M Claire Greene1, Samuel Likindikoki2, Susan Rees3, Annie Bonz4, Debra Kaysen5, Lusia Misinzo2, Tasiana Njau2, Shangwe Kiluwa2, Rachael Turner6, Peter Ventevogel7, Jessie K K Mbwambo2, Wietse A Tol8,9,10. 1. Program on Forced Migration and Health, Columbia University Mailman School of Public Health, New York, New York, United States of America. 2. Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. 3. School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia. 4. HIAS, Silver Spring, Maryland, United States of America. 5. Department Psychiatry, Public Mental Health and Population Sciences, Stanford University, Palo Alto, California, United States of America. 6. Department of Community-Public Health, Johns Hopkins School of Nursing, Baltimore, Maryland, United States of America. 7. Public Health Section, United Nations High Commissioner for Refugees, Geneva, Switzerland. 8. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America. 9. Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark. 10. Peter C. Alderman Foundation, HealthRight International, New York, New York, United States of America.
Abstract
INTRODUCTION: The complex relationship between intimate partner violence and psychological distress warrants an integrated intervention approach. In this study we examined the relevance, acceptability, and feasibility of evaluating a multi-sectoral integrated violence- and mental health-focused intervention (Nguvu). METHODS: We enrolled 311 Congolese refugee women from Nyarugusu refugee camp in Tanzania with past-year intimate partner violence and elevated psychological distress in a feasibility cluster randomized trial. Women were recruited from local women's groups that were randomized to the Nguvu intervention or usual care. Participants from women's groups randomized to Nguvu received 8 weekly sessions delivered by lay refugee incentive workers. Psychological distress, intimate partner violence, other wellbeing, and process indicators were assessed at baseline and 9-weeks post-enrollment to evaluate relevance, acceptability, and feasibility of implementing and evaluating Nguvu in refugee contexts. RESULTS: We found that Nguvu was relevant to the needs of refugee women affected by intimate partner violence. We found reductions in some indicators of psychological distress, but did not identify sizeable changes in partner violence over time. Overall, we found that Nguvu was acceptable and feasible. However, challenges to the research protocol included baseline imbalances between study conditions, differential intervention completion related to intimate partner violence histories, differences between Nguvu groups and facilitators, and some indication that Nguvu may be less beneficial for participants with more severe intimate partner violence profiles. CONCLUSIONS: We found evidence supporting the relevance of Nguvu to refugee women affected by partner violence and psychological distress and moderate evidence supporting the acceptability and feasibility of evaluating and implementing this intervention in a complex refugee setting. A definitive cluster randomized trial requires further adaptations for recruitment and eligibility screening, randomization, and retention. TRIAL REGISTRATION: ISRCTN65771265, June 27, 2016.
INTRODUCTION: The complex relationship between intimate partner violence and psychological distress warrants an integrated intervention approach. In this study we examined the relevance, acceptability, and feasibility of evaluating a multi-sectoral integrated violence- and mental health-focused intervention (Nguvu). METHODS: We enrolled 311 Congolese refugee women from Nyarugusu refugee camp in Tanzania with past-year intimate partner violence and elevated psychological distress in a feasibility cluster randomized trial. Women were recruited from local women's groups that were randomized to the Nguvu intervention or usual care. Participants from women's groups randomized to Nguvu received 8 weekly sessions delivered by lay refugee incentive workers. Psychological distress, intimate partner violence, other wellbeing, and process indicators were assessed at baseline and 9-weeks post-enrollment to evaluate relevance, acceptability, and feasibility of implementing and evaluating Nguvu in refugee contexts. RESULTS: We found that Nguvu was relevant to the needs of refugee women affected by intimate partner violence. We found reductions in some indicators of psychological distress, but did not identify sizeable changes in partner violence over time. Overall, we found that Nguvu was acceptable and feasible. However, challenges to the research protocol included baseline imbalances between study conditions, differential intervention completion related to intimate partner violence histories, differences between Nguvu groups and facilitators, and some indication that Nguvu may be less beneficial for participants with more severe intimate partner violence profiles. CONCLUSIONS: We found evidence supporting the relevance of Nguvu to refugee women affected by partner violence and psychological distress and moderate evidence supporting the acceptability and feasibility of evaluating and implementing this intervention in a complex refugee setting. A definitive cluster randomized trial requires further adaptations for recruitment and eligibility screening, randomization, and retention. TRIAL REGISTRATION: ISRCTN65771265, June 27, 2016.
Authors: Muluken Dessalegn Muluneh; Virginia Stulz; Lyn Francis; Kingsley Agho Journal: Int J Environ Res Public Health Date: 2020-02-01 Impact factor: 3.390
Authors: M Claire Greene; Clarisa Bencomo; Susan Rees; Peter Ventevogel; Samuel Likindikoki; Ashley Nemiro; Annie Bonz; Jessie K K Mbwambo; Wietse A Tol; Terry M McGovern Journal: Int J Environ Res Public Health Date: 2021-11-26 Impact factor: 3.390
Authors: Marx R Leku; Jacqueline N Ndlovu; Christine Bourey; Luke R Aldridge; Nawaraj Upadhaya; Wietse A Tol; Jura L Augustinavicius Journal: BJPsych Open Date: 2022-08-01