An intervention to reduce alcohol use and improve family engagement for fathers in low-resource settings: Development and feasibility testing in Kenya

Men’s alcohol use and co-occurring family problems are critical issues, yet few treatments exist to address these problems in low and middle-income countries (LMICs). This paper describes the development and initial feasibility and acceptability of a novel intervention to address men’s alcohol use and co-occurring family problems. The intervention is based in behavioral activation blended with motivational interviewing and was pilot tested in Kenya. To develop treatment, we engaged in a multi-step, collaborative process with a local Kenyan team. The treatment was piloted with nine fathers reporting problem drinking. To assess initial feasibility and acceptability, recruitment and participation were tracked and descriptive statistics were generated. Semi-structured interviews were conducted with participants and analyzed using thematic content analysis. The development process resulted in a weekly 5-session intervention rooted in behavioral activation, motivational interviewing, and gender transformative strategies. These approaches were combined and adapted to fit contextually salient constructs, such as the importance of the man as provider, and streamlined for lay providers. Feasibility and acceptability results were promising with high attendance, acceptability of implementation strategies and intervention content, and perceived intervention helpfulness. Results describe an acceptable treatment to reduce alcohol use and improve family outcomes in a low-resource context. Findings set the stage for a larger trial.