为塞拉利昂青少年扩大循证心理健康干预措施的替代交付平台:一项试点研究。
Alternative Delivery Platforms for Expanding Evidence-based Mental Health Interventions for Youth in Sierra Leone: A Pilot Study.
作者信息
Desrosiers Alethea, Freeman Jordan, Mitra Romita, Bond Laura, Santo Leila Dal, Farrar Jordan, Borg Ryan, Jambai Musu, Betancourt Theresa S
机构信息
Boston College School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467.
Caritas-Freetown, 19 Savage Street, Freetown, Sierra Leone.
出版信息
Vulnerable Child Youth Stud. 2023;18(1):131-142. doi: 10.1080/17450128.2022.2094518. Epub 2022 Jul 5.
Given the high rates of mental health problems and poor service access among youth in war-affected countries throughout Sub-Saharan Africa, incorporating evidence-based mental health interventions into alternative delivery platforms could improve service access in these settings. We conducted a randomized controlled pilot study with high-risk Sierra Leonean youth to investigate the feasibility of implementing the Youth Readiness Intervention (YRI), a cognitive behavioral and interpersonal therapy-based group intervention, within an employment promotion program (EPP) and preliminary effects of the YRI on mental health outcomes. Participants were 175 youth (females=62%) ages 18-30 recruited via flyers and radio announcements. Participants were assigned to geographic clusters stratified by gender; clusters were randomized into YRI+EPP (n=58) or EPP-only (n=57). Statistically matched controls were recruited from comparable chiefdoms (n=60). The 12-session YRI was delivered bi-weekly, following EPP completion. Qualitative findings indicated that the YRI was highly feasible and acceptable as integrated into the EPP. Mixed linear effects models showed promising trends. Compared with controls, both YRI+EPP and EPP-only males reported significantly reduced post-traumatic stress symptoms, and YRI+EPP reported marginally significantly reduced emotional regulation difficulties. EPP-only females reported significantly reduced functional impairment compared to controls. Findings suggest that the YRI can be feasibly implemented within an EPP. Integrating the YRI into existing delivery platforms may help increase access to mental health care in Sierra Leone and provide a leverage point for scaling up evidence-based mental health interventions in other low-resource settings globally. [Clinicaltrials.gov; NCT0360361; 5/18/18].
鉴于撒哈拉以南非洲受战争影响国家的青少年心理健康问题发生率高且难以获得服务,将循证心理健康干预措施纳入替代服务提供平台可改善这些地区的服务可及性。我们对高风险的塞拉利昂青少年开展了一项随机对照试验性研究,以调查在就业促进项目(EPP)中实施基于认知行为和人际治疗的团体干预措施“青少年准备度干预”(YRI)的可行性,以及YRI对心理健康结果的初步影响。参与者为175名年龄在18至30岁的青少年(女性占62%),通过传单和电台公告招募。参与者按性别分层分配到地理群组;群组被随机分为YRI+EPP组(n=58)或仅EPP组(n=57)。从可比的酋长领地招募了统计学匹配的对照组(n=60)。在EPP完成后,每两周进行一次为期12节的YRI干预。定性研究结果表明,YRI作为EPP的一部分具有高度可行性和可接受性。混合线性效应模型显示出有前景的趋势。与对照组相比,YRI+EPP组和仅EPP组的男性创伤后应激症状均显著减轻,YRI+EPP组的情绪调节困难略有显著减轻。与对照组相比,仅EPP组的女性功能损害显著减轻。研究结果表明,YRI可在EPP中切实实施。将YRI纳入现有的服务提供平台可能有助于增加塞拉利昂获得心理健康护理的机会,并为在全球其他资源匮乏地区扩大循证心理健康干预措施提供一个切入点。[Clinicaltrials.gov;NCT0360361;2018年5月18日]