Factors affecting beneficiary attendance in a community youth mental health promotion program in Karnataka, India.

Abstract Background: Yuva Spandana is a unique community based Youth Mental Health Promotion program implemented across Karnataka. This program provides mental health promotion services like guidance and referral services for any issues related to youth. These services are provided through Youth Guidance centres established within every district stadium across Karnataka. We assessed factors affecting beneficiary attendance to these guidance centres across Karnataka. Methods: A conceptual framework was developed to understand the factors affecting beneficiary attendance through stakeholder consultation. First time beneficiaries attending guidance centres between 1st January 2017 and 31st December 2018 across 30 districts of Karnataka were considered study subjects. Requisite data were drawn from the computerized management information system (CMIS) specifically developed for the program. Multivariate Linear Regression was performed with factors affecting beneficiary attendance as outcome and a host of hypothesized variables within the conceptual framework as potential exposures that contribute towards beneficiary attendance. All variables significantly associated with outcome (p<0.10) in univariate and which changed the β-coefficient of atleast one preceding variable by 10% was retained in the multivariate model. Results: For every sensitization program where more than one issue was addressed, the beneficiary attendance increased by 84% (β =0.84; 95% CI=0.53-1.15). Reaching out to parent beneficiaries through sensitisation programs, increased beneficiary attendance at YSK by 79% (β =0.79; 95% CI=0.20-1.37). Referring clients to resource mapped organisations, significantly increased beneficiary attendance by 81% (β =0.81; 95% CI=0.34-1.28). For every percentage increase in reminder calls made to probable beneficiaries who sought support following a sensitization programme, beneficiary attendance increased by 2.18 times (β =2.18; 95% CI=0.52-3.83). Availability of internet connectivity at these guidance centres in 2017, increased beneficiary attendance by 18 times (β =18.00; 95% CI=5.86-30.13). Conclusions: This study provides important inputs towards increasing beneficiary attendance towards large scale youth mental health promotion programs. Addressing more than one issue during sensitisation programs among beneficiaries; conducting sensitization programs among parent groups; making reminder calls to beneficiaries who requested support through feedback forms to fix appointment at guidance centres; providing referrals to beneficiaries to seek services at resource mapped individuals/organizations and ensuring availability of internet in guidance centres increases beneficiary attendance.