Bronwyn Myers

• PhD
• Director at Curtin University

Current parent training programs for ADHD do not appear to improve the parent-child attachment relationship, even though the quality of this relationship significantly influences the child's socio-emotional development and wellbeing. This mixed-methods, single-arm feasibility study evaluated the potential of a novel ADHD parenting program that aims...

Sputum cultures are the gold standard for tuberculosis (TB) diagnosis and treatment monitoring. However, cultures in MGIT liquid media are susceptible to microbial contamination, often rendering them uninterpretable. Research has shown that maintaining strict cold chains and supervised sample collection can reduce contamination rates, but few longi...

Background Adverse drug reactions (ADRs) to tuberculosis (TB) medications make treatment completion challenging. We investigated the impact of alcohol, human immunodeficiency virus (HIV), and other patient determinants on ADRs and treatment adherence. Methods We administered monthly ADR questionnaires to participants with TB in Worcester, South Af...

Introduction In South Africa, community-oriented primary care teams work to re-engage out-of-care people with HIV (PWH) in treatment, many of whom have substance use (SU) concerns. SU stigma is high among these teams, limiting care engagement efforts. Integrating peer recovery coaches into community-oriented primary care teams could shift SU stigma...

Objective To examine the experiences of Australian parents raising primary school-aged children with ADHD and gather feedback on a proposed ADHD parenting program. Methods Reflexive thematic analysis of semi-structured interviews undertaken with 11 Australian parents of 7- to 11-year-old children with ADHD. Interviews were conducted over Webex, au...

Purpose Workers’ compensation claims can negatively affect the wellbeing of injured workers. For some, these negative effects continue beyond finalisation of the workers’ compensation claim. It is unclear what factors influence wellbeing following finalisation of a workers’ compensation claim. Therefore, the aim of this study was to explore wellbei...

[This corrects the article DOI: 10.2196/46849.].

BACKGROUND There is a shortage of services available to address the growing demand for mental health support in Australia and worldwide. Digital interventions, including conversational agents, can overcome barriers to accessing mental health support. The recent advances in large language models (LLMs) have led to an improvement in the perceived hum...

Background. Grief is a common experience in adolescence. Evidence-based therapies are not readily accessible for grieving young people. Internet-based cognitive behaviour therapy (CBT) for grief in adolescents has recently been investigated in a pilot randomised controlled trial. Research is required to determine acceptability as this unguided inte...

Objective Injured workers can be disadvantaged after a workers’ compensation claims ends. This study investigated the association of a range of variables with wellbeing in injured workers who had finalised a workers’ compensation claim >3 months prior. Methods On-line, cross-sectional survey (n = 129, 55.81% female). Wellbeing was measured using t...

Introduction Accurate assessment of alcohol use informs prevention and management of liver disease. We examined whether phosphatidylethanol (PEth, an alcohol metabolite) blood concentrations are associated with liver fibrosis risk independently of self-reported alcohol use, among persons with and without HIV. Methods We pooled individual-level dat...

Background The COVID-19 pandemic negatively impacted tuberculosis (TB) treatment services, including directly observed therapy (DOT) programs used to promote medication adherence. We compared DOT adherence embedded in a research study before and after COVID-19 lockdowns in South Africa. Methods We analyzed data from 263 observational study partici...

Objective Diabetes is an incapacitating condition affecting millions of people in South Africa. Maintaining optimal glycaemic control is crucial in preventing diabetes complications, highlighting the importance of diabetes self-care. This study examined how Social Determinants of Health (SDoH) are associated with self-care management practices in i...

Aims The aims of this feasibility trial were to assess the acceptability and feasibility of peer-led recovery groups for people with psychosis in a low-resource South African setting, to assess the feasibility of trial methods, and to determine key parameters in preparation for a definitive trial. Methods The design was an individually randomised...

