Background
Understanding and addressing the unmet mental health needs burden in the
Northern Province of Sri Lanka is the subject of the COMGAP-S two-phase study.
Phase Two involves the implementation of the World Health Organization’s mental
health Gap Action Programme (mhGAP) in primary healthcare settings. As part of
the contextual adaptation of mhGAP, eleven of the videos provided in the mhGAP
training package have been re-filmed by a local team. We investigated the
challenges, barriers and good practices of this adaptation effort from the
point of view of team participants. Methods Twelve persons from the adaptation
team, including students of medicine and drama, doctors, drama lecturers and
professionals, consented to in-depth individual interviews following an
open-ended topic guide with a member of the COMGAP-S study team. Interviews
were recorded, transcribed, translated as necessary, and subjected to thematic
analysis. Results The majority of participants perceived the process positively
and had pride in their involvement. Expectations, opportunities, and exposure
were discussed as stemming from the video production. The main challenges
derived from the analysis were lack of discussion around budgeting, logistical
difficulties, struggles with team cooperation, and creative differences. Issues
around exact translation into the local Tamil dialect and modelling around
mental health were emphasised by the majority of participants. Potential uses
for the videos were identified beyond the current study and recommendations
included setting out clear guidance around available funding and role
allocation, and increasing the flexibility in adapting the material.
Conclusions This study illustrated details of the adaptation of existing video
materials to facilitate locally-based training for non-specialists on mhGAP
curricula. With this, we have added to the knowledge base on conducting
cultural and language adaptations and our findings indicate participants felt
adapting the mhGAP films to local context was vital to ensuring training
materials were culturally appropriate and valid. Trial registration This
project was nested within the larger COMGAP-S clinical trial. Ethics approval
was granted from the Ethics Review Committee, Faculty of Medicine, University
of Jaffna (J/ERC/17/81/NDR/0170) and the Faculty Research Ethics Panel, Faculty
of Medical Science, Anglia Ruskin University (SC/jc/FMSFREP/16/17076). The
project is registered with the Sri Lankan Clinical Trial Registry
(SLCTR/2018/008) and listed on the ISRCTN registry (trial ID ISRCTN62598070 ).