Implementing internet-based cognitive behavioural therapy (moodgym) for African students with symptoms of low mood during the COVID-19 pandemic: a qualitative feasibilty study

Ncheka, Joyce M.; Menon, J. Anitha; Davies, E Bethan; Paul, Ravi; Mwaba, Sidney O C; Mudenda, John; Wharrad, Heather; Tak, Harsa; Glazebrook, Cris

Abstract

Background: Online therapies have been shown to be effective in improving students’ mental health. They are cost-effective and therefore have particular advantages in low-income countries like Zambia where mental health resources are limited. This study aimed to explore the perceived impact of the COVID-19 pandemic and the feasibility of implementing an Internet-Based Cognitive Behavioural Therapy (iCBT) intervention (‘moodgym’) to improve resilience in vulnerable Zambian students. Methods: The study was a qualitative interview study. Participants identifying as having symptoms of low mood and completing a baseline, online survey (n = 620) had the option to volunteer for a semi-structured interview to explore views about their experience of the pandemic and the acceptability and perceived benefits and limitations of using moodgym. Results: A total of 50 students (n = 24 female, n = 26 male) participated in the study. One theme with 4 sub-themes, captured the severe emotional and social impact of the COVID-19 pandemic. A second, very strong theme, with 5 sub-themes, reflected the considerable negative effects of the pandemic on the students’ educational experience. This included the challenges of online learning. The third theme, with three subthemes, captured the benefits and acceptability of moodgym, particularly in terms of understanding the relationship between thoughts and feelings and improving academic performance. The fourth theme described the technical difficulties experienced by students in attempting to use moodgym. Conclusion: COVID-19 caused fear and impacted wellbeing in vulnerable students and severely impaired the quality of students’ educational experience. The findings suggest that moodgym might be a valuable support to students in a low-income country.

• Journal Article Type: Article
• Acceptance Date: Jan 20, 2024
• Online Publication Date: Feb 1, 2024
• Publication Date: 2024
• Deposit Date: Feb 29, 2024
• Publicly Available Date: Feb 29, 2024
• Journal: BMC Psychiatry
• Electronic ISSN: 1471-244X
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 24
• Issue: 1
• Article Number: 92
• DOI: https://doi.org/10.1186/s12888-024-05542-4
• Keywords: Low income countries, COVID-19, Students, Qualitative research, Cognitive behavioral therapy
• Public URL: https://nottingham-repository.worktribe.com/output/30927351
• Publisher URL: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05542-4
• Additional Information: Received: 3 October 2023; Accepted: 20 January 2024; First Online: 1 February 2024; : ; : Ethical approval was obtained from the University of Zambia Biomedical Research ethics committee [UNZABREC] under the ethical approval reference number 1296–2020, National Health Research Authority (NHRA) and permission was sought from the management of UNZA and LAMU. Participants were required to complete an online, tick box, informed consent form to participate in an anonymous, online survey and an interview. Participants were able to provide contact details to take part in the interview via a separate weblink. Additional verbal consent was obtained prior to the interview. All methods were carried out in accordance with relevant guidelines and regulations.; : Not applicable.; : The authors declare no competing interests.