The Research Problem
Depression is a widespread problem among university students. These students are burdened with psychological changes such as leaving home, friends, and adjustment to a new system of learning. Additionally, the transition from adolescence to adulthood leads to anxiety among students, which triggers stress and depression.
Depression has adverse effects, which include low academic achievement, reduced functionality at both household and social levels, psychiatric disorders, and may lead to suicidal tendencies. COVID-19 created an environment that worsened the state of mental health among young people. Travel restrictions prevented social interactions with peers, which led to increased psychological stress. There is no special studies and interventions for depression targeting university students. In addition, most of these studies do not focus on university students and the prevalence levels of depression are unknown particularly in the post COVID-19 period.
This study therefore aims at establishing the prevalence of depression, its correlates, and contextual variation among Ugandan university students. Additionally, this study will contextualise, implement, and assess the effectiveness of an evidence based Wellness4Students program (which is part of the ResilienceNHope suite of supportive and informative text/email messaging interventions) for mitigating depression symptoms among the students.
Research Design
The study will focus on university students aged 19-24 in two Ugandan universities, encompassing diverse student profiles, including refugees and people with disabilities, across different study years of undergraduate programs. To achieve its objectives, the research will employ a robust mixed-methods approach. It will utilise a cross-sectional design, with data collection taking place at Makerere University (urban) and Busitema University (rural).
Sample size determination, using the Kish formula, will consider a 30% assumed depression rate from past studies and a 5% allowable error. Probability proportional to size design will guide sample allocation, and the cluster design will be accounted for by the design effect in sample size estimation. Quantitative data will be collected virtually or through computer-assisted personal interviews (CAPI) using the KoboCollect software, employing a structured questionnaire based on the Patient Depression Health Tool (PHQ-9) [7]. Students will be invited to self-subscribe to the Wellness4Students program to receive CBT based supportive text messages with or without embedded weblinks to mental health literacy resources for six months. The text messages would have embedded survey links on enrolment (baseline), six weeks, three months, and six months (end point).
Baseline data will be analysed for prevalence and correlates of depression (primary outcome). Follow-up data will be analysed along with the primary data to assess the impact of the Wellness4MDs program on depression symptoms. Qualitative data will be acquired through key informant interviews (counsellors in the university hospitals, lecturers, and student leaders) and four focus group discussions, two from each university. Trained research assistants, proficient in English, will conduct interviews.
Data analysis will be conducted with Stata version 18, encompassing descriptive statistics, prevalence estimation, bivariate analyses, and multivariable analysis, controlling for background characteristics. Paired t-test and chi-square analysis would be used to assess changes in prevalence and severity of depression symptoms in the students from baseline to the various data collection time points. Findings will be reported at a 95% confidence level with a significance level of 5% (0.05). Qualitative data will undergo thematic analysis utilising NVivo software. We will obtain ethical clearance from research ethics committees and Uganda National Council of Science and Technology (UNCST). In addition, voluntary participation, confidentiality, and counseling support will be obtained and provided to the students.
Project Objectives
The main objective of this study is to establish the prevalence of depression, its correlates, and contextual variation among Ugandan university students. Additionally, this study will contextualise, implement, and assess the effectiveness of an evidence based Wellness4Students program (which is part of the ResilienceNHope suite of supportive and informative text/email messaging interventions) for mitigating depression symptoms among the students
The team will conduct a comprehensive investigation into the prevalence of depression among university students in Uganda, with a specific focus on the post-COVID-19 pandemic period. A secondary goal of the project is to contextualise, implement, and assess the effectiveness of the Canadian innovation, the Wellness4Students program, in mitigating depression symptoms among university students in Uganda.
The project is designed to shed light on the multifaceted nature of depression in this critical group by exploring the factors that correlate with depressive symptoms and examining how the prevalence of depression varies between urban and rural areas as well as workable solutions.
