Awards

Rebecca Dempster of HIAS in the U.S. will develop an online game- and mentorship-based intervention to improve the mental health of refugee adolescent mothers in Kenya that integrates into their daily lives and helps them develop new skills. Digital games can help treat mental health disorders such as depression particularly in young people because they have a natural appeal and are easy to access from home. They will recruit ten young mothers, a psychologist, and software programmers to design a mental health game so that it can be used to identify those with mental health disorders and connect them with counselors, and provides interactive challenges to help treat and protect against those disorders as well as build relevant life skills. They will then train these young mothers to act as mentors to support the online game, and pilot test their approach on a sample of 15 refugee adolescent mothers over three months to evaluate feasibility, acceptability, and effect on maternal depression.

Manish Bhardwaj of Innovators in Health in India will build a social networking platform consisting of voice messages accessed via mobile phone that is monitored by community health workers to connect small groups of young pregnant women and new mothers in India. Currently, community health workers provide home visits to help adolescent mothers combat mental health disorders. However, their capacity is limited. An additional difficulty for adolescent mothers is the lack of social networks caused by moving to new neighborhoods to live with their husbands. Social networks can protect against mental health disorders by providing peer support and the relevant knowledge and experience to overcome any challenges. They will trial their approach in a rural area in India and recruit young mothers with no access to mental health care into specified social groups. Each group will be associated with trained community health workers who provide additional support to the mothers, and manage the messages and posts.

Agnes Ronan, from Pediatric Adolescent Treatment Africa, in South Africa will develop a training and supervision tool for young health workers that combines screening and support in an accessible format to reduce depression in HIV-positive, adolescent mothers. There are an estimated two million adolescent mothers living with HIV in Africa, and stigma prevents many of them accessing health care. Young HIV-positive peer supporters work in local clinics and use informal chats, text messages, and home visits to support HIV-positive adolescents. However, they lack the skills to support the mental health of HIV-positive adolescent mothers. They will adapt existing cognitive behavioral therapy methods based on the WHO's Thinking Healthy program, and co-develop their approach with adolescent mothers, peer supporters, and developers. They will train 70 peer supporters from six southern African countries and each will recruit three HIV-positive adolescent mothers to test the approach.

Joanna Busza of the London School of Hygiene and Tropical Medicine in the United Kingdom will help vulnerable young mothers who sell sex in Zimbabwe by involving them in designing self-help groups incorporating virtual meetings via social media to build support networks and teach them life skills such as money management and parenting. Adolescent sex workers who become mothers are at high risk of developing mental health problems such as anxiety and depression, and often have little support caring for their children. They will involve adolescent women in the design stage by holding interviews and group discussions to gather opinion on social media and group meetings, as well as identify the types of skills they most need and how best to teach them. They will train peer educators to lead six-month virtual support groups and recruit young, pregnant sex workers to pilot test the approach in two urban sites in Zimbabwe.

Tatiana Salisbury of King's College London in the United Kingdom along with colleagues at the Royal College of Art in the United Kingdom and the Manhiça Health Research Centre in Mozambique will develop a strategy to improve the mental health of young mothers in Mozambique by adapting existing technology-based and group-based methods to teach them life skills such as parenting and social skills. Almost half of Mozambican girls have had a baby by the time they are 18 years old. Together with associated events including being excluded from school and family conflicts, this can damage their mental health and lead to suicide. They will recruit experts in mental and maternal health and implementation science, analyze resources and local infrastructure, and, together with young mothers, their families, and other stakeholders, co-develop the skill-strengthening and delivery methods. Delivery methods to be analyzed include text messaging, mobile phone applications, and group meetings. They will then pilot test their strategy with three different delivery methods using up to 60 pregnant and young mothers (aged 15-24 years) over four months, and evaluate their effect on mental health.

