Effectiveness of BëST social support model on mental health outcomes among university students in western Kenya: A quasi-experimental design

Doris Tuitoek; Peter Odera; Tecla Sum Psusma; Gladys Mengich

doi:10.51867/ajernet.6.3.4

Auteurs

Doris Tuitoek
dorischeta@gmail.com
Masinde Muliro University of Science & Technology, Kenya https://orcid.org/0000-0001-8472-1208
Peter Odera Masinde Muliro University of Science and Technology, Kenya https://orcid.org/0000-0002-0493-3620
Tecla Sum Psusma Masinde Muliro University of Science and Technology, Kenya https://orcid.org/0000-0001-7345-4714
Gladys Mengich Masinde Muliro University of Science and Technology, Kenya https://orcid.org/0000-0003-3966-5854

Mots-clés :

BëST Support Model, Intimate Partner Violence, Mental Health Outcomes, University Students, Kenya

Résumé

Intimate partner violence (IPV) is a form of abusive behaviour that can occur in marriage, cohabitation, or any other type of partnership and includes physical, sexual, or psychological abuse. Numerous studies have established the detrimental effects of intimate partner violence on mental health. There is growing evidence that social support may help alleviate these negative effects; thus, this study examined the BeST (Belongingness, Evaluation/Appraisal, Self-esteem, and Tangible) support model derived from the social support theory in alleviating the effects of mental health. This study aimed at evaluating the effectiveness of the BëST support model and factors that influence its effectiveness among victims of intimate partner violence in universities in Western Kenya. This study adopted a quasi-experimental design that recruited university students from the four public institutions in Western Kenya who had experienced any form of IPV since admission to the university. The study enrolled 426 participants: 210 in the treatment group and 216 in the control group. Two universities with the highest prevalence rates were recruited into the intervention group, while those with lower prevalence rates were recruited into the control group. The participants were recruited through snowball sampling, and data was collected at baseline and one and three months post-intervention using a self-administered questionnaire that had screening tools for anxiety, depression, and post-traumatic stress disorders (PTSD). The control group went through unstructured group counselling, while the treatment group underwent the BëST model twice weekly for a period of four weeks; in addition, a counsellor was present during the study period. Data was analysed by use of Statistical Analysis Software, where an Analysis of Variance was used to assess mental health outcomes at baseline, one- and three-months post-intervention, and multiple regression was done to identify factors that affect the model’s effectiveness in improving mental health outcomes. There was a significant decrease in mean scores in all the mental health outcomes from baseline to 3 months post-intervention. The average scores for depression went down from 9.90 to 3.41, anxiety from 7.84 to 2.68, and PTSD from 1.6 to 1.1 in the treatment group, with both the treatment and control groups showing a significant change over time in anxiety and depression (p<0.0001), but not in PTSD. There was a lower likelihood of depression among those who never used illegal drugs, while PTSD was low among participants who never consumed alcohol. This study found that the BëST support model was effective in alleviating anxiety and depression; however, it was not effective in alleviating PTSD. In addition, the use of illegal substances and alcohol affected the model's effectiveness. Recommendations: This study recommends adoption of the model and identification of complementary interventions for IPV victims with PTSD.

Dimensions

REFERENCES

Allen, K.-A., Gray, D. L., Baumeister, R. F., & Leary, M. R. (2022). The need to belong: A deep dive into the origins, implications, and future of a foundational construct. Educational Psychology Review, 34(2), 1133-1156. https://doi.org/10.1007/s10648-021-09633-6

Allen, K.-A., Slaten, C., Hong, S., Lan, M., Craig, H., May, F., & Counted, V. (2024). Belonging in higher education: A twenty-year systematic review. Journal of University Teaching and Learning Practice, 21(05), 1-55. https://doi.org/10.53761/s2he6n66

Armoon, B., SoleimanvandiAzar, N., Fleury, M.-J., Noroozi, A., Bayat, A.-H., Mohammadi, R., Ahounbar, E., & Fattah Moghaddam, L. (2021). Prevalence, sociodemographic variables, mental health condition, and type of drug use associated with suicide behaviors among people with substance use disorders: A systematic review and meta-analysis. Journal of Addictive Diseases, 39(4), 550-569.

https://doi.org/10.1080/10550887.2021.1912572

Benavides, M. O., Berry, O. O., & Mangus, M. (2019). Intimate partner violence: A guide for psychiatrists treating IPV survivors. American Psychiatric Association.

