BMC Psychiatry
Volume 17, Issue 1, 2017

An integrated intervention to reduce intimate partner violence and psychological distress with refugees in low-resource settings: Study protocol for the Nguvu cluster randomized trial (Article) (Open Access)

Tol W.A.* , Greene M.C. , Likindikoki S. , Misinzo L. , Ventevogel P. , Bonz A.G. , Bass J.K. , Mbwambo J.K.K.
  • a Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 N Broadway, HH863, Baltimore, MD 21205, United States
  • b Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 N Broadway, HH863, Baltimore, MD 21205, United States
  • c Muhimbili University of Health and Allied Sciences, Department of Psychiatry, United Nations Road, Dar es Salaam, Tanzania
  • d Muhimbili University of Health and Allied Sciences, Department of Psychiatry, United Nations Road, Dar es Salaam, Tanzania
  • e United Nations High Commissioner for Refugees, Case Postale 2500, Geneva, CH, 1211, Switzerland
  • f International Rescue Committee, 122 East 42nd Street, New York, NY 10168, United States
  • g Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 N Broadway, HH863, Baltimore, MD 21205, United States
  • h Muhimbili University of Health and Allied Sciences, Department of Psychiatry, United Nations Road, Dar es Salaam, Tanzania

Abstract

Background: Intimate partner violence (IPV) is a critical public health and human rights concern globally, including for refugee women in low-resource settings. Little is known about effective interventions for this population. IPV and psychological distress have a bi-directional relationship, indicating the potential benefit of a structured psychological component as part of efforts to reduce IPV for women currently in violent relationships. Methods: This protocol describes a cluster randomized controlled trial aimed at evaluating an 8-session integrated psychological and advocacy intervention (Nguvu) with female adult survivors of past-year IPV displaying moderate to severe psychological distress. Outcomes are reductions in: recurrence of IPV; symptoms of anxiety, depression and post-traumatic stress (primary); and functional impairment (secondary). Hypothesized mediators of the intervention are improvements in social support, coping skills and support seeking. We will recruit 400 participants from existing women's support groups operating within villages in Nyarugusu refugee camp, Tanzania. Women's groups will be randomized to receive the intervention (Nguvu and usual care) or usual care alone. All eligible women will complete a baseline assessment (week 0) followed by a post-treatment (week 9) and a 3-month post-treatment assessment (week 20). The efficacy of the intervention will be determined by between-group differences in the longitudinal trajectories of primary outcomes evaluated using mixed-effects models. Study procedures have been approved by Institutional Review Boards in the United States and Tanzania. Discussion: This trial will provide evidence on the efficacy of a novel integrated group intervention aimed at secondary prevention of IPV that includes a structured psychological component to address psychological distress. The psychological and advocacy components of the proposed intervention have been shown to be efficacious for their respective outcomes when delivered in isolation; however, administering these approaches through a single, integrated intervention may result in synergistic effects given the interrelated, bidirectional relationship between IPV and mental health. Furthermore, this trial will provide information regarding the feasibility of implementing a structured intervention for IPV and mental health in a protracted humanitarian setting. Trial registration:ISRCTN65771265, June 27, 2016. © 2017 The Author(s).

Author Keywords

empowerment Advocacy Cognitive behavioral therapy Mental health Refugees Tanzania Psychological distress Democratic Republic of the Congo Intimate partner violence

Index Keywords

anxiety depression refugee health care planning methodology Research Design mental health human Refugees survivor Stress, Psychological Health Resources mental stress coping behavior controlled study randomized controlled trial social support Spouse Abuse psychotherapy Humans psychology female pilot study prevention and control Article functional disease major clinical study partner violence adult posttraumatic stress disorder Tanzania distress syndrome
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85019560943&doi=10.1186%2fs12888-017-1338-7&partnerID=40&md5=b143a97dbb62087830c8d65e70faf4f6
DOI: 10.1186/s12888-017-1338-7
ISSN: 1471244X
Cited by: 3
Original Language: English