Mental Health Wellness 1 Clinical Trial
Official title:
Towards an Evidence-based Scalable Psychological Intervention for Young Adolescents: Feasibility cRCT of Group Psychological Help for Young Burundian Refugee Adolescents in Tanzania.
The goal of this pilot is to test the World Health Organization (WHO) Early Adolescent Skills for Emotions intervention, a new psychological intervention. The pilot in Tanzania adapted the manual for young adolescent Burundian refugees in Tanzania (ages 10 - 14) with prolonged disabling distress living in communities affected by adversity. We conducted a formative study to adapt the EASE material, followed by small feasibility RCT (M=72) along with a process evaluation.
WHO is developing a set of scalable brief psychological programs: a new generation of
shorter, less expensive and trans-diagnostic programs that can be delivered by
non-specialized providers (e.g. without formal education or experience in mental health), to
reduce common mental health symptoms and improve psychosocial functioning. In this pilot in
Tanzania, the IRC, JHU and WHO seek to assess EASE, a much needed, brief psychological
intervention developed specifically for young adolescents and their caregivers, and
applicable in different humanitarian contexts.
The IRC, JHU and WHO, in collaboration with UNHCR, Muhimbili University of Health and Allied
Sciences in Tanzania, and Village Health Works , adapted and contextualized the EASE
intervention for Burundian refugee young adolescents in Tanzania. The adaptation had three
steps:
First, the IRC conducted a desk review focusing on the cultural context for mental health
research among Burundian refugees, covering local concepts, beliefs and practices associated
with psychosocial support.
Second, the IRC conducted a formative qualitative study, consisting of 88 semi-structured
qualitative interviews (free listing (n=61) and key informant interviews (n=25)), including
with Burundian adolescent boys and girls (See Tables 1 & 2 in Annex for breakdown of
interview participants). This was followed by four focus group discussions (n=20) using
cognitive interviewing techniques with adolescents and caregivers to seek feedback
specifically on example intervention materials.
Third, the IRC and its partners used findings from the desk review and the qualitative study
to inform an adaptation workshop in May 2018 held in Kibondo, Tanzania. For the adaptation
workshop, the IRC convened the WHO, IRC mental health field staff, Village Health Works
staff, and Dr Samuel Likindikoki from the Muhimbili University of Health and Allied Sciences.
The adaptation workshop included a review of the data collected during the ethnographic
study, as well as a mock run-through of the EASE materials, which allowed for an in-depth
review of the intervention content.
The EASE pilot implementation and testing phase had eight main activities: 1) initial
screening of adolescents for eligibility into the EASE program; 2) baseline data collection
with the eligible participants and caregivers; 3) facilitator training; 4) development of a
referral protocol to ensure adequate services for participants who experienced violence or
were at high risk of suicide; 5) implementation of the EASE sessions; 6) implementation of
the "Enhanced treatment as usual" sessions (our control condition, conducted at the same time
as the EASE sessions); 7) endline data collection; and 8) process evaluation.
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