Adapting DIALOG+ and building capacity in schools to support mental wellbeing and resilience in post-conflict Colombia during the COVID-19 pandemic

在 COVID-19 大流行期间，调整 DIALOG 并建设学校能力，以支持冲突后哥伦比亚的心理健康和复原力

• 批准号: ES/V013114/1
• 负责人: Francois Van Loggerenberg
• 金额: $ 24.62万
• 依托单位: Queen Mary University of London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FV013114%2F1
• 关键词: Adapting; DIALOG+; building; capacity; schools

It is estimated that here are around 8.5 million victims of armed conflict in Colombia. Tolima is one of the areas most affected as it was were guerrilla groups formed and it served as a key strategic corridor during the armed conflict. The national Mental Health Study (ENSM-2015) found high levels of mental distress and illness in Colombia's children and adolescents, including high levels of post-traumatic stress symptoms, in the context of poor levels of access to treatment. Tolima specifically is facing many challenges in the transition from conflict to peace, and one of the governmental programmes in place is the Development Programs with Territorial Approach (PDET) which aims to stimulate development, in part by prioritising healthcare access. Throughout the armed conflict and also as the region moves into peacebuilding, there has been a lack of access to mental health professionals, made harder by the fact that there are as few as 1.84 psychiatrists per 100,000 population in Colombia. This means that the role of teachers and school counsellors is key in providing mental health support for children and adolescents in this region. Mental health and well-being through adolescence is important for an optimal transition to adulthood and hence to sustain mental health later in life. In recent years there has been increased attention to the psychological consequences of conflict on adolescents. However, the impact of the armed conflict on children and adolescents is still poorly understood and there is a current need for a well-structured intervention to improve and deliver mental health interventions to this vulnerable group. Pontificia Universidad Javeriana has developed an online diploma to support mental health in the school community, which has proven to be effective in improving school interventions in mental health and improving the skills and knowledge of teachers. Likewise, the Queen Mary University of London team has developed and tested a mental health intervention called DIALOG+, a low-cost/cost saving evidence-based therapeutically effective mental health intervention, which has been used and assessed in many clinical contexts internationally. DIALOG+ was developed based on quality of life research, concepts of patient-centred communication, developments in information technology, and components of solution-focused therapy. The overall aim of this study is to improve the mental health, resilience and quality of life of children and adolescents from Tolima, Colombia, taking into account the additional context of this post-conflict setting during the added stress of the current COVID-19 pandemic. This will be done by training (online and face-to-face) teachers and school counsellors from this region in mental health in order to allow them to develop strategies for the promotion of mental wellbeing and the prevention and early detection of mental health problems. Strengthening of educators' capacities will be achieved whilst modifying and exploring DIALOG+ - a proven technology-assisted tablet/smartphone-based and resource-oriented intervention - as a generic approach for mental health problems identified in adolescents. This exploratory study will provide the information required to conduct a definitive trial that will show if this intervention will help reduce the current treatment gap experienced by children and adolescents with symptoms of mental distress in this, and similar contexts.

据估计，哥伦比亚约有850万武装冲突受害者。托利马是受影响最严重的地区之一，因为那里成立了游击队，在武装冲突期间是一个关键的战略走廊。国家精神健康研究（ENSM-2015）发现，在获得治疗的机会很少的情况下，哥伦比亚儿童和青少年的精神痛苦和疾病水平很高，包括创伤后应激障碍症状水平很高。托利马在从冲突向和平过渡的过程中尤其面临着许多挑战，政府实施的方案之一是“领土办法发展方案”，其目的是刺激发展，部分是通过优先考虑获得医疗保健。在整个武装冲突期间以及随着该区域进入和平建设阶段，一直缺乏获得精神卫生专业人员的机会，哥伦比亚每10万人口中只有1.84名精神病医生，这使得这一问题更加困难。这意味着教师和学校辅导员的作用是为该地区儿童和青少年提供心理健康支持的关键。青春期的心理健康和幸福对于向成年的最佳过渡至关重要，因此也是在以后的生活中保持心理健康的重要因素。近年来，人们越来越关注冲突对青少年的心理影响。然而，武装冲突对儿童和青少年的影响仍然知之甚少，目前需要一个结构良好的干预措施，以改善和提供心理健康干预，这一弱势群体。哈韦里亚纳宗座大学开发了一个在线文凭，以支持学校社区的心理健康，这已被证明是有效的，以改善学校的心理健康干预措施，提高教师的技能和知识。同样，伦敦大学的玛丽皇后学院团队开发并测试了一种名为DIALOG+的心理健康干预措施，这是一种低成本/节省成本的循证治疗有效的心理健康干预措施，已在国际上许多临床环境中使用和评估。DIALOG+是基于生活质量研究、以患者为中心的沟通概念、信息技术的发展和以解决方案为中心的治疗组成部分而开发的。这项研究的总体目标是改善哥伦比亚托利马儿童和青少年的心理健康、复原力和生活质量，同时考虑到当前COVID-19大流行带来的额外压力，这一冲突后环境的额外背景。为此，将对该地区的教师和学校辅导员进行心理健康培训（在线和面对面），使他们能够制定促进心理健康、预防和早期发现心理健康问题的战略。将加强教育工作者的能力，同时修改和探索DIALOG+ -一种经过验证的技术辅助平板电脑/智能手机和以资源为导向的干预措施-作为解决青少年心理健康问题的通用方法。这项探索性研究将提供进行确定性试验所需的信息，该试验将显示这种干预是否有助于减少在这种和类似情况下有精神困扰症状的儿童和青少年目前所经历的治疗差距。

项目成果

Development and Implementation of DIALOG+S in the School Setting as a Tool for Promoting Adolescent Mental Well-Being and Resilience in a Post-Armed Conflict Area in Colombia: Exploratory Cluster Randomized Controlled Trial.

• DOI: 10.2196/46757
• 发表时间: 2023-10-04
• 期刊: JMIR formative research
• 影响因子: 2.2

Mental health problems and resilience in adolescents during the COVID-19 pandemic in a post-armed conflict area in Colombia.

• DOI: 10.1038/s41598-023-35789-y
• 发表时间: 2023-06-16
• 期刊: Scientific reports
• 影响因子: 4.6

Development and Implementation of DIALOG+S in the School Setting as a Tool for Promoting Adolescent Mental Well-Being and Resilience in a Post-Armed Conflict Area in Colombia: Exploratory Cluster Randomized Controlled Trial (Preprint)

在学校环境中开发和实施 DIALOG S 作为促进哥伦比亚武装冲突后地区青少年心理健康和复原力的工具：探索性整群随机对照试验（预印本）

• DOI: 10.2196/preprints.46757
• 发表时间: 2023
• 作者: Gómez-Restrepo C

Adapting DIALOG+ in a School Setting-A Tool to Support Well-being and Resilience in Adolescents Living in Postconflict Areas During the COVID-19 Pandemic: Protocol for a Cluster Randomized Exploratory Study.

• DOI: 10.2196/40286
• 发表时间: 2022-11-09
• 期刊: JMIR research protocols
• 影响因子: 1.7
• 作者: Gómez-Restrepo C;Sarmiento-Suárez MJ;Alba-Saavedra M;Bird VJ;Priebe S;van Loggerenberg F
• 通讯作者: van Loggerenberg F