Aim In South Africa and other low- and middle-income countries (LMIC), personal recovery for people with a severe mental health condition (SMHC) is hampered by lack of community-based support. This paper describes the development of a non-specialist and peer-facilitated recovery intervention (PRIZE) intended as an adjunct to traditional psychiatric...

Grief is highly prevalent in adolescents, however, there have been no studies investigating internet delivered cognitive behaviour therapy for grief in adolescents (ICBT-G-A). In this paper, the co-design of an unguided ICBT-G-A intervention is described, and a protocol outlined for a pilot randomised controlled trial of the intervention. Participa...

Purpose: Workers’ compensation claims can negatively effect the wellbeing of injured workers. For some, these negative effects continue beyond finalisation of the workers’ compensation claim. It is unclear what factors influence wellbeing following finalisation of a workers’ compensation claim. Therefore, the aim of this study was to explore wellbe...

Introduction Autistic young people and/or those with attention deficit hyperactivity disorder (ADHD) who have co-occurring mental health conditions experience significant challenges when transitioning from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). However, barriers and facilitators to this service t...

South Africa has one of the highest prevalence rates globally for fetal alcohol spectrum disorders. Despite this, few interventions are routinely available for countering the adverse effects of perinatal drinking. The current study used the ADAPT-ITT framework to guide the development of a behavioral intervention with remote alcohol use monitoring...

Background Unhealthy alcohol use is widespread in South Africa and has been linked to tuberculosis (TB) disease and poor treatment outcomes. This study used qualitative methods to explore the relationship between TB and alcohol use during TB treatment. Methods Focus group discussions (FGDs) were conducted with 34 participants who had previous or c...

Background The Western Cape region of South Africa has one of the highest global rates of Fetal Alcohol Spectrum Disorder (FASD), underscoring the urgent need for effective interventions. This qualitative study explores pregnant and lactating participants’ perceptions and experiences of a text message and contingency management (CM) intervention....

The prevalence and influence of gangs on adolescents and young adults remain a concern in Western Cape, South Africa—particularly as they have one of the largest gang presence. While less attention has been focused on young women, there is a need to elucidate the relationship between gang exposure and health behaviors, such substance use, in additi...

Background Children with ADHD experience attachment difficulties. They also report poor self-esteem and self-concept, often due to experiences within the parent-child attachment relationship when children are 6-11 years of age (developmental stage, industry versus inferiority). This systematic review examines the efficacy of parent training (PT) fo...

Type 2 Diabetes (T2D) represents a growing disease burden in South Africa. While glycated haemoglobin (HbA1c) testing is the gold standard for long-term blood glucose management, recommendations for HbA1c monitoring frequency are based on expert opinion. This study investigates the effectiveness and cost effectiveness of alternative HbA1c monitorin...

Postgraduate research students have poorer mental health than the general community. Improving their experiences of diversity, inclusion, and belonging at university may bolster their overall wellbeing and reduce poor mental health outcomes. The aim was to explore postgraduate research students’ views on diversity, inclusion, and belonging, to unde...

Background In South Africa, an estimated 11% of the population have high alcohol use, a major risk factor for TB. Alcohol and other substance use are also associated with poor treatment response, with a potential mechanism being altered TB drug pharmacokinetics. Objectives To investigate the impact of alcohol and illicit substance use on the pharm...

Global health reciprocal innovation emphasizes the movement of technologies or interventions between high- and low-income countries to address a shared public health problem, in contrast to unidirectional models of “development aid” or “reverse innovation”. Evidence-based interventions are frequently adapted from the setting in which they were deve...

Background South Africa has the highest rate of fetal alcohol spectrum disorders (FASD) globally. As with alcohol use during pregnancy, alcohol consumption while breastfeeding adversely impacts infant development. We pilot tested an incentive‐based text‐messaging intervention to reduce alcohol use during pregnancy and lactation in South Africa. Me...

