# Evaluating a Culturally Tailored Digital Storytelling Intervention to Improve Trauma Awareness in Conflict-Affected Eastern Congo: Quasi-Experimental Pilot Study

## TL;DR

A short animated video improved mental health awareness and attitudes in a conflict-affected region of Congo.

## Contribution

This study introduces a culturally tailored digital storytelling intervention to enhance trauma awareness in low-resource settings.

## Key findings

- The intervention significantly improved perception, knowledge, and attitudes toward trauma.
- Participants with PTSD symptoms, higher education, and empathy showed stronger positive effects from the video.
- The video was well appreciated, with many participants likely to share it with others.

## Abstract

Posttraumatic stress disorder (PTSD) is highly prevalent in conflict-affected regions like eastern Democratic Republic of Congo; yet, cultural stigma and lack of psychoeducation limit public understanding and help-seeking behaviors.

This study evaluates the effect of a short, culturally adapted animated video on mental health perception, knowledge, and attitudes toward trauma.

A community-based quasi-experimental pre-post design was implemented among 239 participants from South Kivu. The intervention involved viewing a 3-minute animated psychoeducational video portraying locally relevant PTSD symptoms and resilience strategies. Perception, knowledge, and attitude scores were measured before and after the intervention, alongside PTSD prevalence and video appreciation.

Out of 239, 40% (n=96) of the participants screened positively for PTSD. Post intervention, significant improvements were observed in perception (P=.01), knowledge (P<.001), and attitudes (P=.001) toward trauma. Appreciation was high; 82% (n= 195) expressed empathy for the characters, and 74% (n= 176) were likely to share the video. Linear regression showed that having PTSD symptoms (β coefficient=3.29, SE=1.09; P=.003), years of education (β coefficient=0.54, SE=0.08; P<.001), empathy toward the portrayed situations (β coefficient=5.07, SE=0.56; P<.001), perceived acquisition of new knowledge (β coefficient=2.58, SE=0.59; P<.001) and willingness to share the video (β coefficient=1.75, SE=0.50; P=.001) predicted stronger positive effect. A multiple linear regression including all predictors revealed that PTSD symptoms (β coefficient=1.93, SE=0.90; P=.03), years of education (β coefficient=0.47, SE=0.07; P<.001), empathy toward the portrayed situations (β coefficient=3.50, SE=0.55; P<.001), and willingness to share the video (β coefficient=1.75, SE=0.50; P=.001) remained significant predictors of video impact. Age and perceived acquisition of new knowledge were not significant in the multivariate model. This model accounted for 44.6% of the variance in video impact scores (R2=0.446, F6,231=30.99, P<.001).

This study highlights the effectiveness of culturally grounded, low-cost digital media for improving mental health literacy in postconflict settings. Video-based tools may serve as scalable components of trauma-informed care and public health communication in low-resource, high-need areas.