The MindSKILLZ sport-based mental health promotion intervention for adolescents in Kenya: a mixed methods pilot study

Young people in Eastern and Southern Africa face critical mental health challenges, and most have little or no access to mental health care and support. MindSKILLZ is a sport-based mental health promotion and prevention intervention delivered to adolescents aged 10-14 by trained near-peer mentors (Coaches). A pragmatic pilot study was undertaken in Nairobi and Mombasa counties of Kenya to: (a) assess preliminary effects on adolescents' mental health outcomes (assets, depression, emotional conduct problems, and wellbeing); (b) explore effects on Coaches' mental health; and (c) understand program acceptability and potential sustainability and scalability.

This pilot drew on mixed methods. An interrupted time series (ITS) design was used, with surveys administered to participants four times: twice before and twice after the intervention. Focus group discussions and key informant interviews were conducted with adolescent participants, Coaches, and key County Department of Health and implementing stakeholders post intervention. Data were analyzed using segmented fixed effects regression and a thematic qualitative analysis approach.

Surveys from 251 participants showed positive trends across all quantitative measures, though results were not statistically significant. Mental wellbeing, depression symptoms, mental health stigma, support seeking, emotional symptoms, and conduct problems improved from Time 2 (pre-intervention) to Time 3 (immediately post-intervention) - and these improvements mostly grew stronger at Time 4 (follow up). Participants described enhanced coping skills and improved stress and anger management from MindSKILLZ. Coaches described increased mental health knowledge, coping skills, patience, cooperation, and self-esteem. MindSKILLZ was highly acceptable, with key stakeholders mostly highlighting its potential for sustainability and scale given its low resource demands.

Findings demonstrate high program acceptability and suggest promising effects on adolescent wellbeing and other key mental health outcomes. The intervention can potentially address a critical mental health service gap, as it can be universally delivered by lay providers.