Introduction In South Africa (SA), community-oriented primary care (COPC) teams work to re-engage out-of-care people with HIV (PWH) in treatment, many of whom have substance use (SU) concerns. SU stigma is high among these teams, limiting care engagement efforts. Integrating peer recovery coaches (PRCs) into COPC teams could shift SU stigma and imp...

Background More than 57 million people have dementia worldwide. Evidence indicates a change in dementia prevalence and incidence in high-income countries, which is likely to be due to improved life-course population health. Identifying key modifiable risk factors for dementia is essential for informing risk reduction and prevention strategies. We...

South Africa has one of the highest rates of HIV/tuberculosis (TB) co-infection, and poor engagement in HIV/TB care contributes to morbidity and mortality. In South Africa, community health workers (CHWs) are tasked with re-engaging patients who have dropped out of HIV/TB care. CHWs have described substantial challenges with substance use (SU) and...

Background: Self-harm (SH) refers to self-injury or intentional self-poisoning with varying degrees of suicidal intent and is a major public health issue for children and adolescents (C&A) worldwide. Given significant gaps exist in our understanding of the associated psychopathology in C&A, this paper outlines the protocol for a prospective clinica...

Adolescent girls and young women (AGYW) in South Africa experience contextual barriers to HIV risk reduction including incomplete schooling, unintended pregnancy, substance use, and gender-based violence. A cluster randomised trial in Cape Town allocated 24 Black and Coloured communities to a gender-focused HIV risk-reduction intervention or HIV te...

Background People with severe mental health conditions, such as schizophrenia, and their family caregivers are underserved in low- and middle-income countries where structured psychosocial support in the community is often lacking. This can present challenges to recovery and for coping with additional strains, such as a pandemic. Aim This study ex...

Stress is a challenge among non-specialist health workers worldwide, particularly in low-resource settings. Understanding and targeting stress is critical for supporting non-specialists and their patients, as stress negatively affects patient care. Further, stigma toward mental health and substance use conditions also impacts patient care. However,...

Background South Africa has one of the world’s highest rates of foetal alcohol spectrum disorders (FASD). Recent evidence also showed that alcohol use during lactation significantly compromises child development in children exposed to alcohol through breastfeeding, independent of prenatal alcohol exposure. This study explored perceptions of perinat...

Introduction Healthcare workers globally have experienced increased social and occupational stressors in their working environments and communities because of COVID-19 which has increased the risk of mental health concerns. This study aimed to explore the prevalence and correlates of depression and anxiety amongst healthcare workers during the COVI...

Background The term “problem drinking” includes a spectrum of alcohol problems ranging from excessive or heavy drinking to alcohol use disorder. Problem drinking is a leading risk factor for death and disability globally. It has been measured and conceptualised in different ways, which has made it difficult to identify common risk factors for probl...

Aims The aims of this feasibility trial were to assess the acceptability and feasibility of peer-led recovery groups for people with psychosis in a low-resource South African setting, to assess the feasibility of trial methods, and to determine key parameters in preparation for a definitive trial. Methods The design was an individually randomised...

Objective A workers’ compensation claim may have significant negative impacts on an injured worker’s wellbeing. Wellbeing provides a good global measure of potential effects of a claim on an individual, and is important for contemporary economic modelling. The purpose of this study was to synthesize knowledge about the wellbeing of injured workers...

Background South Africa has deployed community health workers (CHWs) to support individuals to enter and stay in HIV/TB care. Although CHWs routinely encounter patients with mental health (particularly depression) and substance use (SU) conditions that impact their engagement in HIV/TB care, CHWs are rarely trained in how to work with these patient...

Substance use disorders (SUDs) are a significant concern for public health. Preliminary research suggests that physical activity (PA) may offer health benefits for individuals in SUD treatment. However, conclusive evidence is still lacking. High relapse rates, the presence of considerable comorbidity, and issues with motivation among people with SU...