Berkman, L. F., Kawachi, I., & Glymour, M. M. (2014). Social epidemiology. Oxford University Press.

https://doi.org/10.1093/med/9780195377903.001.0001

Block, P. (2018). Community: The structure of belonging. Berrett-Koehler Publishers.

Breiding, M. J. (2015). Intimate partner violence surveillance: Uniform definitions and recommended data elements. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention.

Calhoun, C. D., Stone, K. J., Cobb, A. R., Patterson, M. W., Danielson, C. K., & Bendezú, J. J. (2022). The role of social support in coping with psychological trauma: An integrated biopsychosocial model for posttraumatic stress recovery. Psychiatr Q, 93(4), 949-970. https://doi.org/10.1007/s11126-022-10003-w

Canady, B. E., & Babcock, J. C. (2009). The protective functions of social support and coping for women experiencing intimate partner abuse. Journal of Aggression, Maltreatment & Trauma, 18(5), 443-458. https://doi.org/10.1080/10926770903051009

Cantor, A. G., Nelson, H. D., Pappas, M., Atchison, C., Hatch, B., Huguet, N., Flynn, B., & McDonagh, M. (2023). Telehealth for women's preventive services for reproductive health and intimate partner violence: A comparative effectiveness review. Journal of General Internal Medicine, 38(7), 1735-1743. https://doi.org/10.1007/s11606-023-08033-6

Clemente-Teixeira, M., Magalhães, T., Barrocas, J., Dinis-Oliveira, R. J., & Taveira-Gomes, T. (2022). Health outcomes in women victims of intimate partner violence: A 20-year real-world study. International Journal of Environmental Research and Public Health, 19(24), 34-38. https://doi.org/10.3390/ijerph192417035

Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine, 38(5), 300-314.

https://doi.org/10.1097/00006842-197609000-00003

Cohen, S., & Hoberman, H. M. (1983). Positive events and social supports as buffers of life change stress 1. Journal of Applied Social Psychology, 13(2), 99-125. https://doi.org/10.1111/j.1559-1816.1983.tb02325.x

Constantino, R. E., & Bricker, P. L. (1997). Social support, stress, and depression among battered women in the judicial setting. Journal of the American Psychiatric Nurses Association, 3(3), 81-88.

https://doi.org/10.1177/107839039700300305

https://doi.org/10.1016/S1078-3903(97)90022-7

Constantino, R. E., Braxter, B., Ren, D., Burroughs, J. D., Doswell, W. M., Wu, L., Hwang, J. G., Klem, M. L., Joshi, J. B., & Greene, W. B. (2015). Comparing online with face-to-face HELPP intervention in women experiencing intimate partner violence. Issues in Mental Health Nursing, 36(6), 430-438. https://doi.org/10.3109/01612840.2014.991049

Crocker, C. E., Carter, A. J., Emsley, J. G., Magee, K., Atkinson, P., & Tibbo, P. G. (2021). When cannabis use goes wrong: Mental health side effects of cannabis use that present to emergency services. Frontiers in Psychiatry, 12, 640222.

https://doi.org/10.3389/fpsyt.2021.640222

Danielson, C. K., Hahn, A. M., Bountress, K. E., Adams, Z. W., Calhoun, C., Amstadter, A. B., & Thomas, S. (2021). Associations of subjective and objective stress responses with interpersonal trauma, PTSD, stress-induced drinking, and drinking to cope in young adults. Psychology of Addictive Behaviors, 35(1), 29. https://doi.org/10.1037/adb0000700

Dias, N. G., Costa, D., Soares, J., Hatzidimitriadou, E., Ioannidi-Kapolou, E., Lindert, J., Sundin, Ö., Toth, O., Barros, H., & Fraga, S. (2018). Social support and the intimate partner violence victimization among adults from six European countries. Family Practice, 36(2), 117-124. https://doi.org/10.1093/fampra/cmy042

Dougherty, K. D., & Whitehead, A. L. (2011). A place to belong: Small group involvement in religious congregations. Sociology of Religion, 72(1), 91-111. https://doi.org/10.1093/socrel/srq067

