Narrative Intervention to Reduce Caregiver Stress and Aid Schizophrenia Medication Adherence via WhatsApp (NIRC-SASMAW)

Bernard Appiah (PH) PI and Miriam Mutambudzi (PH) co-I
2021-2022 Falk College Seed Grant, 7/1/21-6/30/22

Schizophrenia, a severe form of mental illness, is a global health challenge, with about 1.3 million patients in Sub-Saharan Africa having this disease. Adhering to medications for controlling schizophrenia is a challenge. Patients and caregivers suffer schizophrenia-induced psychological burden (stress and anxiety), which negatively impacts adherence. Thus, efforts to improve adherence among patients would need to tackle the psychological well-being of patients and their caregivers. In Ghana, poor adherence to medications for controlling schizophrenia has been significantly linked to caregiver psychological burden. Thus, there is a critical need for novel approaches to simultaneously improve the psychosocial well-being of patients and caregivers and adherence of patients with schizophrenia.

The specific aims of this study are to create animations on antipsychotics in English, and assess their feasibility and acceptability, and to examine intervention effects on patient/caregiver psychological burden and medication adherence in Ghana. This study will adopt a mixed-methods approach: quantitative and qualitative. It will use in-depth interviews to seek perspectives of patients with schizophrenia and their caregivers in designing humor-filled animations on adherence to medications for treating schizophrenia. It will also use a randomized controlled trial involving patient-caregiver dyads to assess the feasibility and effectiveness of using animation disseminated via WhatsApp in improving medication adherence and reducing stress of patients and their caregivers.

The study has the potential to identify culturally appropriate health communication interventions not only to improve medication adherence but to address stress and anxiety of both patients with schizophrenia and their caregivers including their family members in Ghana, and could lead to outcomes that can be widely disseminated in low- and middle-income countries where WhatsApp is often used to share videos and messages.