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
. 2019 Apr 3;19(1):53.
doi: 10.1186/s12905-019-0744-z.

Women's circles as a culturally safe psychosocial intervention in Guatemalan indigenous communities: a community-led pilot randomised trial

Anne Marie Chomat  1   2 , Aura Isabel Menchú  3 , Neil Andersson  4   5 , Manuel Ramirez-Zea  6 , Duncan Pedersen  7 , Alexandra Bleile  8 , Paola Letona  6 , Ricardo Araya  8
Affiliations
Randomized Controlled Trial

Women's circles as a culturally safe psychosocial intervention in Guatemalan indigenous communities: a community-led pilot randomised trial

Anne Marie Chomat et al. BMC Womens Health. .

Abstract

Background: Indigenous Maya women in Guatemala show some of the worst maternal health indicators worldwide. Our objective was to test acceptability, feasibility and impact of a co-designed group psychosocial intervention (Women's Circles) in a population with significant need but no access to mental health services.

Methods: A parallel group pilot randomised study was undertaken in five rural Mam and three periurban K'iche' communities. Participants included 84 women (12 per community, in seven of the communities) randomly allocated to intervention and 71 to control groups; all were pregnant and/or within 2 years postpartum. The intervention consisted of 10 sessions co-designed with and facilitated by 16 circle leaders. Main outcome measures were: maternal psychosocial distress (HSCL-25), wellbeing (MHC-SF), self-efficacy and engagement in early infant stimulation activities. In-depth interviews also assessed acceptability and feasibility.

Results: The intervention proved feasible and well accepted by circle leaders and participating women. 1-month post-intervention, wellbeing scores (p-value 0.008) and self-care self-efficacy (0.049) scores were higher among intervention compared to control women. Those women who attended more sessions had higher wellbeing (0.007), self-care and infant-care self-efficacy (0.014 and 0.043, respectively), and early infant stimulation (0.019) scores.

Conclusions: The pilot demonstrated acceptability, feasibility and potential efficacy to justify a future definitive randomised controlled trial. Co-designed women's groups provide a safe space where indigenous women can collectively improve their functioning and wellbeing.

Trial registration: ISRCTN13964819 . Registered 26 June 2018, retrospectively registered.

Keywords: Co-design; Cultural safety; Guatemala; Indigenous women; Maternal mental health; Participatory research; Women’s circles.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was obtained from the Douglas Mental Health Institute (McGill University affiliate) and the Guatemala-based Institute of Nutrition of Central America and Panama (INCAP). Informed written consent was received from all participants to participate, using consent forms approved by these research ethics boards.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

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

References

    1. Surkan PJ, Kennedy CE, Hurley KM, Black MM. Maternal depression and early childhood growth in developing countries: systematic review and meta-analysis. Bull World Health Organ. 2011;89(8):608–615. doi: 10.2471/BLT.11.088187. - DOI - PMC - PubMed
    1. Parsons CE, Young KS, Rochat TJ, Kringelbach ML, Stein A. Postnatal depression and its effects on child development: a review of evidence from low- and middle-income countries. Br Med Bull. 2012;101:57–79. doi: 10.1093/bmb/ldr047. - DOI - PubMed
    1. Fox M, Entringer S, Buss C, DeHaene J, Wadhwa PD. Intergenerational transmission of the effects of acculturation on health in Hispanic Americans: a fetal programming perspective. Am J Public Health. 2015;105(Suppl 3):S409–S423. doi: 10.2105/AJPH.2015.302571. - DOI - PMC - PubMed
    1. Stein A, Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M, Howard LM, Pariante CM. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384(9956):1800–1819. doi: 10.1016/S0140-6736(14)61277-0. - DOI - PubMed
    1. Rahman A, Fisher J, Bower P, Luchters S, Tran T, Yasamy MT, Saxena S, Waheed W. Interventions for common perinatal mental disorders in women in low- and middle-income countries: a systematic review and meta-analysis. Bull World Health Organ. 2013;91(8):593–601I. doi: 10.2471/BLT.12.109819. - DOI - PMC - PubMed

Publication types

Associated data