James 2020.
| Study characteristics | |
| Methods |
Study design: RCT Duration of study: the study was conducted between July 2014 and April 2015. Country: Haiti Income classification: low‐income country in 2014‐2015 Geographical scope: metropolitan Port‐au‐Prince (Haiti) during the acute crisis (mortality is still higher than it was before the crisis) Healthcare setting: intervention groups within communities |
| Participants | 1. Age: from 18 to 65 years 2. Gender: both 3. Socioeconomic background: currently employed, n (%): 27 (5.7%) 4. Educational background: mean education, years (SD): 7.3 (4.5); range: 0 to 20 Inclusion criteria: a. aged from 18 to 65 years; b. either gender; c. available to attend 3‐day intervention training; d. able to understand consent procedures; e. resident of community and present in community during recent hurricane/monsoon season. Exclusion criteria: a. unable to attend the 3‐day intervention training; b. unable to understand consent procedures. Note: at baseline, the total sample scores for the Beck Anxiety Inventory (BAI) were 15.6 (13.8). Stated purpose: to assess the effects of an integrated mental health and disaster preparedness intervention on symptoms associated with depression, post‐traumatic stress disorder, anxiety, and functional impairment in earthquake and flood‐affected communities in Haiti |
| Interventions |
Name: mental health integrated disaster preparedness Title/name of PW and number: lay mental health workers 1. Selection: not specified 2. Educational background: not specified 3. Training: intensive week‐long session consisting of manual review and role‐play provided by principal investigators (both mental health professionals) 4. Supervision: not specified 5. Incentives/remuneration: not specified Prevention type: indicated – participants, exposed to severe stressors. presented with some level of baseline anxiety as indicated by the BAI. Intervention details: the mental health integrated disaster preparedness intervention utilizes an experiential approach, including facilitated discussion, space for sharing personal experiences and exchange of peer‐support, establishing safety and practicing coping skills targeting disaster‐related distress, and hands‐on training in disaster preparedness and response techniques for use by participants in their own lives and to support other community members. Day 1 includes discussion about mental health and psychosocial reactions to disaster‐related stress, and teaching associated coping strategies, including skills to reduce potential avoidance of disaster‐related material (e.g. self‐calming through breathing, grounding, mindfulness, and muscle relaxation exercises). On day 2, the workshop transitions to focus on disaster preparedness, including facilitated discussions regarding links between common attributions for disasters (natural causes, God’s will) and preparedness motivation. Facilitators introduce common scientific explanations for disasters such as earthquakes and floods and share recommended preparedness strategies. This is done without discouraging pre‐existing cultural and religious beliefs which participants are encouraged to maintain alongside new information. At the end of day 2 and moving into day 3, participants practice providing disaster and mental health‐related peer support to one another, including through a “mini‐disaster simulation” in which participants demonstrate skills learned throughout the 3 days. The intervention was manualized. Control: waiting list – following the third data collection time point, waiting‐list control group participants were invited to participate in the intervention. |
| Outcomes |
Participants’outcomes of interest for this review
Carers’ outcomes of interest for this review Nil Economic outcomes Nil Time points: baseline, post‐intervention (not available) Note: data were not included in the meta‐analysis because they were not provided in the right format or were not available even after attempted author contact. |
| Notes |
Source of funding: this work was supported by the Research for Health in Humanitarian Crises (R2HC) program, managed by Enhancing Learning and Research for Humanitarian Assistance (ELRHA) (CWM and LJ, ELRHA project number #10944). The £8 million R2HC program is funded equally by the Wellcome Trust and DFID, with ELRHA overseeing the program’s execution and management. The funder had no role in study design, data collection, analysis, interpretation, or writing. Notes on validation of instruments (screening and outcomes): “when possible, culturally‐adapted and validated measures were used”. Additional information: none Handling the data: not applicable Prospective trial registration number: CTRI/2018/02/012002 |