Emezue, C., Chase, J. A. D., Udmuangpia, T., & Bloom, T. L. (2022). Technology‐based and digital interventions for intimate partner violence: A systematic review and meta‐analysis. Campbell Systematic Reviews, 18(3), e1271. https://doi.org/10.1002/cl2.1271

Gulati, G., & Kelly, B. D. (2020). Domestic violence against women and the COVID-19 pandemic: What is the role of psychiatry? International Journal of Law and Psychiatry, 71(4), 101594. https://doi.org/10.1016/j.ijlp.2020.101594

Guntzviller, L. M., Williamson, L. D., & Ratcliff, C. L. (2020). Stress, social support, and mental health among young adult Hispanics. Family & Community Health, 43(1), 82-91. https://doi.org/10.1097/FCH.0000000000000224

Handley, M. A., Lyles, C. R., McCulloch, C., & Cattamanchi, A. (2018). Selecting and improving quasi-experimental designs in effectiveness and implementation research. Annual Review of Public Health, 39, 5-25. https://doi.org/10.1146/annurev-publhealth-040617-014128

House, J. S. (1981). Work stress and social support. Addison-Wesley Publishing Company. https://books.google.co.ke/books?id=qO2RAAAAIAAJ

House, J. S. (1983). Work stress and social support. Addison-Wesley series on occupational stress. https://cir.nii.ac.jp/crid/1573387450356124032

Ignaszewski, M. J. (2021). The epidemiology of drug abuse. The Journal of Clinical Pharmacology, 61(5), S10-S17.

https://doi.org/10.1002/jcph.1937

Johnson, D. R., Soldner, M., Leonard, J. B., Alvarez, P., Inkelas, K. K., Rowan-Kenyon, H. T., & Longerbeam, S. D. (2007). Examining sense of belonging among first-year undergraduates from different racial/ethnic groups. Journal of College Student Development, 48(5), 525-542.

https://doi.org/10.1353/csd.2007.0054

Jose, R., & Novaco, R. W. (2016). Intimate partner violence victims seeking a temporary restraining order: Social support and resilience attenuating psychological distress. Journal of Interpersonal Violence, 31(20), 3352-3376. https://doi.org/10.1177/0886260515584352

Karakurt, G., Koç, E., Katta, P., Jones, N., & Bolen, S. D. (2022). Treatments for female victims of intimate partner violence: Systematic review and meta-analysis. Frontiers in Psychology, 13, 793021. https://doi.org/10.3389/fpsyg.2022.793021

King, P. E. (2019). Religion and identity: The role of ideological, social, and spiritual contexts. In Beyond the self (1st ed., pp. 197-204). Routledge.

https://doi.org/10.4324/9780203764688-11

KNBS. (2023). Kenya demographic and health survey 2022. Kenya National Bureau of Statistics.

Kort-Butle, L. (2017). Social support theory: The encyclopaedia of juvenile delinquency and justice. In Wiley Blackwell.

https://doi.org/10.1002/9781118524275.ejdj0066

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ‐9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

Lakey, B., & Cohen, S. (2000). Social support theory and measurement. In S. Cohen, L. G. Underwood, & B. H. Gottlieb (Eds.), Social support measurement and intervention: A guide for health and social scientists (pp. 29-52). Oxford University Press. https://doi.org/10.1093/med:psych/9780195126709.003.0002

Leahy-Warren, P. (2014). Social support theory. In Theories guiding nursing research and practice: Making nursing knowledge development explicit (pp. 85-101). Springer Publishing Company. https://doi.org/10.1891/9780826164056.0006

Lewer, D., Freer, J., King, E., Larney, S., Degenhardt, L., Tweed, E. J., Hope, V. D., Harris, M., Millar, T., & Hayward, A. (2020). Frequency of health‐care utilization by adults who use illicit drugs: A systematic review and meta‐analysis. Addiction, 115(6), 1011-1023.

https://doi.org/10.1111/add.14892

Li, G., Sun, X., Gao, T., Liang, K., Wu, M., Zhu, Y., Gao, X., Li, P., Kong, Y., & Shu, J. (2024). Analysis of risk factors and construction of a prediction model for posttraumatic stress disorder among Chinese college students during the COVID-19 pandemic. Journal of Affective Disorders, 362(5), 230-236. https://doi.org/10.1016/j.jad.2024.06.111

