Piloting a community-based psychosocial group intervention designed to reduce distress among conflict-affected adults in Colombia: a mixed-method study of remote, hybrid, and in-person modalities during the COVID-19 pandemic
Abstract Background Community members in Quibdó (Choco, Colombia) are highly vulnerable to psychosocial problems associated with the internal armed conflict, poverty, and insufficient public services, and exacerbated by the COVID-19 pandemic. A pilot study was conducted with conflict-affected adults...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | International Journal of Mental Health Systems |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13033-023-00597-4 |
| _version_ | 1797578115079208960 |
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| author | Michel Rattner Leah Emily James Juan Fernando Botero Hernando Chiari Guillermo Andrés Bastidas Beltrán Mateo Bernal Juan Nicolás Cardona Carlos Gantiva |
| author_facet | Michel Rattner Leah Emily James Juan Fernando Botero Hernando Chiari Guillermo Andrés Bastidas Beltrán Mateo Bernal Juan Nicolás Cardona Carlos Gantiva |
| author_sort | Michel Rattner |
| collection | DOAJ |
| description | Abstract Background Community members in Quibdó (Choco, Colombia) are highly vulnerable to psychosocial problems associated with the internal armed conflict, poverty, and insufficient public services, and exacerbated by the COVID-19 pandemic. A pilot study was conducted with conflict-affected adults in Quibdó to assess feasibility and outcomes of a community-based psychosocial support group intervention using three different intervention modalities: in-person, remote (conducted online), and hybrid (half of sessions in-person, half-remote). This group model integrated problem-solving and culturally based expressive activities and was facilitated by local community members with supervision by mental health professionals. Methods This study utilized a mixed-explanatory sequential design (a quantitative phase deriving in a qualitative phase) with 39 participants and 8 staff members. Participants completed quantitative interviews before and after an eight-week group intervention. A subset of 17 participants also completed in-depth qualitative interviews and a focus group discussion was conducted with staff at post-intervention. Results From pre- to post-intervention, participants in all modalities demonstrated improved wellbeing and reduced symptoms of generalized distress, anxiety, depression, and posttraumatic stress. Use of coping skills varied across modalities, with remote groups associated with a decrease in some forms of coping, including use of social support. In qualitative interviews and the focus group discussion, participants and staff described logistical challenges and successes, as well as facilitators of change such as problem resolution, emotional regulation and social support with variations across modalities, such that remote groups provided fewer opportunities for social support and cohesion. Conclusions Results offer preliminary evidence that this model can address psychosocial difficulties across the three modalities, while also identifying potential risks and challenges, therefore providing useful guidance for service delivery in conflict-affected settings during the COVID-19 pandemic and other challenging contexts. Implications of this study for subsequent implementation of a Randomized Control Trial (RCT) are discussed. |
| first_indexed | 2024-03-10T22:17:47Z |
| format | Article |
| id | doaj.art-af627b85989e451eb484bb7c1965f685 |
| institution | Directory Open Access Journal |
| issn | 1752-4458 |
| language | English |
| last_indexed | 2024-03-10T22:17:47Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Mental Health Systems |
| spelling | doaj.art-af627b85989e451eb484bb7c1965f6852023-11-19T12:24:10ZengBMCInternational Journal of Mental Health Systems1752-44582023-10-0117111610.1186/s13033-023-00597-4Piloting a community-based psychosocial group intervention designed to reduce distress among conflict-affected adults in Colombia: a mixed-method study of remote, hybrid, and in-person modalities during the COVID-19 pandemicMichel Rattner0Leah Emily James1Juan Fernando Botero2Hernando Chiari3Guillermo Andrés Bastidas Beltrán4Mateo Bernal5Juan Nicolás Cardona6Carlos Gantiva7Department of Psychology, Palo Alto UniversityHeartland Alliance InternationalHeartland Alliance InternationalDepartment of Psychology, Universidad de Los AndesHeartland Alliance InternationalDepartment of Psychology, Universidad de Los AndesDepartment of Psychology, Universidad de Los AndesDepartment of