Background The COVID-19 pandemic negatively impacted all levels of tuberculosis (TB) treatment services, including directly observed therapy (DOT) programs used to promote medication adherence. We compared the rate of adherence to DOT before and during the pandemic among observational research study participants on drug-susceptible (DS)-TB therapy...

Background Condom use among young people in South Africa has declined in recent years and adolescent girls and young women continue to bear the highest incidence of HIV in the country. Young women who have dropped out of school may be more at risk because of traditional gender norms that create substantial power imbalances and a lack of power to ne...

Evidence for the feasibility of brief psychological interventions for pregnant women experiencing intimate partner violence (IPV) in rural, low-income country settings is scarce. In rural Ethiopia, the prevalence of antenatal depressive symptoms and lifetime IPV are 29% and 61%, respectively. We aimed to assess the feasibility and related implement...

Although alcohol use is associated with depression, it is unclear if brief alcohol reduction interventions can ameliorate depression and psychological distress among people with HIV (PWH). We use data from a two-arm randomised controlled trial to examine this question. PWH on antiretroviral treatment (ART) were randomly assigned to receive a brief...

Introduction The demand for adolescent mental health services has increased significantly in recent years, leading to excessive wait times for adolescents seeking mental health services and poor mental health outcomes. Timely access to mental health services is critical to reducing the risk of symptom chronicity and progression to mental disorder....

Background: Survivors of sexual violence are at higher risk of adverse mental health outcomes compared to those exposed to other interpersonal traumas. Objective: To examine the trajectory of both post-traumatic stress disorder (PTSD) and depression as well as the role of early counselling over 24 months among rape survivors. Method: The South Afri...

This study aimed to examine the relationship between externalizing behaviors, substance use, and sexual risk among adolescent girls and young women (AGYW) in Cape Town, South Africa, who experience social disadvantage characterized by poverty and school dropout. We analyzed baseline data from 500 AGYW in a cluster-randomized trial who had dropped o...

Background: Unhealthy alcohol use is widespread in South Africa and has been linked to tuberculosis (TB) disease and poor treatment outcomes. This study used qualitative methods to explore the relationship between TB and alcohol use during TB treatment. Methods: Focus groups (FGs) were conducted with 34 participants who had previous or current drug...

Background: Globally, there is a treatment gap for substance use treatment and harm reduction services. As peer-delivered interventions expand to address this gap in both high-income countries (HICs) and low and middle-income countries (LMICs), they provide an opportunity to examine mutual capacity building, the bidirectional exchange of ideas bet...

In this paper we begin by highlighting the large treatment gap in South Africa for mental health conditions. We then describe the mental health services available, including the provision of evidence-based treatments in South Africa at each level of care, using the WHO's optimal mix of mental healthcare services as a framework. The optimal mix of s...

Background: The prevalence of child and adolescent mental health issues is increasing faster than the number of services available, leading to a shortfall. Mental health chatbots are a highly scalable method to address this gap. Manage Your Life Online (MYLO) is an artificially intelligent chatbot that emulates the method of levels therapy. Method...

Introduction South Africa lacks services to detect and address alcohol use during pregnancy, particularly outside of health-care facilities. This study aimed to explore pregnant women and healthcare providers’ perceptions of the acceptability, feasibility and appeal of a community-based counselling programme for pregnant women with alcohol problems...

Objective: To adapt an evidence-based psychological intervention for pregnant women experiencing depressive symptoms and intimate partner violence (IPV) in rural Ethiopia. Method: We conducted a desk review of contextual factors in Sodo, Ethiopia, followed by qualitative interviews with 16 pregnant women and 12 antenatal care (ANC) providers. We...

Background The association of traumatic experiences with problematic alcohol use has been described, but data on possible mediation effects of mental distress are sparse. We examined whether mental ill-health mediated the association between trauma exposure across the lifespan and alcohol use. Method We analysed cross-sectional data from a sample...

