Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 Nov 18;16(1):410.
doi: 10.1186/s12888-016-1117-x.

Feasibility trial of a scalable psychological intervention for women affected by urban adversity and gender-based violence in Nairobi

Katie S Dawson  1 , Alison Schafer  2 , Dorothy Anjuri  3 , Lincoln Ndogoni  4 , Caroline Musyoki  3 , Marit Sijbrandij  5 , Mark van Ommeren  6 , Richard A Bryant  7
Affiliations
Randomized Controlled Trial

Feasibility trial of a scalable psychological intervention for women affected by urban adversity and gender-based violence in Nairobi

Katie S Dawson et al. BMC Psychiatry. .

Abstract

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.

Keywords: Gender based violence; Mental health; Psychological intervention; Trauma; Trial.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Participant flow
See this image and copyright information in PMC

References

    1. Ferrari AJ, Charlson FJ, Norman RE, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS One. 2013;10 - PMC - PubMed
    1. WHO . Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO; 2013.
    1. Kenya National Bureau of Statistics . Kenya demographic and health survey, 2014. Maryland: KNBS and ICF International; 2015.
    1. Garcia-Moreno C, Hegarty K, Flavia A, d’Oliveira L, Koziol-MacLain J, Colombini M, Feder G. The health-system response to violence against women. Lancet. 2014;385:1567–1579. doi: 10.1016/S0140-6736(14)61837-7. - DOI - PubMed
    1. Tol WA, Stavrou V, Greene MC, Mergenthaler C, van Ommeren M, Garcia-Moreno C. Sexual and gender-based violence in areas of armed conflict: A systematic review of mental health and psychosocial support interventions. Confl Heal. 2013;7:16–25. doi: 10.1186/1752-1505-7-16. - DOI - PMC - PubMed

Publication types