcement of mental health concepts and discussions among young people and their families
• Civil society organizers and partners should consider extending mental health investments to other young people besides those living with HIV