Developing an integrated intervention to address intimate partner violence and psychological distress in Congolese refugee women in Tanzania

M. Claire Greene, Susan Rees, Samuel Likindikoki, Ann G. Bonz, Amy Joscelyne, Debra Kaysen, Reginald D.V. Nixon, Tasiana Njau, Marian T.A. Tankink, Agnes Tiwari, Peter Ventevogel, Jessie K.K. Mbwambo, Wietse Anton Tol

Research output: Contribution to journalArticle

Abstract

Background: Multi-sectoral, integrated interventions have long been recommended for addressing mental health and its social determinants (e.g., gender-based violence) in settings of ongoing adversity. We developed an integrated health and protection intervention to reduce psychological distress and intimate partner violence (IPV), and tested its delivery by lay facilitators in a low-resource refugee setting. Methods: Formative research to develop the intervention consisted of a structured desk review, consultation with experts and local stakeholders (refugee incentive workers, representatives of humanitarian agencies, and clinical experts), and qualitative interviews (40 free list interviews with refugees, 15 key informant interviews). Given existing efforts by humanitarian agencies to prevent gender-based violence in this particular refugee camp, including with (potential) perpetrators, we focused on a complementary effort to develop an integrated intervention with potential to reduce IPV and associated mental health impacts with female IPV survivors. We enrolled Congolese refugee women with elevated psychological distress and past-year histories of IPV (n = 60) who received the intervention delivered by trained and supervised lay refugee facilitators. Relevance, feasibility and acceptability of the intervention were evaluated through quantitative and qualitative interviews with participants. We assessed instrument test-retest reliability (n = 24), inter-rater reliability (n = 5 interviews), internal consistency, and construct validity (n = 60). Results: We designed an 8-session intervention, termed Nguvu ('strength'), incorporating brief Cognitive Processing Therapy (focused on helping clients obtaining skills to overcome negative thoughts and self-perceptions and gain control over the impact these have on their lives) and Advocacy Counseling (focused on increasing autonomy, empowerment and strengthening linkages to community supports). On average, participants attended two-thirds of the sessions. In qualitative interviews, participants recommended adaptations to specific intervention components and provided recommendations regarding coordination, retention, safety concerns and intervention participation incentives. Analysis of the performance of outcome instruments overall revealed acceptable reliability and validity. Conclusions: We found it feasible to develop and implement an integrated, multi-sectoral mental health and IPV intervention in a refugee camp setting. Implementation challenges were identified and may be informative for future implementation and evaluation of multi-sectoral strategies for populations facing ongoing adversity. Trial registration: ISRCTN65771265, June 27, 2016.

Original languageEnglish (US)
Article number38
JournalConflict and Health
Volume13
Issue number1
DOIs
StatePublished - Aug 17 2019

Fingerprint

Refugees
Tanzania
refugee
violence
Psychology
Interviews
Mental Health
qualitative interview
Violence
Reproducibility of Results
Motivation
mental health
Cognitive Therapy
interview
incentive
Intimate Partner Violence
expert
Self Concept
Survivors
Counseling

Keywords

  • Advocacy
  • Cognitive processing therapy
  • Democratic Republic of the Congo
  • Empowerment
  • Intimate partner violence
  • Mental health
  • Psychological distress
  • Refugees
  • Tanzania

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health

Cite this

Developing an integrated intervention to address intimate partner violence and psychological distress in Congolese refugee women in Tanzania. / Greene, M. Claire; Rees, Susan; Likindikoki, Samuel; Bonz, Ann G.; Joscelyne, Amy; Kaysen, Debra; Nixon, Reginald D.V.; Njau, Tasiana; Tankink, Marian T.A.; Tiwari, Agnes; Ventevogel, Peter; Mbwambo, Jessie K.K.; Tol, Wietse Anton.

In: Conflict and Health, Vol. 13, No. 1, 38, 17.08.2019.

