基于友谊长椅（Friendship Bench）的数字心理健康干预的大学-产业案例研究：Inuka Coaching。
完整摘要 · 中文译文
背景：精神、神经和物质使用障碍是全球致残的主要原因。在撒哈拉以南非洲（SSA），投入不足、服务集中化、污名化和劳动力短缺造成了巨大的治疗缺口。数字交付可以扩大可及性，但可持续模式仍集中于高收入环境。大学-产业（U-I）合作可能弥合能力与规模化方面的差距，尽管文化和工作时间线的差异常常阻碍进展。本研究记录了在SSA开展的一项数字心理健康干预在设计、开发和早期评价过程中的混合U-I方法，并提炼了实践经验。 方法：我们报告了一项回顾性、多国案例研究，对象为Inuka Coaching，这是一种由教练引导、基于聊天的问题解决疗法，通过移动端/网络交付。四个连续阶段整合了学术性与实用性流程：（I）需求评估，采用文献综述、49次访谈和7个焦点小组，覆盖肯尼亚、加纳和尼日利亚；（II）在内罗毕举行由20名利益相关者参与的黑客松，共同创建最小可行产品（MVP），随后进行假设检验；（III）在津巴布韦与13名来访者和5名教练进行可行性和可接受性测试；（IV）在内罗毕18个初级保健中心开展试点，纳入80名成年人，在基线、4周和3个月时测量自评问卷-20（SRQ-20）、患者健康问卷-9（PHQ-9）和广泛性焦虑障碍量表-7（GAD-7）。 结果：第1阶段产出了面向非学术利益相关者的结构化设计输入，这些输入由需求评估活动综合而成。第2阶段交付了 一个最小可行产品（MVP）和初步的规模化路径，通过与利益相关方的迭代测试而形成。第3阶段通过可用性测试产出了一个完善的工作原型。第4阶段交付了试点评估方案和数据集；由此产生的临床和可行性研究结果已在经伦理批准的出版物中另行报告。本案例研究聚焦于大学-产业（U-I）合作过程本身，不呈现也不讨论 underlying 研究活动的结果。合作动态与各阶段相对应：产业方主导快速迭代和产品化（第2-3阶段）；学术方主导有效性、测量和报告（第1和第4阶段）。主要挑战包括：由于伦理审批时间线导致最终用户参与有限、发表与产品时间表存在分歧，以及数据访问限制。 结论：这是撒哈拉以南非洲（SSA）首个有文献记录的、用于开发和评估数字心理健康干预的大学-产业混合合作。明确的目标、灵活的阶段性领导、早期假设检验、主动的伦理规划以及双重传播可以减少研究浪费并支持迭代开发。未来的合作可能受益于将最终用户全程嵌入的生活实验室安排、弥合工作文化的跨学科治理，以及在资源匮乏环境中管理文化差异的决策框架。
完整摘要 · 英文原文
BACKGROUND: Mental, neurological, and substance use disorders are a leading cause of disability globally. In sub-Saharan Africa (SSA), underinvestment, centralised services, stigma, and workforce shortages create large treatment gaps. Digital delivery can expand access, yet sustainable models remain concentrated in high-income settings. University-industry (U-I) collaboration may bridge capability and scaling gaps, though differing cultures and timelines often impede progress. This study documents a hybrid U-I approach across design, development, and early evaluation of a digital mental health intervention in SSA, and extracts practical lessons. METHODS: We report a retrospective, multi-country case study of Inuka Coaching, a coach-guided, chat-based problem-solving therapy delivered via mobile/web. Four sequential phases integrated academic and pragmatic processes: (I) needs assessment using literature review, 49 interviews, and 7 focus groups across Kenya, Ghana, and Nigeria; (II) a 20-stakeholder Nairobi hackathon co-creating a minimum viable product (MVP), followed by assumption testing; (III) feasibility and acceptability testing with 13 clients and 5 coaches in Zimbabwe; and (IV) a pilot across 18 Nairobi primary care centres enrolling 80 adults, measuring Self-Reporting Questionnaire-20 (SRQ-20), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder scale-7 (GAD-7) at baseline, 4 weeks, and 3 months. RESULTS: Phase 1 produced structured design inputs for non-academic stakeholders, synthesized from the needs-assessment activities. Phase 2 delivered an MVP and a preliminary route-to-scale, shaped through iterative testing with stakeholders. Phase 3 produced a refined working prototype through usability testing. Phase 4 delivered a pilot evaluation protocol and dataset; the resulting clinical and feasibility findings are reported separately in an ethically approved publication. This case study focuses on the U-I collaboration process itself and does not present or discuss the results of the underlying research activities. Partnership dynamics were phase-aligned: industry led rapid iteration and productisation (Phases 2-3); academia led validity, measurement, and reporting (Phases 1 and 4). Key challenges included limited end-user involvement due to ethics timelines, divergent publishing and product schedules, and data-access restrictions. CONCLUSIONS: This is the first documented hybrid U-I partnership for developing and evaluating a digital mental health intervention in SSA. Clear objectives, flexible phase-specific leadership, early assumption testing, proactive ethics planning, and dual dissemination can reduce research waste and support iterative development. Future collaborations may benefit from living-lab arrangements embedding end-users throughout, cross-disciplinary governance to bridge work cultures, and decision frameworks to manage cultural differences in low-resource settings.