In a groundbreaking development in the field of mental health interventions, a novel study protocol has emerged focusing on emotion regulation among young people in Kenya. This pioneering study, spearheaded by researchers Rugendo, Lyimo, Daya, and their colleagues, introduces MAISHA—a blended intervention that aims to address the complex emotional challenges faced by youth in resource-limited settings. The study protocol, detailed in a forthcoming 2025 publication in BMC Psychology, offers a meticulously designed cluster randomized controlled trial (RCT) to test the efficacy and acceptability of this intervention. This initiative not only holds extraordinary promise for improving mental health outcomes but also exemplifies the growing trend of integrating technology with traditional therapy approaches to maximize reach and effectiveness.
Emotion regulation, the ability to manage and respond to emotional experiences in adaptive ways, is a foundational component of psychological wellbeing. Impairments in this domain are linked to a variety of mental health disorders, including anxiety, depression, and behavioral problems, especially in adolescence and young adulthood. In low- and middle-income countries like Kenya, young people face numerous stressors—ranging from economic hardship to social and political instability—that exacerbate emotional distress. However, limited mental health infrastructure and stigma associated with seeking help hinder adequate support. Against this backdrop, MAISHA represents an innovative response tailored to overcome these systemic barriers through a hybrid delivery model.
The MAISHA intervention combines digital and face-to-face components to provide scalable and culturally sensitive support. The digital element features interactive modules, accessible via mobile devices, that educate participants on core emotion regulation skills such as mindfulness, cognitive reappraisal, and distress tolerance. These modules are designed using evidence-based techniques from cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), but contextualized to the Kenyan socio-cultural milieu. Complementing this, group sessions led by trained facilitators foster peer support and real-time practice of emotion regulation strategies, ensuring human connection remains central despite the technological medium.
Crucially, the study employs a cluster randomized controlled trial design—a gold standard for evaluating intervention efficacy—where communities, rather than individuals, are randomly assigned to intervention or control groups. This approach minimizes contamination effects and enhances ecological validity by reflecting real-world implementation conditions. The protocol outlines careful monitoring of participant outcomes using validated psychological scales, alongside qualitative assessments to gauge acceptability and cultural fit. Through this rigorous methodology, the research team aims to dissect not only whether MAISHA works but also how and why it might succeed or fail in different Kenyan contexts.
The anticipated impact of this study transcends immediate clinical benefits. If successful, MAISHA could serve as a blueprint for other low-resource environments grappling with youth mental health challenges. The intervention’s blended structure addresses a critical gap: it leverages ubiquitous mobile technology to extend reach while retaining the nuance of human facilitation necessary for deep behavioral change. By empowering young people with skills to regulate their emotions, MAISHA could foster resilience, reduce maladaptive behaviors, and ultimately contribute to healthier communities. This represents a paradigm shift from reactive, crisis-driven mental health services toward proactive, preventive models.
This research also highlights the potential of digital mental health interventions in sub-Saharan Africa, a region historically underserved in psychiatric care. While mobile phone penetration continues to surge in Kenya and neighboring countries, digital interventions tailored to local languages, cultural norms, and infrastructural realities remain scarce. MAISHA breaks new ground by embedding local stakeholders in its development, ensuring relevance and sustainability. Moreover, the project includes capacity-building components such as training local facilitators, establishing a sustainable referral system, and integrating feedback loops to refine the intervention dynamically.
Another critical dimension of MAISHA is its emphasis on inclusivity and equity. By targeting young people in diverse Kenyan communities, including rural and urban settings, the initiative strives to mitigate disparities in access driven by geography, gender, and socioeconomic status. The cluster RCT design allows for analysis of differential effects, potentially illuminating which subgroups benefit the most or require adaptation. This nuanced understanding can inform policy decisions and resource allocation, fostering more personalized mental health services across heterogeneous populations.
