Jinane Abi Ramia|Melissa Harper Shehadeh|Wissam Kheir|Edwina Zoghbi|Sarah Watts|Eva Heim|Rabih El Chammay
Community cognitive interviewing to inform local adaptations of an e-mental health intervention in Lebanon
Ministry of Public Health|Lebanese University|University of Geneva|Ministry of Public Health|Lebanese University|Lebanese University|University of Sydney|University of Zurich|Ministry of Public Health|Lebanese University
lebanon need innovative approaches increase access mental health care meet countrys current high demand emental health included national mental health strategy parallel world health organization produced online intervention called stepbystep treat symptoms depression tested lebanon coming yearsthe primary aim study conduct bottomup communitydriven qualitative cognitive interviewing multistakeholder perspective inform cultural adaptation internetdelivered mental health intervention based behavioural activation lebanonnational mental health programme staff conducted total 11 key informant interviews three mental health professionals six frontline workers primary health care centres phccs two community members also eight focus group discussions one seven frontline workers seven others total 66 community members lebanese syrians palestinians conducted several phccs inform adaptation stepbystep results transcribed analysed thematically project coordinator two research assistantsfeedback generated cognitive interviewing mainly revolved around amending story illustrations delivery methods ensure relevance sensitivity local context results obtained informed major edits content stepbystep also model provision notably intervention made approximately 30 shorter includes additional videos content alongside originally proposed comic bookstyle delivery less emphasis total inactivity symptom low mood focus enjoyable activities lift mood story ways contact participants provide support updated line local gender norms many suggested featured activities revised line suggestions community membersthese findings promote advocate use communitydriven adaptation evidencebased psychological interventions phenomena recorded mirror findings research barriers care seeking region changes made intervention useful improving utility uptake stepbystep