Background and aims: Reduction of alcohol consumption is important for people undergoing treatment for HIV. We tested the efficacy of a brief intervention for reducing the average volume of alcohol consumed among patients on HIV antiretroviral therapy (ART). Design, setting and participants: This study used a two-arm multi-centre randomized cont...

BACKGROUND: Smoking of illicit drugs may lead to more rapid TB disease progression or late treatment presentation, yet research on this topic is scant. We examined the association between smoked drug use and bacterial burden among patients newly initiated on drug-susceptible TB (DS-TB) therapy.METHODS: Data from 303 participants initiating DS-TB tr...

Objective Alcohol misuse is among modifiable risk factors of hypertension and cardiovascular diseases. Previous studies have described the associations of a range of traumatic experiences with problematic alcohol use, but data on possible mediation effects of mental distress are sparse. We examined whether mental ill-health mediated the association...

Background: Autistic people are more likely to report problematic alcohol and other substance use when compared to the general population. Evidence suggests that up to one in three autistic adults may have an alcohol or other substance use disorder (AUD/SUD), although the evidence base for behavioural addictions is less clear. Autistic people may...

Severe mental health conditions (SMHCs) significantly contribute to the global disease burden. In low-and-middle-income countries (LMICs) like South Africa, the long-term impact of SMHCs on individuals and their families is serious. However, mental health services focus on clinical recovery, with little attention given to the personal recovery need...

Adverse pregnancy outcomes (APOs) are common occurrences that contribute to negative maternal and child health outcomes. Our aim was to test the hypothesis that trauma exposure and depression are drivers of the better-recognised risk factors for miscarriage, abortion and stillbirths. Our comparative cohort study based in Durban, South Africa recrui...

Background Accurately quantifying alcohol use among persons with HIV (PWH) is important for validly assessing the efficacy of alcohol reduction interventions. Methods We used data from a randomized controlled trial of an intervention to reduce alcohol use among PWH who were receiving antiretroviral therapy in Tshwane, South Africa. We calculated a...

Background: The COVID-19 pandemic had a global impact on health systems and the delivery of health services, including for chronic conditions such as HIV. In South Africa, impacts on HIV services have widely been quantitatively described. Across different health settings, patients have also qualitatively described numerous negative impacts to thei...

Background: The prevalence of child and adolescent mental health issues are rising faster than the number of services available, leading to a shortfall. Mental health chatbots are a highly scalable way to address this gap. Manage Your Life Online (‘MYLO’) is an artificially intelligent chatbot that emulates Method of Levels Therapy (MOL). MOL is a...

BACKGROUND The prevalence of child and adolescent mental health issues is increasing faster than the number of services available, leading to a shortfall. Mental health chatbots are a highly scalable method to address this gap. Manage Your Life Online (MYLO) is an artificially intelligent chatbot that emulates the method of levels therapy. Method o...

Objective Brief interventions could reduce adolescents’ risk of depression and alcohol-related harms, but evidence of their feasibility and acceptability for low-and middle-income countries is lacking. To address this gap, we conducted a feasibility trial of the ASPIRE intervention, a four-session multi-component counselling intervention for South...

Background People with severe mental health conditions such as schizophrenia are an underserved and under-researched group in low and middle income countries, requiring evidence to promote development of services for their needs. This study investigated the experiences and coping strategies of people with lived experience of this condition, and the...

Background The available care for people with psychosis in South Africa is inadequate to support personal recovery. Group peer support interventions are a promising approach to foster recovery, but little is known about the preferences of service users, or the practical application of this care model, in low- and middle-income countries (LMIC). Thi...

Structural barriers perpetuate mental-health disparities for minoritized U.S. populations; global mental health (GMH) takes an interdisciplinary approach to increasing mental-health-care access and relevance. Mutual capacity-building partnerships between low- and middle-income countries and high-income countries are beginning to use GMH strategies...

