Barriers and Facilitators to Father’s Engagement in a Depression and Alcohol Use Intervention in Kenya: Father, Family, and Community Factors

Ali Giusto (), Florence Jaguga, Victor Pereira-Sanchez, Wilter Rono, Noah Triplett, Hani Rukh-E-Qamar, Mattea Parker and Milton L. Wainberg
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Ali Giusto: Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY 10032, USA
Florence Jaguga: Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret P.O. Box 3-30100, Kenya
Victor Pereira-Sanchez: Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY 10016, USA
Wilter Rono: Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret P.O. Box 3-30100, Kenya
Noah Triplett: Department of Psychology, University of Washington, Seattle, WA 98195, USA
Hani Rukh-E-Qamar: Department of Psychology, McGill University, Montreal, QC H3A 0G4, Canada
Mattea Parker: Department of Psychology, Tuskegee University, Tuskegee, AL 36088, USA
Milton L. Wainberg: Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY 10032, USA

IJERPH, 2023, vol. 20, issue 6, 1-12

Abstract: In Kenya, there is a treatment gap for depression and alcohol use that is especially large for fathers, which has consequences for families. While treatments exist, there are challenges to implementation. This study aimed to understand barriers and facilitators to implementing a treatment for fathers’ depression and alcohol use in Eldoret, Kenya. Guided by the Consolidated Framework for Implementation Research and the Integrated Sustainability Framework, we conducted 18 key informant interviews and 7 focus group discussions (31 total participants) with stakeholders in Eldoret (hospital leaders, policy makers, mental health providers, community leaders, fathers, lay providers, and patients previously engaged in treatment). Interviews were analyzed using the framework method; themes were matrixed by framework domains. Participants identified barriers and facilitators, and opportunities for implementation, in the following domains: innovation, outer setting, inner setting, individual, sustainability, and characteristics of systems. Barriers included a lack of resources, stigma, masculine norms, cost of services, and alcohol dependence. Facilitators included community buy-in, family support, providers with lived experience, government support, and relevant treatment content. Findings will inform implementation strategy development for an intervention for fathers with depression and alcohol use, and family problems with local relevance and scalable potential.

Keywords: implementation; fathers; CFIR; sustainability; depression; alcohol use; family (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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