Psychology, Universidad de Los AndesAbstract Background Community members in Quibdó (Choco, Colombia) are highly vulnerable to psychosocial problems associated with the internal armed conflict, poverty, and insufficient public services, and exacerbated by the COVID-19 pandemic. A pilot study was conducted with conflict-affected adults in Quibdó to assess feasibility and outcomes of a community-based psychosocial support group intervention using three different intervention modalities: in-person, remote (conducted online), and hybrid (half of sessions in-person, half-remote). This group model integrated problem-solving and culturally based expressive activities and was facilitated by local community members with supervision by mental health professionals. Methods This study utilized a mixed-explanatory sequential design (a quantitative phase deriving in a qualitative phase) with 39 participants and 8 staff members. Participants completed quantitative interviews before and after an eight-week group intervention. A subset of 17 participants also completed in-depth qualitative interviews and a focus group discussion was conducted with staff at post-intervention. Results From pre- to post-intervention, participants in all modalities demonstrated improved wellbeing and reduced symptoms of generalized distress, anxiety, depression, and posttraumatic stress. Use of coping skills varied across modalities, with remote groups associated with a decrease in some forms of coping, including use of social support. In qualitative interviews and the focus group discussion, participants and staff described logistical challenges and successes, as well as facilitators of change such as problem resolution, emotional regulation and social support with variations across modalities, such that remote groups provided fewer opportunities for social support and cohesion. Conclusions Results offer preliminary evidence that this model can address psychosocial difficulties across the three modalities, while also identifying potential risks and challenges, therefore providing useful guidance for service delivery in conflict-affected settings during the COVID-19 pandemic and other challenging contexts. Implications of this study for subsequent implementation of a Randomized Control Trial (RCT) are discussed.https://doi.org/10.1186/s13033-023-00597-4Low-middle-income countriesCOVID-19Community-basedGroup interventionLay-providersMixed methods |
| spellingShingle | Michel Rattner Leah Emily James Juan Fernando Botero Hernando Chiari Guillermo Andrés Bastidas Beltrán Mateo Bernal Juan Nicolás Cardona Carlos Gantiva Piloting a community-based psychosocial group intervention designed to reduce distress among conflict-affected adults in Colombia: a mixed-method study of remote, hybrid, and in-person modalities during the COVID-19 pandemic International Journal of Mental Health Systems Low-middle-income countries COVID-19 Community-based Group intervention Lay-providers Mixed methods |
| title | Piloting a community-based psychosocial group intervention designed to reduce distress among conflict-affected adults in Colombia: a mixed-method study of remote, hybrid, and in-person modalities during the COVID-19 pandemic |
| title_full | Piloting a community-based psychosocial group intervention designed to reduce distress among conflict-affected adults in Colombia: a mixed-method study of remote, hybrid, and in-person modalities during the COVID-19 pandemic |
| title_fullStr | Piloting a community-based psychosocial group intervention designed to reduce distress among conflict-affected adults in Colombia: a mixed-method study of remote, hybrid, and in-person modalities during the COVID-19 pandemic |
| title_full_unstemmed | Piloting a community-based psychosocial group intervention designed to reduce distress among conflict-affected adults in Colombia: a mixed-method study of remote, hybrid, and in-person modalities during the COVID-19 pandemic |
| title_short | Piloting a community-based psychosocial group intervention designed to reduce distress among conflict-affected adults in Colombia: a mixed-method study of remote, hybrid, and in-person modalities during the COVID-19 pandemic |
| title_sort | piloting a community based psychosocial group intervention designed to reduce distress among conflict affected adults in colombia a mixed method study of remote hybrid and in person modalities during the covid 19 pandemic |
| topic | Low-middle-income countries COVID-19 Community-based Group intervention Lay-providers Mixed methods |
| url | https://doi.org/10.1186/s13033-023-00597-4 |
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