Lin, H.-F., Postmus, J. L., Hu, H., & Stylianou, A. M. (2023). IPV experiences and financial strain over time: Insights from the blinder-oaxaca decomposition analysis. Journal of Family and Economic Issues, 44(2), 434-446. https://doi.org/10.1007/s10834-022-09847-y

Mahapatro, M., Prasad, M. M., & Singh, S. P. (2021). Role of social support in women facing domestic violence during lockdown of COVID-19 while cohabiting with the abusers: Analysis of cases registered with the family counseling centre, Alwar, India. Journal of Family Issues, 42(11), 2609-2624. https://doi.org/10.1177/0192513x20984496

Moeller, R. W., Seehuus, M., & Peisch, V. (2020). Emotional intelligence, belongingness, and mental health in college students. Frontiers in Psychology, 11, 499794. https://doi.org/10.3389/fpsyg.2020.00093

Niwenahisemo, L. C., Hong, S., & Kuang, L. (2024). Assessing anxiety symptom severity in Rwandese adolescents: Cross-gender measurement invariance of GAD-7. Frontiers in Psychiatry, 15, 1346267. https://doi.org/10.3389/fpsyt.2024.1346267

Ogbe, E., Harmon, S., Van den Bergh, R., & Degomme, O. (2020). A systematic review of intimate partner violence interventions focused on improving social support and/mental health outcomes of survivors. PLoS One, 15(6), e0235177. https://doi.org/10.1371/journal.pone.0235177

Omowumi, O. O., & Olufunmilayo, I. F. (2024). Perceived social support and the experience of intimate partner violence among married and cohabiting young women in urban slums, Ibadan, Nigeria: A descriptive study. BMJ Public Health, 2(1), e000425. https://doi.org/10.1136/bmjph-2023-000425

Pasinringi, M. A. A., Vanessa, A. A., & Sandy, G. (2022). The relationship between social support and mental health degrees in emerging adulthood of students. Golden Ratio of Social Science and Education, 2(1), 12-23. https://doi.org/10.52970/grsse.v2i1.162

Perry, J. C., & Lavins-Merillat, B. D. (2018). Self-esteem and school belongingness: A cross-lagged panel study among urban youth. Professional School Counseling, 22(1), 2156759X19826575. https://doi.org/10.1177/2156759X19826575

Prins, A., Bovin, M. J., Smolenski, D. J., Marx, B. P., Kimerling, R., Jenkins-Guarnieri, M. A., Kaloupek, D. G., Schnurr, P. P., Kaiser, A. P., & Leyva, Y. E. (2016). The primary care PTSD screen for DSM-5 (PC-PTSD-5): Development and evaluation within a veteran primary care sample. Journal of General Internal Medicine, 31(10), 1206-1211. https://doi.org/10.1007/s11606-016-3703-5

Richardson, R. A., Haight, S. C., Hagaman, A., Sikander, S., Maselko, J., & Bates, L. M. (2022). Social support and intimate partner violence in rural Pakistan: A longitudinal investigation of the bi-directional relationship. SSM-Population Health, 19, 101173. https://doi.org/https://doi.org/10.1016/j.ssmph.2022.101173

Robinson, L. D., & Deane, F. P. (2022). Substance use disorder and anxiety, depression, eating disorder, PTSD, and phobia comorbidities among individuals attending residential substance use treatment settings. Journal of Dual Diagnosis, 18(3), 165-176. https://doi.org/10.1080/15504263.2022.2090648

Santos, A., Matos, M., & Machado, A. (2016). Effectiveness of a group intervention program for female victims of intimate partner violence. Small Group Research, 48(1), 34-61. https://doi.org/10.1177/1046496416675226

Sanz-Barbero, B., Barón, N., & Vives-Cases, C. (2019). Prevalence, associated factors and health impact of intimate partner violence against women in different life stages. PLoS One, 14(10), e0221049. https://doi.org/10.1371/journal.pone.0221049