Cultural competence is a term associated with the health system's responsiveness to the diversity of language, ethnicity, and social groups[1-3]. The concept extends beyond considering and recognizing diversity awareness and expresses the effectiveness of how such diversity is accepted, internalized, and addressed practically. Currently, the SPIRIT...

Background The occurrence and timing of mycobacterial culture conversion is used as a proxy for tuberculosis treatment response. When researchers serially sample sputum during tuberculosis studies, contamination or missed visits leads to missing data points. Traditionally, this is managed by ignoring missing data or simple carry-forward techniques....

Background Failure to consider relevant cultural, ethnic and diversity parameters (and the intersection between these parameters) during trial protocol development and trial conduct may negatively impact recruitment, intervention development and delivery, and participant adherence and retention, potentially reducing overall internal validity. This...

Background: Community health workers (CHWs) are increasingly providing task-shared psychological interventions for depression and alcohol use in primary health care in low-income and middle-income countries. We aimed to compare the effectiveness of CHWs dedicated to deliver care with CHWs designated to deliver care over and above their existing re...

Background Although evidence indicates that task-shared psychological interventions can reduce mental health treatment gaps in resource-constrained settings, systemic barriers have limited their widespread implementation. Evidence on how to sustain and scale such approaches is scant. This study responds to this gap by examining the experiences of S...

Background South Africa has the highest number of people with HIV (PWH) globally and a significant burden of co-occurring substance use disorder (SUD). Health care worker (HCW) stigma towards SUD is a key barrier to HIV care engagement among PWH with SUD. Support from peers—individuals with lived experience of SUD—may be a promising solution for ad...

Background Evidence-based brief psychological interventions are safe and effective for the treatment of antenatal depressive symptoms. However, the adaptation of such interventions for low- and middle-income countries has not been prioritised. This study aimed to select and adapt a brief psychological intervention for women with antenatal depressiv...

Background Despite a high prevalence of problematic substance use among people living with HIV in South Africa, there remains limited access to substance use services within the HIV care system. To address this gap, our team previously developed and adapted a six-session, peer-delivered problem-solving and behavioral activation-based intervention (...

Common mental disorders (CMDs) constitute a major public health and economic burden on low- and middle-income countries (LMICs). Systematic reviews of economic evaluations of psychological treatments for CMDs are limited. This systematic review examines methods, reports findings, and appraises the quality of economic evaluations of psychological tr...

Background The EN hancing A ssessment of C ommon T herapeutic factors (ENACT) tool measures a set of therapeutic competencies required for the effective psychological intervention, including delivery by non-specialists. This paper describes the systematic adaptation of the ENACT for the South African (SA) context and presents the tool's initial psy...

Little is known about gender effects of alcohol and drug use (AOD) among people living with HIV (PLWH) in resource-limited settings. Using multilevel models, we tested whether gender moderated the effect of Khanya, a cognitive-behavioral therapy-based intervention addressing antiretroviral (ART) adherence and AOD reduction. We enrolled 61 participa...

Heavy alcohol consumption and other drug use are prominent across Africa and increase the risk of exposure to violence, HIV acquisition, and other life-threatening injuries. This review synthesizes evidence on alcohol and other drug (AOD) interventions in Africa; evaluates the differences between interventions that do and do not specifically target...

Severe mental illnesses (SMI) contribute significantly to the global burden of disease. In low-and-middle-income countries (LMICs), the treatment gap impacts the clinical and personal recovery of people living with an SMI. The drive to reduce this treatment gap in LMICs makes it pertinent to understand service providers’ views on recovery from SMI....

Research documents trauma experiences and Post-Traumatic Stress Disorder (PTSD) among juvenile justice-involved youth; however, much less is known about the trauma and PTSD of their parents. This manuscript examines the extent to which youth PTSD and parent PTSD relate to youth’s mental health problems (e.g., anxiety, depression), emotional regulat...