Anxiety, Depressive Symptoms, Trauma, Psychological
Conditions
Keywords
women, low-resourced settings, psychosocial intervention
Brief summary
CMHD are particularly prevalent among women, posing a major threat to their own and their children's wellbeing. Despite the high prevalence of CMHD and the existence of effective treatments, interventions supporting women living in low-resourced settings remain limited. This study builds on a parent study (Zamcharts NCT03991182), which identified a high prevalence of women with anxiety and/or depression. We propose to design, test, and validate a community-based intervention nested within the public primary health system in Zambia, to identify and treat women with mild-to-severe CMHDs.
Interventions
BEHAVIORALProblem Management + For Moms
Psychosocial intervention conducted by a trained Wellbeing-Community health worker. Adapted from Problem Management +, thinking healthy and Strong Minds-Strong Communities intervention to target women with small children and mental health symptoms living in low-resourced settings. Combines several evidence-based strategies such us psychoeducational, motivational interviewing, cognitive restructuring and relaxation exercises. Organized in 10 weekly sessions (8 individual 2 in group) provided in-person, by phone or virtually.
Sponsors
Innovations for Poverty Action
Swiss Tropical & Public Health Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Women participating in ZamCharts parent study * SRQ-20 \>7 (clinically significant symptoms of depression or/anxiety), * not planning to move within the next 6 months, * with capacity to consent * not receiving current mental health care.
Exclusion criteria
* Women with active suicidal ideation (determined by Paykel=4 OR 5), * severe substance use (ACOK-SUD \>4), * mania or psychotic symptoms
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Mental health symptoms. SRQ-20 | Change between Baseline (at enrollment) and 6 months after enrollment | 20 items measuring risk of common mental health problem. |
| Feasibility of the study | Assessed 4 months after enrollment | % of 1 or more sessions completed. Qualitative feedback from participants and providers. |
| Acceptability | Assessed 4 months after enrollment | % of participants completing more than 6 sessions. Qualitative feedback from participants and providers. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Mental health symptoms. PSYCHLOPS | Used for the pre-post treatment analysis. Change between Baseline (at enrollment) and 4 months after enrollment | Psychological Outcome Profiles (5 items) |
| Functionality | Used for the pre-post treatment analysis. Change between Baseline (at enrollment) and 4 months after enrollment | WHO-DAS2 |
| World Bank's Toolkit and Inventory | Used for the pre-post treatment analysis. Change between Baseline (at enrollment) and 4 months after enrollment | Selected measures from the World Bank Toolkit to address mother-child interactions and child early development. |
| Change in Anxiety and Depression symptoms. | Used for the pre-post treatment analysis. Change between Baseline (at enrollment) and 4 months after enrollment | HSCL-25. 10 questions anxiety, 15 depression; (α = 0.90). |
Countries
Zambia
Outcome results
None listed