Sardinha, L., Maheu-Giroux, M., Stöckl, H., Meyer, S. R., & García-Moreno, C. (2022). Global, regional, and national prevalence estimates of physical or sexual, or both, intimate partner violence against women in 2018. The Lancet, 399(10327), 803-813.

https://doi.org/10.1016/S0140-6736(21)02664-7

Schultz, K., Walls, M., & Grana, S. J. (2021). Intimate partner violence and health: The roles of social support and communal mastery in five American Indian communities. Journal of Interpersonal Violence, 36(13-14), NP6725-NP6746. https://doi.org/10.1177/0886260518821463

Simons, H. R., Thorpe, L. E., Jones, H. E., Lewis, J. B., Tobin, J. N., & Ickovics, J. R. (2020). Perinatal depressive symptom trajectories among adolescent women in New York City. Journal of Adolescent Health, 67(1), 84-92. https://doi.org/10.1016/j.jadohealth.2019.12.017

Simpson, T. L., Kaysen, D. L., Fleming, C. B., Rhew, I. C., Jaffe, A. E., Desai, S., Hien, D. A., Berliner, L., Donovan, D., & Resick, P. A. (2022). Cognitive processing therapy or relapse prevention for comorbid posttraumatic stress disorder and alcohol use disorder: A randomized clinical trial. PLOS One, 17(11), e0276111. https://doi.org/10.1371/journal.pone.0276111

Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092-1097. https://doi.org/10.1001/archinte.166.10.1092

Stark, L., Seff, I., Mutumba, M., & Fulu, E. (2023). Intimate partner violence and mental health: Deepening our understanding of associations, pathways, and prevention in low-and middle-income countries. In (Vol. 20, pp. 1505): MDPI. https://doi.org/10.3390/ijerph20021505

Stewart, D. E. (2006). The international consensus statement on women's mental health and the WPA consensus statement on interpersonal violence against women. World Psychiatry, 5(1), 61.

Stylianou, A. M., Counselman-Carpenter, E., & Redcay, A. (2021). "My sister is the one that made me stay above water": How social supports are maintained and strained when survivors of intimate partner violence reside in emergency shelter programs. Journal of Interpersonal Violence, 36(13-14), 6005-6028. https://doi.org/10.1177/0886260518816320

Tejada, J. J., & Punzalan, J. R. B. (2012). On the misuse of Slovin's formula. The Philippine Statistician, 61(1), 129-136.

Tonsing, K. N., Tonsing, J. C., & Orbuch, T. (2021). Domestic violence, social support, coping and depressive symptomatology among South Asian women in Hong Kong. Journal of Loss & Trauma, 26(2), 134-152. https://doi.org/10.1080/15325024.2020.1738056

Voth Schrag, R. J., Ravi, K. E., & Robinson, S. R. (2020). The role of social support in the link between economic abuse and economic hardship. Journal of Family Violence, 35(1), 85-93. https://doi.org/10.1007/s10896-018-0019-8

Williams, P., Barclay, L., & Schmied, V. (2004). Defining social support in context: A necessary step in improving research, intervention, and practice. Qualitative Health Research, 14(7), 942-960. https://doi.org/10.1177/1049732304266997

Wright, E. N., Anderson, J., Phillips, K., & Miyamoto, S. (2022). Help-seeking and barriers to care in intimate partner sexual violence: A systematic review. Trauma, Violence, & Abuse, 23(5), 1510-1528. https://doi.org/10.1177/1524838021998305

Zharima, C., Singh, R., Closson, K., Beksinska, M., Zulu, B., Jesson, J., Pakhomova, T., Dong, E., Dietrich, J., Kaida, A., & Basham, C. A. (2024). Economic hardship and perpetration of intimate partner violence by young men in South Africa during the COVID-19 pandemic (2021-2022): A cross-sectional study. Injury Epidemiology, 11(1), 2. https://doi.org/10.1186/s40621-024-00483-8

Žukauskienė, R., Kaniušonytė, G., Bergman, L. R., Bakaitytė, A., & Truskauskaitė-Kunevičienė, I. (2021). The role of social support in identity processes and posttraumatic growth: A study of victims of intimate partner violence. Journal of Interpersonal Violence, 36(15-16), 7599-7624.

https://doi.org/10.1177/0886260519836785