Research output: Contribution to journalArticle

Greene, MC, Rees, S, Likindikoki, S, Bonz, AG, Joscelyne, A, Kaysen, D, Nixon, RDV, Njau, T, Tankink, MTA, Tiwari, A, Ventevogel, P, Mbwambo, JKK & Tol, WA 2019, 'Developing an integrated intervention to address intimate partner violence and psychological distress in Congolese refugee women in Tanzania', Conflict and Health, vol. 13, no. 1, 38. https://doi.org/10.1186/s13031-019-0222-0
Greene, M. Claire ; Rees, Susan ; Likindikoki, Samuel ; Bonz, Ann G. ; Joscelyne, Amy ; Kaysen, Debra ; Nixon, Reginald D.V. ; Njau, Tasiana ; Tankink, Marian T.A. ; Tiwari, Agnes ; Ventevogel, Peter ; Mbwambo, Jessie K.K. ; Tol, Wietse Anton. / Developing an integrated intervention to address intimate partner violence and psychological distress in Congolese refugee women in Tanzania. In: Conflict and Health. 2019 ; Vol. 13, No. 1.
@article{8d222a6df0584db18bae8ac3159e87e1,
title = "Developing an integrated intervention to address intimate partner violence and psychological distress in Congolese refugee women in Tanzania",
abstract = "Background: Multi-sectoral, integrated interventions have long been recommended for addressing mental health and its social determinants (e.g., gender-based violence) in settings of ongoing adversity. We developed an integrated health and protection intervention to reduce psychological distress and intimate partner violence (IPV), and tested its delivery by lay facilitators in a low-resource refugee setting. Methods: Formative research to develop the intervention consisted of a structured desk review, consultation with experts and local stakeholders (refugee incentive workers, representatives of humanitarian agencies, and clinical experts), and qualitative interviews (40 free list interviews with refugees, 15 key informant interviews). Given existing efforts by humanitarian agencies to prevent gender-based violence in this particular refugee camp, including with (potential) perpetrators, we focused on a complementary effort to develop an integrated intervention with potential to reduce IPV and associated mental health impacts with female IPV survivors. We enrolled Congolese refugee women with elevated psychological distress and past-year histories of IPV (n = 60) who received the intervention delivered by trained and supervised lay refugee facilitators. Relevance, feasibility and acceptability of the intervention were evaluated through quantitative and qualitative interviews with participants. We assessed instrument test-retest reliability (n = 24), inter-rater reliability (n = 5 interviews), internal consistency, and construct validity (n = 60). Results: We designed an 8-session intervention, termed Nguvu ('strength'), incorporating brief Cognitive Processing Therapy (focused on helping clients obtaining skills to overcome negative thoughts and self-perceptions and gain control over the impact these have on their lives) and Advocacy Counseling (focused on increasing autonomy, empowerment and strengthening linkages to community supports). On average, participants attended two-thirds of the sessions. In qualitative interviews, participants recommended adaptations to specific intervention components and provided recommendations regarding coordination, retention, safety concerns and intervention participation incentives. Analysis of the performance of outcome instruments overall revealed acceptable reliability and validity. Conclusions: We found it feasible to develop and implement an integrated, multi-sectoral mental health and IPV intervention in a refugee camp setting. Implementation challenges were identified and may be informative for future implementation and evaluation of multi-sectoral strategies for populations facing ongoing adversity. Trial registration: ISRCTN65771265, June 27, 2016.",
keywords = "Advocacy, Cognitive processing therapy, Democratic Republic of the Congo, Empowerment, Intimate partner violence, Mental health, Psychological distress, Refugees, Tanzania",
author = "Greene, {M. Claire} and Susan Rees and Samuel Likindikoki and Bonz, {Ann G.} and Amy Joscelyne and Debra Kaysen and Nixon, {Reginald D.V.} and Tasiana Njau and Tankink, {Marian T.A.} and Agnes Tiwari and Peter Ventevogel and Mbwambo, {Jessie K.K.} and Tol, {Wietse Anton}",
year = "2019",
month = "8",
day = "17",
doi = "10.1186/s13031-019-0222-0",
language = "English (US)",
volume = "13",
journal = "Conflict and Health",
issn = "1752-1505",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Developing an integrated intervention to address intimate partner violence and psychological distress in Congolese refugee women in Tanzania

AU - Greene, M. Claire

AU - Rees, Susan

AU - Likindikoki, Samuel

AU - Bonz, Ann G.

AU - Joscelyne, Amy

AU - Kaysen, Debra

AU - Nixon, Reginald D.V.

AU - Njau, Tasiana

AU - Tankink, Marian T.A.

AU - Tiwari, Agnes

AU - Ventevogel, Peter

AU - Mbwambo, Jessie K.K.

