Perceptions of a Culturally Tailored Narrative Video for Skin Cancer Prevention Among Spanish-Speaking Hispanic Outdoor Workers: Exploratory Study.

Mental health conditions affect millions worldwide, causing significant disability and high economic and social costs []. The burden is particularly high in conflict-affected populations, with estimates from a 2019 systematic review and meta-analysis indicating that more than 1 in 5 people (22.1%, 95% uncertainty interval 18.8%-25.7%) experience mental disorders such as depression, anxiety, posttraumatic stress disorder (PTSD), bipolar disorder, or schizophrenia []. Additionally, the prevalence of depression and anxiety in these settings is approximately 5 times higher than the global average at 10.8% and 21.7%, respectively []. To achieve equitable global mental health, “task sharing” and community-based interventions have been identified as key innovations to be promoted and prioritized []. Growing evidence shows that nonprofessionals or lay coaches ease the burden on the health system and can effectively provide counseling for common mental health disorders (CMDs) such as depression and anxiety after receiving training from professionals [,]. These coaches can be recruited from the communities they serve and may even be peers []. Studies in low- and middle-income countries have found that such interventions have the potential to reduce symptoms of trauma, depression, and anxiety []. An example is Zimbabwe’s Friendship Bench, where community grandmothers were trained to deliver problem-solving therapy for CMDs []. In a randomized controlled trial in Zimbabwe with 573 adults screening positive for CMDs, the intervention led to significant improvements in primary CMD outcomes (measured using the Shona Symptom Questionnaire), as well as reductions in secondary depressive symptoms (measured using the Patient Health Questionnaire) at 6 months []. Inuka Coaching is a digital version of the Friendship Bench method and has been piloted in Kenya [] and Zimbabwe []. Clients first take a 20-question scan, the Self-Reporting Questionnaire–20 (SRQ-20), and are subsequently linked to a certified coach for text or video sessions. The SRQ-20 is a tool developed by the World Health Organization to screen for CMDs and consists of 20 brief “yes” or “no” questions assessing symptoms of anxiety, depression, and somatic distress experienced over the preceding month []. Each Inuka Coaching session begins with active listening, where clients identify their concerns, select a primary issue to address, brainstorm solutions, and then collaboratively develop an action plan for follow-up. The coach refers clients needing specialized support to mental health professionals. Session quality is ensured through a structured quality assurance process that includes regular transcript reviews by certified psychiatrists, coach performance ratings, and the use of pre- and postintervention assessments to monitor client progress.