Hall Jonathan, Ainamani Herbert E, Vassiliou Phaidon T B, Döring Stefan, Gredebäck Gustaf, Peltonen Kirsi, Scharpf Florian, Sen Umay, Sutter Matthias, Walsh James I, Hecker Tobias
Department of Peace and Conflict Research, Uppsala University, Uppsala, Sweden.
Department of Mental Health, Kabale University School of Medicine, Kabale University, Kabale, Uganda.
Trials. 2025 Sep 1;26(1):331. doi: 10.1186/s13063-025-09042-y.
Climate extremes in Africa threaten the food security of war-affected refugees, who often experience mental health challenges that hinder their capacity for agricultural adaptation. Cost-effective, climate-smart farming interventions are crucial for addressing food insecurity in humanitarian contexts, yet evidence on their effectiveness is limited, and the potential benefits of integrating them with mental health interventions remain unexplored. We hypothesize that the success of agricultural interventions, especially under adversity, is influenced by mental health and psychological functioning.
This study employs a three-arm, parallel-group, cluster-randomized controlled trial (cRCT) in the Nakivale refugee settlement, Uganda. Thirty villages within the settlement will be randomized in a 1:1:1 allocation ratio to one of three conditions: Enhanced Usual Care, a Home Gardening Intervention (HGI) or HGI combined with the peer-delivered psychosocial intervention Self-Help Plus (SH + HGI). A total of 900 refugee mothers and their children (aged 3-4 years) will be enrolled, with 30 dyads per village. The primary outcome is food insecurity at 12 months post-intervention, assessed using the Food Insecurity Experience Scale (FIES). Secondary outcomes include dietary diversity, child malnutrition and mothers' psychological distress. Data will be collected at baseline, 3-month and 12-month follow-ups. Primary analyses will use an intention-to-treat (ITT) approach.
This study will shed light on the role of mental health in agricultural adaptation for food security, evaluating the efficacy of scalable, cost-effective interventions in a refugee setting. The findings will have implications for the design and implementation of integrated food security and mental health programs in humanitarian and other resource-constrained settings.
ClinicalTrials.gov NCT06425523. Registered on 24 May 2024.
非洲的极端气候威胁着受战争影响的难民的粮食安全，这些难民经常面临心理健康挑战，这阻碍了他们进行农业适应的能力。具有成本效益且气候智能型的农业干预措施。。
