Compri Beatrice, Turrini Giulia, Purgato Marianna, Bryant Richard, Cristobal Paula, Haro Josep Maria, Kalisch Raffael, Lorant Vincent, McDaid David, McGreevy Kerry R, Mediavilla Roberto, Nosè Michela, Park A-La, Petri-Romão Papoula, Roversi Aurélia, Sijbrandij Marit, Tortelli Andrea, Witteveen Anke, Barbui Corrado
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.
School of Psychology, University of New South Wales, Sydney, NSW, Australia.
Glob Ment Health (Camb). 2025 Jun 9;12:e62. doi: 10.1017/gmh.2025.10024. eCollection 2025.
Migrants often experience psychological distress due to pre-, peri- and post-migration stressors. Scalable interventions like Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+) have been developed to address these challenges. This study evaluates a stepped-care program combining DWM and PM+ for migrants in Italy, examining its context, implementation, and mechanisms of impact. A mixed-methods process evaluation was conducted alongside a randomized controlled trial (RCT), following the Medical Research Council (MRC) framework. Post-trial qualitative data were collected through individual interviews with intervention participants (n = 10) and stakeholders (n = 10), as well as a focus group with intervention providers (n = 8). Thematic analysis was performed using NVivo. Cultural stigma and practical barriers influenced engagement, while community leaders fostered trust and participation. Interventions were feasible and acceptable. Digital delivery improved accessibility for some but posed challenges for those with low technological literacy or private spaces. The stepped-care approach supported gradual engagement with mental health strategies, enhancing self-care and emotional awareness, while provider relationships were key to sustaining motivation. The stepped-care model alleviated psychological distress and was well-received. Findings underscore the need for cultural sensitivity, digital accessibility and community engagement to optimize migrant mental health support.
移民常常因移民前、移民期间和移民后的压力源而经历心理困扰。为应对这些挑战，已开发出了诸如“压力时期做重要之事”（DWM）和“问题管理强化版”（PM+）等可扩展的干预措施。本研究评估了一项针对意大利移民的将DWM和PM+相结合的逐步照护计划，考察其背景、实施情况及影响机制。按照医学研究理事会（MRC）的框架，在一项随机对照试验（RCT）的同时进行了混合方法的过程评估。试验后通过对干预参与者（n = 10）和利益相关者（n = 10）进行个人访谈，以及与干预提供者进行焦点小组访谈（n = 8）收集了定性数据。使用NVivo进行了主题分析。文化污名和实际障碍影响了参与度，而社区领袖促进了信任和参与。干预措施是可行且可接受的。数字交付对一些人提高了可及性，但对技术素养低或缺乏私人空间的人构成了挑战。逐步照护方法支持逐步参与心理健康策略，增强自我护理和情绪意识，而提供者关系是维持动力的关键。逐步照护模式减轻了心理困扰，且受到好评。研究结果强调了文化敏感性、数字可及性和社区参与对于优化移民心理健康支持的必要性。
