Cargando…
Cultural adaptation of a scalable psychological intervention for Burundian refugee adolescents in Tanzania: a qualitative study
BACKGROUND: There is an urgent need for evidence-based, scalable, psychological interventions to improve the mental health of adolescents affected by adversity in low-resource settings. Early Adolescents Skills for Emotions (EASE) was developed by the WHO as a brief, transdiagnostic, group intervent...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477522/ https://www.ncbi.nlm.nih.gov/pubmed/34579750 http://dx.doi.org/10.1186/s13031-021-00391-4 |
_version_ | 1784575860697726976 |
---|---|
author | Singh, Aneeha Nemiro, Ashley Malik, Aiysha Guimond, Marie-France Nduwimana, Estella Likindikoki, Samuel Annan, Jeannie Tol, Wietse A. |
author_facet | Singh, Aneeha Nemiro, Ashley Malik, Aiysha Guimond, Marie-France Nduwimana, Estella Likindikoki, Samuel Annan, Jeannie Tol, Wietse A. |
author_sort | Singh, Aneeha |
collection | PubMed |
description | BACKGROUND: There is an urgent need for evidence-based, scalable, psychological interventions to improve the mental health of adolescents affected by adversity in low-resource settings. Early Adolescents Skills for Emotions (EASE) was developed by the WHO as a brief, transdiagnostic, group intervention for early adolescents exhibiting internalising problems, delivered by trained and supervised lay providers. This study describes the cultural adaptation of EASE for Burundian adolescents living in Mtendeli refugee camps in Tanzania. METHODS: A phased approach to adaptation of the EASE intervention and its implementation, was adopted and comprised of: (1) a desk review to synthesize existing research on mental health issues in conflict-affected Burundian communities, (2) a rapid qualitative assessment involving free listing and key informant interviews with multiple stakeholders, (3) cognitive interviews with end users, and (4) a two-part adaptation workshop involving the implementing partner staff, members of the refugee community and mental health experts. We applied the Bernal framework to systematically document and track adaptations across eight dimensions of the intervention. RESULTS: Problems associated with worry, stress, sadness, shame and fear were identified as amongst the most critical mental health concerns, alongside a range of experiences of different forms of violence (such as gender-based violence, violence when fleeing from their homes) and associated problems. Problems associated with violence that included past experiences of fleeing as well as ongoing problems of gender-based violence in the camp. The most significant adaptations that were required included providing options for low literacy of participants, safety planning to address the high prevalence of sexual violence, simplification of strategies for the benefit of the end users and of lay facilitators, and implementation changes to consider involvement of refugee incentive workers. A majority of changes were across dimensions of language, people, metaphors, content, methods and context, while there were fewer changes regarding the goals and concepts of EASE. CONCLUSIONS: The approach to adaptation of a psychological intervention suggested both minor and major required changes. Adaptations based on the findings of this study are anticipated to enhance relevance and acceptability of the EASE intervention and its delivery for camp-residing Burundian refugees in Tanzania. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13031-021-00391-4. |
format | Online Article Text |
id | pubmed-8477522 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-84775222021-09-28 Cultural adaptation of a scalable psychological intervention for Burundian refugee adolescents in Tanzania: a qualitative study Singh, Aneeha Nemiro, Ashley Malik, Aiysha Guimond, Marie-France Nduwimana, Estella Likindikoki, Samuel Annan, Jeannie Tol, Wietse A. Confl Health Research BACKGROUND: There is an urgent need for evidence-based, scalable, psychological interventions to improve the mental health of adolescents affected by adversity in low-resource settings. Early Adolescents Skills for Emotions (EASE) was developed by the WHO as a brief, transdiagnostic, group intervention for early adolescents exhibiting internalising problems, delivered by trained and supervised lay providers. This study describes the cultural adaptation of EASE for Burundian adolescents living in Mtendeli refugee camps in Tanzania. METHODS: A phased approach to adaptation of the EASE intervention and its implementation, was adopted and comprised of: (1) a desk review to synthesize existing research on mental health issues in conflict-affected Burundian communities, (2) a rapid qualitative assessment involving free listing and key informant interviews with multiple stakeholders, (3) cognitive interviews with end users, and (4) a two-part adaptation workshop involving the implementing partner staff, members of the refugee community and mental health experts. We applied the Bernal framework to systematically document and track adaptations across eight dimensions of the intervention. RESULTS: Problems associated with worry, stress, sadness, shame and fear were identified as amongst the most critical mental health concerns, alongside a range of experiences of different forms of violence (such as gender-based violence, violence when fleeing from their homes) and associated problems. Problems associated with violence that included past experiences of fleeing as well as ongoing problems of gender-based violence in the camp. The most significant adaptations that were required included providing options for low literacy of participants, safety planning to address the high prevalence of sexual violence, simplification of strategies for the benefit of the end users and of lay facilitators, and implementation changes to consider involvement of refugee incentive workers. A majority of changes were across dimensions of language, people, metaphors, content, methods and context, while there were fewer changes regarding the goals and concepts of EASE. CONCLUSIONS: The approach to adaptation of a psychological intervention suggested both minor and major required changes. Adaptations based on the findings of this study are anticipated to enhance relevance and acceptability of the EASE intervention and its delivery for camp-residing Burundian refugees in Tanzania. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13031-021-00391-4. BioMed Central 2021-09-27 /pmc/articles/PMC8477522/ /pubmed/34579750 http://dx.doi.org/10.1186/s13031-021-00391-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Singh, Aneeha Nemiro, Ashley Malik, Aiysha Guimond, Marie-France Nduwimana, Estella Likindikoki, Samuel Annan, Jeannie Tol, Wietse A. Cultural adaptation of a scalable psychological intervention for Burundian refugee adolescents in Tanzania: a qualitative study |
title | Cultural adaptation of a scalable psychological intervention for Burundian refugee adolescents in Tanzania: a qualitative study |
title_full | Cultural adaptation of a scalable psychological intervention for Burundian refugee adolescents in Tanzania: a qualitative study |
title_fullStr | Cultural adaptation of a scalable psychological intervention for Burundian refugee adolescents in Tanzania: a qualitative study |
title_full_unstemmed | Cultural adaptation of a scalable psychological intervention for Burundian refugee adolescents in Tanzania: a qualitative study |
title_short | Cultural adaptation of a scalable psychological intervention for Burundian refugee adolescents in Tanzania: a qualitative study |
title_sort | cultural adaptation of a scalable psychological intervention for burundian refugee adolescents in tanzania: a qualitative study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477522/ https://www.ncbi.nlm.nih.gov/pubmed/34579750 http://dx.doi.org/10.1186/s13031-021-00391-4 |
work_keys_str_mv | AT singhaneeha culturaladaptationofascalablepsychologicalinterventionforburundianrefugeeadolescentsintanzaniaaqualitativestudy AT nemiroashley culturaladaptationofascalablepsychologicalinterventionforburundianrefugeeadolescentsintanzaniaaqualitativestudy AT malikaiysha culturaladaptationofascalablepsychologicalinterventionforburundianrefugeeadolescentsintanzaniaaqualitativestudy AT guimondmariefrance culturaladaptationofascalablepsychologicalinterventionforburundianrefugeeadolescentsintanzaniaaqualitativestudy AT nduwimanaestella culturaladaptationofascalablepsychologicalinterventionforburundianrefugeeadolescentsintanzaniaaqualitativestudy AT likindikokisamuel culturaladaptationofascalablepsychologicalinterventionforburundianrefugeeadolescentsintanzaniaaqualitativestudy AT annanjeannie culturaladaptationofascalablepsychologicalinterventionforburundianrefugeeadolescentsintanzaniaaqualitativestudy AT tolwietsea culturaladaptationofascalablepsychologicalinterventionforburundianrefugeeadolescentsintanzaniaaqualitativestudy |