Chiwoneso Tinago of West Chester University of Pennsylvania in the U.S. will partner with adolescent mothers and local health workers in Zimbabwe to create peer-support groups incorporating cellphone-based technology such as the WhatsApp messenger application to provide coping and parenting skills to improve the mental health of young mothers. Young mothers less than 18 years old in Zimbabwe are often socially isolated due to forced marriages and exclusion from school, and therefore have no help when bringing up their children. This leaves them vulnerable to physical, emotional, and mental health problems, which also harms their children. They will hold one-hour focus groups with around 100 adolescent mothers and other community members including health workers and teachers, to identify the important topics and the best set-up for the support group meetings. They will then train community health workers and educators to run the peer-support groups, and evaluate its effect on depression and anxiety.

Sarah Murray and colleagues of Johns Hopkins Bloomberg School of Public Health and School of Nursing in the U.S. along with colleagues at the University of Bamako in Mali will develop a group approach to provide better antenatal care to pregnant adolescents in Mali and protect them from common mental disorders such as depression. Over half of adolescent girls in Mali have a child before their 18th birthday, and as a consequence are more likely to live in poverty, be uneducated, and experience violence. Although antenatal health services and support are available, they are limited. To address this, they will develop a group format for more efficient delivery of antenatal mental health care that encourages open discussions and provides social networks and support. This will be done in collaboration with adolescent mothers, their husbands, and health care providers. They will train health care workers to teach relevant coping strategies in a group format using cognitive behavioral therapy techniques, and pilot test their approach on small groups of pregnant adolescents with partners in Bamako, Mali.

Anne Marie Chomat of McGill University in Canada will design an intervention to overcome the mental health problems faced by young mothers in Guatemala by engaging them, along with their partners and fathers, elders, and adolescents in their communities, in order to address the complex factors affecting maternal health. Women in Maya indigenous areas of Guatemala, which has recently faced a civil war, experience particularly high rates of poverty, gender inequality, adolescent births, and mental health disorders. This in turn harms their children, with over 50% suffering from severe developmental delays. They recognize that community members are best placed to find solutions to their own problems and can better promote community-level change. So, they will engage community members from multiple generations and positions, including traditional healers and spiritual leaders, to co-develop an intervention. Their project will take place in four communities in two rural regions of Guatemala, and the community groups will work together to define the problems and contribute to designing and implementing the intervention.

Guitele Rahill and Manisha Joshi of the University of South Florida in the U.S. will harness the Haitian tradition of storytelling to produce online videos, brochures, and posters that support pregnant teenagers in Haiti who are at high risk of depression. There has been an increase in unplanned teenage pregnancies since the 2010 earthquake, due in part to the loss of parents, and a rise in transactional sex and sexual assaults facilitated by very limited resources. Pregnancy places a substantial additional stress on these children, which in turn causes long-term difficulties for their children. In Haiti, to tell a story you announce "Krik?", and to hear it you respond "Krak!" They will use this familiar story-telling framework and actors who resemble the target group to teach pregnant teenagers about childbirth, motherhood, and how to cope with depression. They will conduct two focus groups of six pregnant teens to identify the specific challenges they face, and use their feedback to help ensure the approach will work.

Lisa Butler of the University of Connecticut in the U.S. will develop an approach to improve the mental health of pregnant and new mothers between 15 and 19 years old in Botswana that incorporates interactive group sessions mediated by trained community workers, informative text messages, and an SMS-based mental health screening tool. Between 19-25% of women in low- to middle-income countries suffer from depression during pregnancy, which can also have serious effects on the child. In Botswana, there are large numbers of young, single mothers, who lack support and are particularly vulnerable to depression. They will develop the materials and format for their approach with support from a community working group of adolescent mothers and health providers to ensure it is culturally appropriate and addresses their specific needs. They will also incorporate a theoretical model designed to address the triggers and reduce the stigma of mental health disorders. Their approach will be field tested with 80 pregnant adolescents in a traditional village in Botswana to evaluate its feasibility and acceptability.