Here are the findings.
Overall, the intervention within the context of Hope Clubs had a positive effect and did not lead to any unexpected negative outcomes on the five scales used to measure depression, self-rated health, perceived social support, disability, and disease self-management. Key findings that emerged from the quantitative and qualitative analysis include:
1. Mean scores for the depression inventory decreased in each arm from baseline to midpoint, and from midpoint to endpoint. However, because both arms decreased similarly one cannot conclude that this decrease is due to the intervention.
2. High levels of depressive illness were observed at baseline evaluation of Hope Club participants. Data revealed half of respondents in Arm 1 (48%) and Arm 2 (52%) screened positive for symptoms of depressive illness, based on the mean score on the depression scale.
3. Persons who have lymphatic filariasis, but do not attend Hope Clubs, had an overall lower mean depression score (12.17, SD. 8.35) compared to persons who do attend Hope Clubs (14.03, SD. 8.59), suggesting that the Hope Clubs are indeed serving the population with the greatest need for support.
4. Based on analysis of qualitative data obtained from a focus group, participants learned specific communication, action-planning, and disease self-management skills from the CDSM intervention.
The outcomes from this study will help inform possible integration strategies for mental health activities into NTD care systems, with a focus on disease self-management. This study also highlights the challenges of conducting mental health research in endemic countries where scales are not validated and the stress of daily life may be high. We intend to pull together researchers from the different mental health studies to identify key learnings.