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Prevention and promotion effects of Self Help Plus: secondary analysis of cluster randomised controlled trial data among South Sudanese refugee women in Uganda
INTRODUCTION: Evidence-based and scalable prevention and promotion focused mental health and psychosocial support interventions are needed for conflict-affected populations in humanitarian settings. This study retrospectively assessed whether participation in Self Help Plus (SH+) versus enhanced usu...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503328/ https://www.ncbi.nlm.nih.gov/pubmed/37699637 http://dx.doi.org/10.1136/bmjopen-2020-048043 |
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author | Augustinavicius, Jura Purgato, Marianna Tedeschi, Federico Musci, Rashelle Leku, Marx Ronald Carswell, Kenneth Lakin, Daniel van Ommeren, Mark Cuijpers, Pim Sijbrandij, Marit Karyotaki, Eirini Tol, Wietse A Barbui, Corrado |
author_facet | Augustinavicius, Jura Purgato, Marianna Tedeschi, Federico Musci, Rashelle Leku, Marx Ronald Carswell, Kenneth Lakin, Daniel van Ommeren, Mark Cuijpers, Pim Sijbrandij, Marit Karyotaki, Eirini Tol, Wietse A Barbui, Corrado |
author_sort | Augustinavicius, Jura |
collection | PubMed |
description | INTRODUCTION: Evidence-based and scalable prevention and promotion focused mental health and psychosocial support interventions are needed for conflict-affected populations in humanitarian settings. This study retrospectively assessed whether participation in Self Help Plus (SH+) versus enhanced usual care (EUC) resulted in reduced incidence of probable mental disorder and increased positive mental health and well-being post-intervention among South Sudanese refugee women in Uganda. METHODS: This study used secondary data from treatment-oriented pilot (n=50) and fully-powered cluster randomised controlled trials (cRCT)s (n=694) of SH+ versus EUC. Data from baseline and post-intervention assessments were combined. A composite latent indicator for mental health problems was generated using mental health and well-being measures included in both cRCTs. In order to assess incidence, a binary variable approximating probable mental disorder was created to exclude those with probable mental disorder from the analysis sample and as the primary prevention outcome. The promotive effects of SH+ relative to EUC were examined in the same sample by assessing subjective well-being and psychological flexibility scale scores. RESULTS: A single factor for mental health problems was identified with all factor loadings >0.30 and acceptable internal consistency ([Formula: see text] =0.70). We excluded 161 women who met criteria for probable mental disorder at baseline. Among those with at least moderate psychological distress but without probable mental disorder at baseline and with follow-up data (n=538), the incidence of probable mental disorder at post-intervention was lower among those who participated in SH+ relative to EUC (Risk ratio =0.16, 95% CI: 0.05 to 0.53). Participation in SH+ versus EUC was also associated with increased subjective well-being ([Formula: see text] =2.62, 95% CI: 1.63 to 3.60) and psychological flexibility ([Formula: see text] =4.55, 95% CI: 2.92 to 6.18) at post-intervention assessment. CONCLUSIONS: These results support the use and further testing of SH+ as a selective and indicated prevention and promotion focused psychosocial intervention in humanitarian settings. TRIAL REGISTRATION NUMBER: ISRCTN50148022. |
format | Online Article Text |
id | pubmed-10503328 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-105033282023-09-16 Prevention and promotion effects of Self Help Plus: secondary analysis of cluster randomised controlled trial data among South Sudanese refugee women in Uganda Augustinavicius, Jura Purgato, Marianna Tedeschi, Federico Musci, Rashelle Leku, Marx Ronald Carswell, Kenneth Lakin, Daniel van Ommeren, Mark Cuijpers, Pim Sijbrandij, Marit Karyotaki, Eirini Tol, Wietse A Barbui, Corrado BMJ Open Mental Health INTRODUCTION: Evidence-based and scalable prevention and promotion focused mental health and psychosocial support interventions are needed for conflict-affected populations in humanitarian settings. This study retrospectively assessed whether participation in Self Help Plus (SH+) versus enhanced usual care (EUC) resulted in reduced incidence of probable mental disorder and increased positive mental health and well-being post-intervention among South Sudanese refugee women in Uganda. METHODS: This study used secondary data from treatment-oriented pilot (n=50) and fully-powered cluster randomised controlled trials (cRCT)s (n=694) of SH+ versus EUC. Data from baseline and post-intervention assessments were combined. A composite latent indicator for mental health problems was generated using mental health and well-being measures included in both cRCTs. In order to assess incidence, a binary variable approximating probable mental disorder was created to exclude those with probable mental disorder from the analysis sample and as the primary prevention outcome. The promotive effects of SH+ relative to EUC were examined in the same sample by assessing subjective well-being and psychological flexibility scale scores. RESULTS: A single factor for mental health problems was identified with all factor loadings >0.30 and acceptable internal consistency ([Formula: see text] =0.70). We excluded 161 women who met criteria for probable mental disorder at baseline. Among those with at least moderate psychological distress but without probable mental disorder at baseline and with follow-up data (n=538), the incidence of probable mental disorder at post-intervention was lower among those who participated in SH+ relative to EUC (Risk ratio =0.16, 95% CI: 0.05 to 0.53). Participation in SH+ versus EUC was also associated with increased subjective well-being ([Formula: see text] =2.62, 95% CI: 1.63 to 3.60) and psychological flexibility ([Formula: see text] =4.55, 95% CI: 2.92 to 6.18) at post-intervention assessment. CONCLUSIONS: These results support the use and further testing of SH+ as a selective and indicated prevention and promotion focused psychosocial intervention in humanitarian settings. TRIAL REGISTRATION NUMBER: ISRCTN50148022. BMJ Publishing Group 2023-09-12 /pmc/articles/PMC10503328/ /pubmed/37699637 http://dx.doi.org/10.1136/bmjopen-2020-048043 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Mental Health Augustinavicius, Jura Purgato, Marianna Tedeschi, Federico Musci, Rashelle Leku, Marx Ronald Carswell, Kenneth Lakin, Daniel van Ommeren, Mark Cuijpers, Pim Sijbrandij, Marit Karyotaki, Eirini Tol, Wietse A Barbui, Corrado Prevention and promotion effects of Self Help Plus: secondary analysis of cluster randomised controlled trial data among South Sudanese refugee women in Uganda |
title | Prevention and promotion effects of Self Help Plus: secondary analysis of cluster randomised controlled trial data among South Sudanese refugee women in Uganda |
title_full | Prevention and promotion effects of Self Help Plus: secondary analysis of cluster randomised controlled trial data among South Sudanese refugee women in Uganda |
title_fullStr | Prevention and promotion effects of Self Help Plus: secondary analysis of cluster randomised controlled trial data among South Sudanese refugee women in Uganda |
title_full_unstemmed | Prevention and promotion effects of Self Help Plus: secondary analysis of cluster randomised controlled trial data among South Sudanese refugee women in Uganda |
title_short | Prevention and promotion effects of Self Help Plus: secondary analysis of cluster randomised controlled trial data among South Sudanese refugee women in Uganda |
title_sort | prevention and promotion effects of self help plus: secondary analysis of cluster randomised controlled trial data among south sudanese refugee women in uganda |
topic | Mental Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503328/ https://www.ncbi.nlm.nih.gov/pubmed/37699637 http://dx.doi.org/10.1136/bmjopen-2020-048043 |
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