BMJ Open (Apr 2022)
Scalable psychological interventions for Syrian refugees in Europe and the Middle East: STRENGTHS study protocol for a prospective individual participant data meta-analysis
- ,
- Pim Cuijpers,
- Kenneth Carswell,
- Ceren Acarturk,
- Martha Bird,
- Zeynep Ilkkursun,
- Marit Sijbrandij,
- Ersin Uygun,
- Bayard Roberts,
- Richard Bryant,
- Egbert Sondorp,
- David McDaid,
- Christine Knaevelsrud,
- Mark J D Jordans,
- A-La Park,
- Aemal Akhtar,
- Ulrich Schnyder,
- Sebastian Burchert,
- Trudy Mooren,
- Anke B Witteveen,
- Peter Ventevogel,
- Anne M de Graaff,
- Mhd Salem Alkneme,
- May Aoun,
- Manar Awwad,
- Ahmad Y Bawaneh,
- Felicity L Brown,
- Annelieke Drogendijk,
- Michelle Engels,
- Daniela C Fuhr,
- Pernille Hansen,
- Edith van 't Hof,
- Luana Giardinelli,
- Mahmoud Hemmo,
- Jonas M Hessling,
- Nikolai Kiselev,
- Gülsah Kurt,
- Saara Martinmäki,
- Naser Morina,
- Hadeel Naser,
- Monique C Pfaltz,
- Matthis Schick,
- Julia Spaaij,
- Frederik Steen,
- Karine Taha,
- Claire Whitney,
- Martine van den Dool,
- Cansu Mirzanlı,
- Nana Wiedemann,
- Aniek Woodward
Affiliations
- The Royal College of Emergency Medicine, London, London, UK
- Pim Cuijpers
- 6 Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam, Amsterdam, The Netherlands
- Kenneth Carswell
- Department of Mental Health and Substance Use, World Health Organization, Geneve, Switzerland
- Ceren Acarturk
- 7 Department of Psychology, Koc University, Istanbul, Türkiye
- Martha Bird
- Zeynep Ilkkursun
- Department of Psychology, Koç University, Istanbul, Turkey
- Marit Sijbrandij
- 6 Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam, Amsterdam, The Netherlands
- Ersin Uygun
- Trauma and Disaster Mental Health Master Programme, Istanbul Bilgi University, Istanbul, İstanbul, Turkey
- Bayard Roberts
- Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Richard Bryant
- School of Psychology, UNSW, Sydney, New South Wales, Australia
- Egbert Sondorp
- KIT Royal Tropical Institute, Amsterdam, The Netherlands
- David McDaid
- 10 Department of Health Policy, London School of Economics and Political Science, London, UK
- Christine Knaevelsrud
- 9 Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
- Mark J D Jordans
- 9 Health Service and Population Research Department, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King`s College, London, UK
- A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, The London School of Economics and Political Science, London, UK
- Aemal Akhtar
- Karolinska Institute, Sweden, UK
- Ulrich Schnyder
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
- Sebastian Burchert
- 17 Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
- Trudy Mooren
- Anke B Witteveen
- Department of Clinical, Neuro- and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Peter Ventevogel
- 18 Public Health Section, UNHCR, Geneva, Switzerland
- Anne M de Graaff
- 1 Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, The Netherlands
- Mhd Salem Alkneme
- Division of Clinical-Psychological Intervention, Department of Education and Psychology, Freie Universitat Berlin, Berlin, Germany
- May Aoun
- Research and Development Department, War Child, Amsterdam, The Netherlands
- Manar Awwad
- Technical Unit, International Medical Corps, London, UK
- Ahmad Y Bawaneh
- Technical Unit, International Medical Corps, London, UK
- Felicity L Brown
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
- Annelieke Drogendijk
- ARQ International, ARQ National Psychotrauma Centre, Amsterdam, The Netherlands
- Michelle Engels
- International Federation of Red Cross and Red Crescent Societies Reference Centre for Psychosocial Support, Copenhagen, Denmark
- Daniela C Fuhr
- 23 Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Pernille Hansen
- 13 Reference Centre for Psychosocial Support, International Federation of Red Cross and Red Crescent Societies, Copenhagen, Denmark
- Edith van 't Hof
- Department of Mental Health and Substance Abuse, World Health Organization, Geneve, Switzerland
- Luana Giardinelli
- Technical Unit, International Medical Corps, London, UK
- Mahmoud Hemmo
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
- Jonas M Hessling
- Division of Clinical-Psychological Intervention, Department of Education and Psychology, Freie Universitat Berlin, Berlin, Germany
- Nikolai Kiselev
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
- Gülsah Kurt
- 15 School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Saara Martinmäki
- ARQ International, ARQ National Psychotrauma Centre, Amsterdam, The Netherlands
- Naser Morina
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Hadeel Naser
- Technical Unit, International Medical Corps, London, UK
- Monique C Pfaltz
- Department of Psychology and Social Work, Mid Sweden University, Sundsvall, Sweden
- Matthis Schick
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
- Julia Spaaij
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
- Frederik Steen
- Research and Development Department, War Child, Amsterdam, The Netherlands
- Karine Taha
- Research and Development Department, War Child, Amsterdam, The Netherlands
- Claire Whitney
- Technical Unit, International Medical Corps, London, UK
- Martine van den Dool
- Cansu Mirzanlı
- Nana Wiedemann
- 13 Reference Centre for Psychosocial Support, International Federation of Red Cross and Red Crescent Societies, Copenhagen, Denmark
- Aniek Woodward
- 19 KIT Health, KIT Royal Tropical Institute, Amsterdam, Noord-Holland, The Netherlands
- DOI
- https://doi.org/10.1136/bmjopen-2021-058101
- Journal volume & issue
-
Vol. 12,
no. 4
Abstract
Introduction The World Health Organization’s (WHO) scalable psychological interventions, such as Problem Management Plus (PM+) and Step-by-Step (SbS) are designed to be cost-effective non-specialist delivered interventions to reduce symptoms of common mental disorders, such as anxiety, depression and post-traumatic stress disorder (PTSD). The STRENGTHS consortium aims to evaluate the effectiveness, cost-effectiveness and implementation of the individual format of PM+ and its group version (gPM+), as well as of the digital SbS intervention among Syrian refugees in seven countries in Europe and the Middle East. This is a study protocol for a prospective individual participant data (IPD) meta-analysis to evaluate (1) overall effectiveness and cost-effectiveness and (2) treatment moderators of PM+, gPM+ and SbS with Syrian refugees.Methods and analysis Five pilot randomised controlled trials (RCTs) and seven fully powered RCTs conducted within STRENGTHS will be combined into one IPD meta-analytic dataset. The RCTs include Syrian refugees of 18 years and above with elevated psychological distress (Kessler Psychological Distress Scale (K10>15)) and impaired daily functioning (WHO Disability Assessment Schedule 2.0 (WHODAS 2.0>16)). Participants are randomised into the intervention or care as usual control group, and complete follow-up assessments at 1-week, 3-month and 12-month follow-up. Primary outcomes are symptoms of depression and anxiety (25-item Hopkins Symptom Checklist). Secondary outcomes include daily functioning (WHODAS 2.0), PTSD symptoms (PTSD Checklist for DSM-5) and self-identified problems (PSYCHLOPS). We will conduct a one-stage IPD meta-analysis using linear mixed models. Quality of evidence will be assessed using the GRADE approach, and the economic evaluation approach will be assessed using the CHEC-list.Ethics and dissemination Local ethical approval has been obtained for each RCT. This IPD meta-analysis does not require ethical approval. The results of this study will be published in international peer-reviewed journals.
