Continuing Health Impact Assessment (CHIA) of the computer-based Drug and Alcohol Training Assessment in Kenya (eDATA K)

Tobacco, alcohol and other substance use disorders (SUD) are among the most important risk factors for the global burden of disease, with a 38 percent increase in global burden of the disease from substance use in the 20 years between 1990 and 2010, mainly driven by increased drug use (57 percent) and alcohol use (32 percent). The tobacco consumption is also worrisome considering the highest incidence of smoking is among men in low and middle income countries (LMIC), and that in the poorest LMIC households, 10 percent of the total income is spent on tobacco, to the detriment of consumption of healthy food and other essential elements for the health of the whole family.

Clinical prevention and care for these disorders are lacking in LMIC. A project funded by Grand Challenges Canada and run by NextGenU.org and the Africa Mental Health Foundation seeks to address that gap through:

1. Piloting online training in SUD intervention for health care workers in rural and urban areas of Kenya
2. Conducting randomized control trials (RCT) of the impact of alcohol brief intervention
3. Determining the feasibility of sustaining the delivery of the interventions post-randomized control trials

The studies are ongoing, with screening data collected on more than 22,000 adults, enabling recruitment of 1,200 patients from October 2014 to February 2015 in 10 facilities from three counties. The clinical courses to address substance use disorders, and other NextGenU courses, are being used in 134 countries.

The screening included SUD, BMI and physical activity level (to mask the purpose of the trials and to decrease barriers from stigma).

Preliminary analysis shows that the outcomes include alcohol use reduction for the patients, and decrease in stigma from healthcare worker, as well as feasibility of sustaining the intervention post RCT.

This project will analyze the data, including the impact on quality of life, self-stigma, depression, risky sexual practices, general health and mental health status, and other substance use consumption. It will also perform knowledge translation of the clinical impact, and continue to carry out the feasibility assessment of sustaining the interventions.