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

BACKGROUND Post-traumatic stress disorder (PTSD) is highly prevalent in conflict-affected regions like eastern Democratic Republic of Congo (DRC), yet cultural stigma and lack of psychoeducation limit public understanding and help-seeking behaviors. OBJECTIVE This study evaluates the effect of a short, culturally adapted animated video on mental health perception, knowledge, and attitudes toward trauma. METHODS 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. RESULTS Forty percent of the participants screened positively for PTSD. Post-intervention, significant improvements were observed in perception (P = 0.01), knowledge (P < 0.001), and attitudes (p = 0.001) toward trauma. Appreciation was high: 82% expressed empathy for the characters, and 74% were likely to share the video. Linear regression showed that having PTSD symptoms (β = 3.29, P = 0.003), years of education (β = 0.54, P < 0.001), empathy toward the portrayed situations (β = 5.07, P < 0.001), perceived acquisition of new knowledge (β = 2.58, P < 0.001) and willingness to share the video (β = 1.75, P = 0.001) predicted stronger positive effect. A multiple linear regression including all predictors revealed that PTSD symptoms (β = 1.93, P = 0.034), years of education (β = 0.47, P < 0.001), empathy toward the portrayed situations (β = 3.50, P < 0.001), and willingness to share the video (β = 1.75, p = 0.001) 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, F(6, 231) = 30.99, P < 0.001). CONCLUSIONS This study highlights the effectiveness of culturally grounded, low-cost digital media for improving mental health literacy in post-conflict settings. Video-based tools may serve as scalable components of trauma-informed care and public health communication in low-resource, high-need areas.