AU - Tol, Wietse Anton

PY - 2019/8/17

Y1 - 2019/8/17

N2 - Background: Multi-sectoral, integrated interventions have long been recommended for addressing mental health and its social determinants (e.g., gender-based violence) in settings of ongoing adversity. We developed an integrated health and protection intervention to reduce psychological distress and intimate partner violence (IPV), and tested its delivery by lay facilitators in a low-resource refugee setting. Methods: Formative research to develop the intervention consisted of a structured desk review, consultation with experts and local stakeholders (refugee incentive workers, representatives of humanitarian agencies, and clinical experts), and qualitative interviews (40 free list interviews with refugees, 15 key informant interviews). Given existing efforts by humanitarian agencies to prevent gender-based violence in this particular refugee camp, including with (potential) perpetrators, we focused on a complementary effort to develop an integrated intervention with potential to reduce IPV and associated mental health impacts with female IPV survivors. We enrolled Congolese refugee women with elevated psychological distress and past-year histories of IPV (n = 60) who received the intervention delivered by trained and supervised lay refugee facilitators. Relevance, feasibility and acceptability of the intervention were evaluated through quantitative and qualitative interviews with participants. We assessed instrument test-retest reliability (n = 24), inter-rater reliability (n = 5 interviews), internal consistency, and construct validity (n = 60). Results: We designed an 8-session intervention, termed Nguvu ('strength'), incorporating brief Cognitive Processing Therapy (focused on helping clients obtaining skills to overcome negative thoughts and self-perceptions and gain control over the impact these have on their lives) and Advocacy Counseling (focused on increasing autonomy, empowerment and strengthening linkages to community supports). On average, participants attended two-thirds of the sessions. In qualitative interviews, participants recommended adaptations to specific intervention components and provided recommendations regarding coordination, retention, safety concerns and intervention participation incentives. Analysis of the performance of outcome instruments overall revealed acceptable reliability and validity. Conclusions: We found it feasible to develop and implement an integrated, multi-sectoral mental health and IPV intervention in a refugee camp setting. Implementation challenges were identified and may be informative for future implementation and evaluation of multi-sectoral strategies for populations facing ongoing adversity. Trial registration: ISRCTN65771265, June 27, 2016.

AB - Background: Multi-sectoral, integrated interventions have long been recommended for addressing mental health and its social determinants (e.g., gender-based violence) in settings of ongoing adversity. We developed an integrated health and protection intervention to reduce psychological distress and intimate partner violence (IPV), and tested its delivery by lay facilitators in a low-resource refugee setting. Methods: Formative research to develop the intervention consisted of a structured desk review, consultation with experts and local stakeholders (refugee incentive workers, representatives of humanitarian agencies, and clinical experts), and qualitative interviews (40 free list interviews with refugees, 15 key informant interviews). Given existing efforts by humanitarian agencies to prevent gender-based violence in this particular refugee camp, including with (potential) perpetrators, we focused on a complementary effort to develop an integrated intervention with potential to reduce IPV and associated mental health impacts with female IPV survivors. We enrolled Congolese refugee women with elevated psychological distress and past-year histories of IPV (n = 60) who received the intervention delivered by trained and supervised lay refugee facilitators. Relevance, feasibility and acceptability of the intervention were evaluated through quantitative and qualitative interviews with participants. We assessed instrument test-retest reliability (n = 24), inter-rater reliability (n = 5 interviews), internal consistency, and construct validity (n = 60). Results: We designed an 8-session intervention, termed Nguvu ('strength'), incorporating brief Cognitive Processing Therapy (focused on helping clients obtaining skills to overcome negative thoughts and self-perceptions and gain control over the impact these have on their lives) and Advocacy Counseling (focused on increasing autonomy, empowerment and strengthening linkages to community supports). On average, participants attended two-thirds of the sessions. In qualitative interviews, participants recommended adaptations to specific intervention components and provided recommendations regarding coordination, retention, safety concerns and intervention participation incentives. Analysis of the performance of outcome instruments overall revealed acceptable reliability and validity. Conclusions: We found it feasible to develop and implement an integrated, multi-sectoral mental health and IPV intervention in a refugee camp setting. Implementation challenges were identified and may be informative for future implementation and evaluation of multi-sectoral strategies for populations facing ongoing adversity. Trial registration: ISRCTN65771265, June 27, 2016.

KW - Advocacy

KW - Cognitive processing therapy

KW - Democratic Republic of the Congo

KW - Empowerment

KW - Intimate partner violence

KW - Mental health

KW - Psychological distress

KW - Refugees

KW - Tanzania

UR - http://www.scopus.com/inward/record.url?scp=85070870719&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070870719&partnerID=8YFLogxK

U2 - 10.1186/s13031-019-0222-0

DO - 10.1186/s13031-019-0222-0

M3 - Article

VL - 13

JO - Conflict and Health

JF - Conflict and Health

SN - 1752-1505

IS - 1

M1 - 38

ER -