Improving mental health in low-resource settings: A feasibility randomized controlled trial of a transdiagnostic psychological intervention among Burundian refugee adolescents and their caregivers
Improving mental health in low-resource settings: A feasibility randomized controlled trial of a transdiagnostic psychological intervention among Burundian refugee adolescents and their caregivers
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DOI：
10.1016/j.brat.2021.103944
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发表时间：
2021-08-12
影响因子：
4.1
通讯作者：
Tol, Wietse A.
中科院分区：
文献类型：
--
作者：
Fine, Shoshanna L.;Malik, Aiysha;Tol, Wietse A.
有一个关于干预措施，可以改善生活在低资源环境中的受不良影响的青少年的心理健康的证据不足。我们评估了世界卫生组织在坦桑尼亚的布隆迪难民青少年及其照顾者中进行的青少年早期情绪技能（EASE）干预的可行性、可接受性、相关性和安全性。本研究包括可行性整群随机对照试验（cRCT）和过程评价。可行性cRCT包括82名青少年及其64名照顾者，其中两组随机分配到EASE，两组随机分配到增强对照条件。EASE是由成年难民提供的，他们事先没有接受过心理健康培训。过程评价包括36个半结构化的定性访谈与关键利益相关者，包括青少年，照顾者和促进者。EASE参与者和主持人对其格式、可访问性和内容给予了积极的反馈。受过训练的非专业难民协调员能够高度忠实地提供EASE。研究方案在平衡随机化、有限失访和心理测量学上有希望的措施方面运作良好，但在短筛选和心理困扰症状自评量表之间观察到不一致。这项形成性研究表明EASE在针对流离失所的青少年心理困扰方面的潜力，并为未来的最终试验奠定了基础。
There is a paucity of evidence regarding interventions that can improve the mental health of adversity-affected young adolescents living in low-resource settings. We evaluated the feasibility, acceptability, relevance, and safety of the World Health Organization's Early Adolescent Skills for Emotions (EASE) intervention among Burundian refugee adolescents and their caregivers in Tanzania. This study consisted of a feasibility cluster randomized controlled trial (cRCT) and a process evaluation. The feasibility cRCT included 82 young adolescents and their 64 caregivers, with two clusters randomized to EASE and two to an enhanced control condition. EASE was delivered by adult refugees without prior training in mental health. The process evaluation consisted of 36 semi-structured qualitative interviews with key stakeholders, including adolescents, caregivers, and facilitators. EASE participants and facilitators gave positive feedback about its format, accessibility, and content. Trained non-specialist refugee facilitators were able to deliver EASE with high fidelity. The research protocol functioned well in terms of balanced randomization, limited loss to follow-up, and psychometrically promising measures, but discordance was observed between the short screener and psychological distress symptom checklist. This formative study suggests the potential of EASE in targeting psychological distress among displaced young adolescents and lays the groundwork for a future definitive trial.