The MAISHA study protocol meticulously documents ethical considerations inherent in research with vulnerable populations. Recognizing the stigma surrounding mental health in many Kenyan societies, the design incorporates stringent confidentiality measures and community sensitization efforts. Informed consent procedures are adapted for youth participants, balancing autonomy with parental involvement where culturally appropriate. Additionally, the inclusion criteria account for comorbidities and ensure that participants with severe mental health needs receive referrals to specialized care, safeguarding participant safety and ethical integrity.
Technological innovation underpins much of MAISHA’s potential for scalability. The intervention’s digital modules are designed for offline use, acknowledging connectivity challenges in some regions. The use of engaging multimedia content—animations, quizzes, videos—enhances user engagement, critical for adherence and behavioral change. The platform architecture supports real-time data collection, enabling adaptive management of the intervention and facilitating impact evaluation. If proven effective, this digital infrastructure can be expanded or customized for other mental health priorities, creating a versatile tool for broader public health initiatives.
The developers of MAISHA are also attuned to challenges that may arise. Cultural stigma around discussing emotions, potential resistance to digital modalities, and variability in facilitator skills are recognized as potential barriers. To mitigate these, the protocol incorporates formative research phases, iterative pilot testing, and ongoing supervision for facilitators. Community advisory boards are engaged to lend local insights and foster trust. Such participatory approaches enhance the acceptability and cultural resonance of the intervention, critical determinants of success beyond mere efficacy.
The publication of this study protocol comes at a pivotal time, as mental health gains increasing visibility on global health agendas. The COVID-19 pandemic has spotlighted the urgent need for accessible, resilient mental health services, especially for young populations. MAISHA’s blended intervention model exemplifies how innovative, contextually-informed solutions can address this need, marrying technology with human connection to enable scalable, meaningful impact. The rigorous evaluation planned will contribute invaluable evidence to the growing literature on digital and hybrid mental health interventions in low-resource settings.
Future implications of this work extend beyond Kenya’s borders. The knowledge generated through this trial could inform global strategies for mental health promotion among youth, particularly in regions facing similar systemic challenges. By disseminating findings through scientific and public channels, Rugendo and colleagues aim to catalyze a movement toward evidence-based, culturally grounded, and technologically savvy mental health services. This aligns with the ongoing evolution of psychiatry and psychology toward integrating digital therapeutics, personalized care, and community empowerment.
Furthermore, MAISHA underscores the critical role of multidisciplinary collaboration. The research team comprises psychologists, public health experts, technology developers, and local community partners, exemplifying the synergy needed to tackle complex health challenges. This collaborative framework optimizes intervention design, implementation, and evaluation, ensuring that the program is scientifically rigorous yet responsive to local realities. Such models are increasingly recognized as essential for sustainable health innovation, particularly when addressing the multifaceted nature of mental health.
In conclusion, the MAISHA intervention represents a bold and thoughtfully engineered response to the pressing mental health needs of Kenyan youth. Its innovative blend of digital and face-to-face components, coupled with a rigorous cluster RCT evaluation, positions it at the forefront of mental health research in low- and middle-income countries. The anticipated insights will not only clarify MAISHA’s efficacy and acceptability but also illuminate pathways for scaling similar interventions globally. As mental health continues to ascend in public consciousness, initiatives like MAISHA offer hope that accessible, culturally attuned, and engaging support can transform the emotional wellbeing of young people worldwide.
Subject of Research:
Efficacy and acceptability of a blended intervention aimed at improving emotion regulation among young people in Kenya.
Article Title:
Efficacy and acceptability of a blended intervention for emotion regulation (MAISHA) among young people in Kenya: study protocol for a cluster RCT.
Article References:
Rugendo, E., Lyimo, G.S., Daya, R. et al. Efficacy and acceptability of a blended intervention for emotion regulation (MAISHA) among young people in Kenya: study protocol for a cluster RCT. BMC Psychol (2025). https://doi.org/10.1186/s40359-025-03837-z
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