Puja Patel1, Bonnie N Kaiser2, Christina S Meade3, Ali Giusto4, David Ayuku5, Eve Puffer4. 1. Duke Global Health Institute, Duke University, Durham, NC, USA; Psychology, University of North Carolina Greensboro, Greensboro, NC, USA. Electronic address: pppatel2@uncg.edu. 2. Duke Global Health Institute, Duke University, Durham, NC, USA; Anthropology, University of California San Diego, La Jolla, CA, USA. 3. Duke Global Health Institute, Duke University, Durham, NC, USA; Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA. 4. Duke Global Health Institute, Duke University, Durham, NC, USA; Psychology and Neuroscience, Duke University, Durham, NC, USA. 5. Behavioral Sciences, Moi University, Eldoret, Kenya.
Abstract
BACKGROUND: In Kenya, the prevalence of alcohol use disorder (AUD) is close to 6%, but a notable treatment gap persists. AUD is especially pronounced among men, leading to negative consequences at both individual and family levels. This study examines the experiences of problem-drinking fathers in Kenya regarding previous treatment-seeking related to alcohol use. Experiences and dynamics of the family are also explored as they pertain to treatment-seeking experiences. METHODS: In Eldoret, Kenya, semi-structured qualitative interviews were conducted with 11 families with a male exhibiting problem drinking, his spouse, and one child. Thematic content analysis was used to examine themes related to barriers and facilitators to treatment. RESULTS: Participants only reported informal help received from family and community members; they exhibited little awareness of available formal treatments. Families were both deeply affected by alcohol use and actively involved in help-seeking. Indeed, fathers' experiences are described as help-accepting rather than help-seeking. Three overarching themes emerged from the results: poverty, people, and practices. Poverty could be a motivator to accept help to support one's family financially, but stress from lack of work also drove drinking behaviours. People were also crucial as both barriers and facilitators of help-accepting. Negative help strategies or peer influence deterred fathers from accepting help to quit. Positive motivation, social support, and stigma against drinking were motivators. Practices that were culturally salient, such as religiosity and gender roles, facilitated help acceptance. Overall, most help efforts were short-term and only lead to very short-term behaviour change. CONCLUSION: Families and communities are active in help provision for problem-drinking men in Kenya, though results confirm remaining need for effective interventions. Future interventions could benefit from recognizing the role of family to aid in treatment-engagement and attending to the importance of poverty, people, and practices in designing treatment strategies.
BACKGROUND: In Kenya, the prevalence of alcohol use disorder (AUD) is close to 6%, but a notable treatment gap persists. AUD is especially pronounced among men, leading to negative consequences at both individual and family levels. This study examines the experiences of problem-drinking fathers in Kenya regarding previous treatment-seeking related to alcohol use. Experiences and dynamics of the family are also explored as they pertain to treatment-seeking experiences. METHODS: In Eldoret, Kenya, semi-structured qualitative interviews were conducted with 11 families with a male exhibiting problem drinking, his spouse, and one child. Thematic content analysis was used to examine themes related to barriers and facilitators to treatment. RESULTS:Participants only reported informal help received from family and community members; they exhibited little awareness of available formal treatments. Families were both deeply affected by alcohol use and actively involved in help-seeking. Indeed, fathers' experiences are described as help-accepting rather than help-seeking. Three overarching themes emerged from the results: poverty, people, and practices. Poverty could be a motivator to accept help to support one's family financially, but stress from lack of work also drove drinking behaviours. People were also crucial as both barriers and facilitators of help-accepting. Negative help strategies or peer influence deterred fathers from accepting help to quit. Positive motivation, social support, and stigma against drinking were motivators. Practices that were culturally salient, such as religiosity and gender roles, facilitated help acceptance. Overall, most help efforts were short-term and only lead to very short-term behaviour change. CONCLUSION: Families and communities are active in help provision for problem-drinking men in Kenya, though results confirm remaining need for effective interventions. Future interventions could benefit from recognizing the role of family to aid in treatment-engagement and attending to the importance of poverty, people, and practices in designing treatment strategies.
Authors: K M Keyes; M L Hatzenbuehler; K A McLaughlin; B Link; M Olfson; B F Grant; D Hasin Journal: Am J Epidemiol Date: 2010-11-02 Impact factor: 4.897
Authors: Christina S Meade; Sheri L Towe; Melissa H Watt; Ryan R Lion; Bronwyn Myers; Donald Skinner; Stephen Kimani; Desiree Pieterse Journal: Drug Alcohol Depend Date: 2015-04-30 Impact factor: 4.492
Authors: Vikram Patel; Ricardo Araya; Sudipto Chatterjee; Dan Chisholm; Alex Cohen; Mary De Silva; Clemens Hosman; Hugh McGuire; Graciela Rojas; Mark van Ommeren Journal: Lancet Date: 2007-09-15 Impact factor: 79.321
Authors: Abhijit Nadkarni; Benedict Weobong; Helen A Weiss; Jim McCambridge; Bhargav Bhat; Basavaraj Katti; Pratima Murthy; Michael King; David McDaid; A-La Park; G Terence Wilson; Betty Kirkwood; Christopher G Fairburn; Richard Velleman; Vikram Patel Journal: Lancet Date: 2016-12-15 Impact factor: 79.321
Authors: Ali Giusto; Savannah L Johnson; Kathryn L Lovero; Milton L Wainberg; Wilter Rono; David Ayuku; Eve S Puffer Journal: Int J Drug Policy Date: 2021-06-06