Understanding depression treatment and perinatal service preferences of Kenyan pregnant adolescents: A discrete choice experiment
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Date
2023Author
Manasi, Kumar
Tele, Albert
Kathono, Joseph
Nyongesa, Vincent
Yator, Obadia
Mwaniga, Shillah
Huang, Keng Y
McKay, Mary
Lai, Joanna
Levy, Marcy
Cuijpers, Pim
Quaife, Matthew
Unutzer, Jurgen
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Background: Understanding mental health treatment preferences of adolescents and youth is particularly important for interventions to be acceptable and successful. Person-centered care mandates empowering individuals to take charge of their own health rather than being passive recipients of services.
Methods: We conducted a discrete choice experiment to quantitatively measure adolescent treatment preferences for different care characteristics and explore tradeoffs between these. A total of 153 pregnant adolescents were recruited from two primary healthcare facilities in the informal urban settlement of Nairobi. We selected eight attributes of depression treatment option models drawn from literature review and previous qualitative work. Bayesian d-efficient design was used to identify main effects. A total of ten choice tasks were solicited per respondent. We evaluated mean preferences using mixed logit models to adjust for within subject correlation and account for unobserved heterogeneity.
Results: Respondents showed a positive preference that caregivers be provided with information sheets, as opposed to co-participation with caregivers. With regards to treatment options, the respondents showed a positive preference for 8 sessions as compared to 4 sessions. With regards to intervention delivery agents, the respondents had a positive preference for facility nurses as compared to community health volunteers. In terms of support, the respondents showed positive preference for parenting skills as compared to peer support. Our respondents expressed negative preferences of ANC service combined with older mothers as compared to adolescent friendly services and of being offered refreshments alone. A positive preference was revealed for combined refreshments and travel allowance over travel allowance or refreshments alone. A number of these suggestions were about enhancing their experience of maternity clinical care experience.
Conclusion: This study highlights unique needs of this population. Pregnant adolescents' value responsive maternity and depression care services offered by nurses. Participants shared preference for longer psychotherapy sessions and their preference was to have adolescent centered maternal mental health and child health services within primary care.
Citation
Kumar M, Tele A, Kathono J, Nyongesa V, Yator O, Mwaniga S, Huang KY, McKay M, Lai J, Levy M, Cuijpers P, Quaife M, Unutzer J. Understanding depression treatment and perinatal service preferences of Kenyan pregnant adolescents: A discrete choice experiment. PLoS One. 2023 Mar 8;18(3):e0273274. doi: 10.1371/journal.pone.0273274. PMID: 36888596; PMCID: PMC9994687.Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
- Faculty of Health Sciences (FHS) [10378]
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