Lay therapist delivered low intensity psychosocial intervention for refugees and asylum seekers (PROSPER): protocol for a pilot randomised controlled trial.



Rawlinson, Rebecca, Aslam, Rabeea’h, Burnside, Girvan ORCID: 0000-0001-7398-1346, Chiumento, Anna, Eriksson-Lee, Malena, Humphreys, Amy, Khan, Naila, Lawrence, Daniel, McCluskey, Rachel, Mackinnon, Annette
et al (show 9 more authors) (2020) Lay therapist delivered low intensity psychosocial intervention for refugees and asylum seekers (PROSPER): protocol for a pilot randomised controlled trial.

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Abstract

<h4>Background: </h4> Asylum seekers and refugees (AS&Rs) experience impaired mental health and wellbeing, related to stresses in their country of origin, experiences in transit and reception on arrival, including significant barriers to accessing mainstream services. Their contact with healthcare is often crisis-driven and mediated through non-governmental organisations (NGOs). Problem Management Plus (PM+) is a psychosocial intervention recommended by the World Health Organization to address distress experienced by adults affected by humanitarian crises. We are investigating its application for the first time in a high income country. Methods In a pilot randomised controlled trial, PM+ will be delivered to AS&Rs in contact with NGOs in Liverpool City Region, UK, by lay therapists who have lived experience of forced migration. Following systematic review and stakeholder engagement, PM+ has been adapted to the local context, and lay therapists have been trained in its delivery. We will assess the feasibility of conducting a three-arm RCT of five 90-minute sessions of PM+, delivered individually or in groups by lay therapists to AS&Rs experiencing emotional distress and functional impairment, compared with each other and with usual support offered by local NGOs. Distress and impairment at baseline will be measured by Hospital Anxiety and Depression Scale (HADS) and WHO Disability Assessment Schedule (WHO-DAS). We aim to recruit 105 participants, 35 per arm. Primary health outcomes are anxiety and depressive symptoms at 3 months, measured by HADS. Secondary outcomes include subjective wellbeing, functional status, progress on identified problems, post-traumatic stress disorder, depressive disorder and service usage. Longer term impact will be assessed at 6-months post baseline, on the same parameters. We will assess the feasibility of conducting a full RCT in relation to the following elements: recruitment and retention of lay therapists and study participants; fidelity of delivery of PM+; and suitability of the study measures, including any linguistic or cultural barriers. Discussion We will use these findings to specify the parameters for a full randomised controlled trial to test the effectiveness and cost effectiveness of PM+ in reducing emotional distress and health inequalities, and improving functional ability and wellbeing, amongst asylum seekers and refugees.

Item Type: Article
Uncontrolled Keywords: Behavioral and Social Science, Brain Disorders, Comparative Effectiveness Research, Mind and Body, Clinical Research, Depression, Mental Health, Clinical Trials and Supportive Activities, 6.6 Psychological and behavioural, 3.1 Primary prevention interventions to modify behaviours or promote wellbeing, 3 Prevention of disease and conditions, and promotion of well-being, 6 Evaluation of treatments and therapeutic interventions, Mental health, 3 Good Health and Well Being
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 08 Apr 2021 09:06
Last Modified: 14 Mar 2024 19:38
DOI: 10.21203/rs.2.24388/v2
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3118256