Feasibility trial of a scalable psychological intervention for women affected by urban adversity and gender-based violence in Nairobi
Open accessAbstract
BACKGROUND: Living in conditions of chronic adversity renders many women more vulnerable to experiencing gender-based violence (GBV). In addition to GBV's physical and social consequences, the psychological effects can be pervasive. Access to evidence-based psychological interventions that seek to support the mental health of women affected by such adversity is rare in low- and middle-income countries. METHODS: The current study evaluates a brief evidence-informed psychological intervention developed by the World Health Organization for adults impacted by adversity (Problem Management Plus; PM+). A feasibility randomised control trial (RCT) was conducted to inform a fully powered trial. Community health workers delivered the intervention to 70 women residing in three peri-urban settings in Nairobi, Kenya. Women, among whom 80% were survivors of GBV (N = 56), were randomised to receive five sessions of either PM+ (n = 35) by community health workers or enhanced treatment as usual (ETAU; n = 35). RESULTS: PM+ was not associated with any adverse events. Although the study was not powered to identify effects and accordingly did not identify effects on the primary outcome measure of general psychological distress, women survivors of adversity, including GBV, who received PM+ displayed greater reductions in posttraumatic stress disorder symptoms following treatment than those receiving ETAU. CONCLUSIONS: This feasibility study suggests that PM+ delivered by lay health workers is an acceptable and safe intervention to reach women experiencing common mental disorders and be inclusive for those affected by GBV and can be studied in a RCT in this setting. The study sets the stage for a fully powered, definitive controlled trial to assess this potentially effective intervention. TRIAL REGISTRATION: ACTRN12614001291673 , 10/12/2014, retrospectively registered during the recruitment phase.
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The trends were in favor of a symptom reduction in the treatment arm in all measures compared with the control group in both studies.
“However, the trends were in favor of a symptom reduction in the treatment arm in all measures compared with the control group in both studies.”
From A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A randomized controlled trial (2020) · cites this paper as [36]
The Results (page not specified) show lower post-treatment scores for the PM+ arm than the control arm on all three measures, although only the PCL difference was statistically significant. The paper reports one feasibility trial, so it cannot establish that the trend occurred in both studies. Its table also does not show greater pre-to-post reductions in the treatment arm on every measure. (LLM, conf=0.87)
Experimental — accuracy not yet measuredNo power calculations were conducted as this was a feasibility study; sample size for this study was based on sample sizes of prior PM+ feasibility trials.
“No power calculations were conducted as this was a feasibility study; sample size for this study was based on sample sizes of prior PM+ feasibility trials (Dawson et al., 2016; Rahman et al., 2016).”
From Feasibility trial of a scalable transdiagnostic group psychological intervention for Syrians residing in a refugee camp (2021) · cites this paper as Dawson et al., 2016
Two studies did not significantly reduce psychological distress symptoms.
“the treatment did not significantly reduce psychological distress symptoms in two studies [36, 37]”
From A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A randomized controlled trial (2020) · cites this paper as [36]
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References 36 · Cited by 43
- Authors
- Dawson, K. S., Schafer, A., Anjuri, D., Ndogoni, L., Musyoki, C., Sijbrandij, M., van Ommeren, M., & Bryant, R. A.
- Affiliations
- UNSW Sydney (AU)
- Vrije Universiteit Amsterdam (NL)
- Corresponding author
- Bryant, Richard A.
- Venue
- BMC Psychiatry
- Published
- 2016-11-18
- Volume
- 16
- Issue
- 1
- Pages
- 410-410
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC5116169
- OpenAlex
- W2554147083
- Cited by
- 43
- References
- 36
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 6 · 2023: 5 · 2022: 4 · 2021: 6 · 2020: 5 · 2019: 3 · 2018: 3 · 2017: 1
- FWCI
- 3.08
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Greater South Information System
- Funders
- Grand Challenges Canada
- World Vision Australia
- World Vision Canada
- Topics
- Social Sciences › Health › Intimate Partner and Family Violence
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- Problem Management Plus, psychological intervention, gender-based violence, women survivors, community health workers, lay health workers, post-traumatic stress disorder, psychological distress, common mental disorders, feasibility, Nairobi
- MeSH terms
- Adult, Mental Disorders, Feasibility Studies, Female, Humans, Kenya, Psychotherapy, Urban Population, Violence, Women, Survivors
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