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. 2024 May 16;14(5):e083261.
doi: 10.1136/bmjopen-2023-083261.

Effectiveness of combining prevention psychological interventions with interventions that address the social determinants of mental health in low and middle-income countries: protocol of a systematic review and meta-analysis

Eleonora Prina  1 , Beatrice Bano  2   3 , Rakesh Singh  4   5 , Emiliano Albanese  3   6 , Daniela Trujillo  7 , María Cecilia Dedios Sanguineti  8 , Katherine Sorsdahl  9 , Nagendra P Luitel  4 , Emily C Garman  9 , Marianna Purgato  2   10 , Corrado Barbui  2   10 , Mark J D Jordans  5 , Crick Lund  5   9
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Effectiveness of combining prevention psychological interventions with interventions that address the social determinants of mental health in low and middle-income countries: protocol of a systematic review and meta-analysis

Eleonora Prina et al. BMJ Open. .

Abstract

Introduction: Common mental health conditions (CMHCs), including depression, anxiety and post-traumatic stress disorder (PTSD), are highly prevalent in low and middle-income countries (LMICs). Preventive strategies combining psychological interventions with interventions addressing the social determinants of mental health may represent a key strategy for effectively preventing CMHCs. However, no systematic reviews have evaluated the effectiveness of these combined intervention strategies for preventing CMHCs.

Methods and analysis: This systematic review will include randomised controlled trials (RCTs) focused on the effectiveness of interventions that combine preventive psychological interventions with interventions that address the social determinants of mental health in LMICs. Primary outcome is the frequency of depression, anxiety or PTSD at postintervention as determined by a formal diagnostic tool or any other standardised criteria. We will search Epistemonikos, Cochrane Controlled Trials Register (CENTRAL), MEDLINE, Embase, PsycINFO, CINAHL, Global Index Medicus, ClinicalTrials.gov (Ctgov), International Clinical Trials Registry Platform (ICTRP). Two reviewers will independently extract the data and evaluate the risk of bias of included studies using the Cochrane risk of bias tool 2. Random-effects meta-analyses will be performed, and certainty of evidence will be rated using the Grading of Recommendations Assessment, Development and Evaluation approach.

Ethics and dissemination: This study uses data from published studies; therefore, ethical review is not required. Findings will be presented in a published manuscript.

Trial registration number: CRD42023451072.

Keywords: PSYCHIATRY; PUBLIC HEALTH; Primary Prevention.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Causal pathway indicating inclusion criteria for the review. CBT, cognitive behavior therapy; CMHCs, common mental health conditions; LMICs, low and middle-income countries; PTSD, post-traumatic stress disorder; STYL, Sustainable Transformation of Youth in Liberia. 1Blattman et al 2017. 2Lachman et al 2020.
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