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哥伦比亚针对冲突幸存者的基于社区的团体心理社会支持模式的可行性、可接受性和初步有效性:对新冠疫情期间面对面和远程干预方式的评估

Feasibility, acceptability and preliminary effectiveness of a community-based group psychosocial support model for conflict survivors in Colombia: An assessment of in-person and remote intervention modalities during the COVID-19 pandemic.

作者信息

James Leah E, García Mejía Nicolás, Botero-García Juan F, Rattner Michel

机构信息

Heartland Alliance International, Chicago, IL, USA.

Institute of Behavioral Science, University of Colorado, Boulder, CO, USA.

出版信息

Glob Ment Health (Camb). 2024 Apr 30;11:e61. doi: 10.1017/gmh.2024.50. eCollection 2024.

DOI:10.1017/gmh.2024.50
PMID:38774886
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11106545/
Abstract

BACKGROUND

Community-based psychosocial support (CB-PSS) interventions utilizing task sharing and varied (in-person, remote) modalities are essential strategies to meet mental health needs, including during the COVID-19 pandemic. However, knowledge gaps remain regarding feasibility and effectiveness.

METHODS

This study assesses feasibility, acceptability and preliminary effectiveness of a CB-PSS intervention for conflict-affected adults in Colombia through parallel randomized controlled trials, one delivered in-person ( = 165) and the other remotely ( = 103), implemented during the COVID-19 pandemic and national protests. Interventions were facilitated by nonspecialist community members and consisted of eight problem-solving and expressive group sessions.

FINDINGS

Attendance was moderate and fidelity was high in both modalities. Participants in both modalities reported high levels of satisfaction, with in-person participants reporting increased comfort expressing emotions and more positive experiences with research protocols. Symptoms of depression, anxiety and posttraumatic stress disorder improved among in-person participants, but there were no significant changes for remote participants in comparison to waitlist controls.

IMPLICATIONS

This CB-PSS intervention appears feasible and acceptable in both in-person and remote modalities and associated with reduction in some forms of distress when conducted in-person but not when conducted remotely. Methodological limitations and potential explanations and areas for future research are discussed, drawing from related studies.

摘要

背景

基于社区的心理社会支持(CB-PSS)干预措施,利用任务分担和多种(面对面、远程)方式,是满足心理健康需求的重要策略,包括在新冠疫情期间。然而,在可行性和有效性方面仍存在知识空白。

方法

本研究通过平行随机对照试验,评估了哥伦比亚一项针对受冲突影响成年人的CB-PSS干预措施的可行性、可接受性和初步有效性,一项是面对面实施(n = 165),另一项是远程实施(n = 103),在新冠疫情和全国抗议期间进行。干预由非专业社区成员协助进行,包括八次解决问题和表达性小组会议。

结果

两种方式的出勤率适中,保真度高。两种方式的参与者都报告了高度的满意度,面对面参与者报告在表达情绪时更自在,对研究方案有更积极的体验。面对面参与者的抑郁、焦虑和创伤后应激障碍症状有所改善,但与等待名单对照组相比,远程参与者没有显著变化。

启示

这种CB-PSS干预措施在面对面和远程方式中似乎都是可行和可接受的,面对面实施时与某些形式的痛苦减轻相关,但远程实施时则不然。借鉴相关研究,讨论了方法学局限性、潜在解释和未来研究领域。

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本文引用的文献

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Barriers and Facilitators to Implementing a Community-Based Psychosocial Support Intervention Conducted In-Person and Remotely: A Qualitative Study in Quibdó, Colombia.在哥伦比亚基布多实施面对面和远程社区心理社会支持干预的障碍和促进因素:一项定性研究。
Glob Health Sci Pract. 2024 Feb 28;12(1). doi: 10.9745/GHSP-D-23-00032.
2
Piloting a community-based psychosocial group intervention designed to reduce distress among conflict-affected adults in Colombia: a mixed-method study of remote, hybrid, and in-person modalities during the COVID-19 pandemic.试行一项旨在减轻哥伦比亚受冲突影响成年人痛苦的社区心理社会小组干预措施:一项关于新冠疫情期间远程、混合及面对面模式的混合方法研究。
Int J Ment Health Syst. 2023 Oct 24;17(1):35. doi: 10.1186/s13033-023-00597-4.
3
Effects of a Contextual Adaptation of the Unified Protocol in Multiple Emotional Disorders in Individuals Exposed to Armed Conflict in Colombia: A Randomized Clinical Trial.在哥伦比亚经历武装冲突的个体中,对统一方案进行情境适应对多种情绪障碍的效果:一项随机临床试验。
JAMA Psychiatry. 2023 Oct 1;80(10):991-999. doi: 10.1001/jamapsychiatry.2023.2392.
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The Mental Health Costs of Armed Conflicts-A Review of Systematic Reviews Conducted on Refugees, Asylum-Seekers and People Living in War Zones.武装冲突对心理健康的影响——对难民、寻求庇护者和生活在战区的人进行的系统评价综述。
Int J Environ Res Public Health. 2023 Feb 6;20(4):2840. doi: 10.3390/ijerph20042840.
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Ensuring equity in mental health and psychosocial support during the COVID-19 pandemic and beyond.在新冠疫情期间及之后确保心理健康和心理社会支持的公平性。
Confl Health. 2023 Feb 19;17(1):7. doi: 10.1186/s13031-023-00500-5.
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Remote mental health care interventions during the COVID-19 pandemic: An umbrella review.新冠疫情期间的远程心理健康干预措施:伞式综述。
Behav Res Ther. 2022 Dec;159:104226. doi: 10.1016/j.brat.2022.104226. Epub 2022 Nov 11.
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Implement Sci. 2022 Jan 12;17(1):4. doi: 10.1186/s13012-021-01179-z.
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