Abstract:
Abstract
Peer-delivered interventions for adolescent mental health can help address poor access to mental health interventions. Ques-
tions remain about how interventions can be adapted for peer delivery and whether peers can be trained. In this study, we
adapted problem solving therapy (PST) for peer-delivery with adolescents in Kenya and explored whether peer counselors can
be trained in PST. We adapted treatment prior to and during training using the Cultural Adaptation and Contextualization for
Implementation framework. Nine peer counselors (Ages 20–24) were selected and trained over 10 days. Peer competencies
and knowledge were measured pre-post using a written exam, a written case study, and role plays rated using a standardized
competency measure. We chose a version of PST used in India with secondary school adolescents originally delivered by
teachers. All materials were translated into Kiswahili. Language and format were adapted to Kenyan adolescents as well as
for delivery by peers with a focus on understandability and relevance (e.g., noting shared experience). Metaphors, examples,
and visual materials were adapted for the context to reflect the culture and vernacular of Kenyan youth. Peer counselors
were able to be trained in PST. Pre-post competencies and understanding of content showed improvements with peers mini-
mally meeting patient needs (pre) on average to moderate/fully meeting patient needs (post). Post-training written exam
score showed an average 90% correct. There is an adapted version of PST for Kenyan adolescents and peer delivery. Peer
counselors can be trained to deliver a 5-session PST in a community context