Tol W A, Augustinavicius J, Carswell K, Brown F L, Adaku A, Leku M R, García-Moreno C, Ventevogel P, White R G, van Ommeren M
PCAF Global Mental Health Program, Health Right International, Kampala, Uganda.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Glob Ment Health (Camb). 2018 Jul 27;5:e25. doi: 10.1017/gmh.2018.14. eCollection 2018.
In this period of unprecedented levels of displacement, scalable interventions are needed to address mental health concerns of forced migrants in low-resource settings. This paper describes the adaptation and piloting of a guided, multi-media, self-help intervention, Self-Help Plus (SH+), which was developed to reduce psychological distress in large groups of people affected by adversity.
Using a phased approach that included community consultations, cognitive interviewing, facilitator training, pilot implementation, and a qualitative process evaluation, we adapted SH+ for use among South Sudanese refugees in a refugee settlement in northern Uganda.
The SH+ materials, including audio-recorded sessions and an accompanying illustrated manual, were translated into Juba Arabic. Cognitive interviewing primarily resulted in adaptations to language with some minor adaptations to content. Facilitator training and supervision led to further suggested changes to delivery methods. An uncontrolled pilot study ( = 65) identified changes in the expected direction on measures of psychological distress, functional impairment, depression, wellbeing, and psychological flexibility. The process evaluation resulted in further adaptations to intervention materials and the decision to focus future effectiveness evaluations of the intervention in its current form on South Sudanese female refugees.
We found that this potentially scalable, guided self-help intervention could be adapted for and feasibly implemented among female South Sudanese refugees in northern Uganda. These findings lay the groundwork for a future rigorous evaluation of SH+ in this context.
在这一流离失所情况达到前所未有的时期，需要有可扩展的干预措施来解决资源匮乏地区被迫移民的心理健康问题。本文描述了一种有指导的多媒体自助干预措施“自助增强版”（SH+）的改编及试点情况，该措施旨在减轻受逆境影响的大批人群的心理困扰。
采用包括社区咨询、认知访谈、 facilitator培训、试点实施和定性过程评估在内的分阶段方法，我们对SH+进行了改编，以便在乌干达北部一个难民营中的南苏丹难民中使用。
SH+材料，包括录音课程和一本配有插图的手册，被翻译成朱巴阿拉伯语。认知访谈主要导致对语言的改编，对内容也有一些小的改编。facilitator培训和监督导致对交付方式提出进一步的修改建议。一项非对照试点研究（n = 65）发现，在心理困扰、功能损害、抑郁、幸福感和心理灵活性的测量方面，出现了预期方向的变化。过程评估导致对干预材料的进一步改编，并决定将该干预措施当前形式的未来有效性评估重点放在南苏丹女性难民身上。
我们发现，这种具有潜在可扩展性的有指导的自助干预措施可以改编并在乌干达北部的南苏丹女性难民中切实实施。这些发现为未来在这种背景下对SH+进行严格评估奠定了基础。
