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Randomized Controlled Trial
. 2024 Apr 24;21(5):527.
doi: 10.3390/ijerph21050527.

Comparing Mediators and Moderators of Mental Health Outcomes from the Implementation of Group Problem Management Plus (PM+) among Venezuelan Refugees and Migrants and Colombian Returnees in Northern Colombia

Lucy Miller-Suchet  1   2 , Natalia Camargo  3 , Manaswi Sangraula  4 , Diany Castellar  5 , Jennifer Diaz  3 , Valeria Meriño  3 , Ana Maria Chamorro Coneo  3 , David Chávez  6 , Marcela Venegas  7 , Maria Cristobal  2 , Annie G Bonz  2 , Camilo Ramirez  7 , Ana Maria Trejos Herrera  3 , Peter Ventevogel  8 , Adam D Brown  9   10 , Matthew Schojan  2 , M Claire Greene  1
Affiliations
Randomized Controlled Trial

Comparing Mediators and Moderators of Mental Health Outcomes from the Implementation of Group Problem Management Plus (PM+) among Venezuelan Refugees and Migrants and Colombian Returnees in Northern Colombia

Lucy Miller-Suchet et al. Int J Environ Res Public Health. .

Abstract

Colombia hosts the largest number of refugees and migrants fleeing the humanitarian emergency in Venezuela, many of whom experience high levels of displacement-related trauma and adversity. Yet, Colombian mental health services do not meet the needs of this population. Scalable, task-sharing interventions, such as Group Problem Management Plus (Group PM+), have the potential to bridge this gap by utilizing lay workers to provide the intervention. However, the current literature lacks a comprehensive understanding of how and for whom Group PM+ is most effective. This mixed methods study utilized data from a randomized effectiveness-implementation trial to examine the mediators and moderators of Group PM+ on mental health outcomes. One hundred twenty-eight migrant and refugee women in northern Colombia participated in Group PM+ delivered by trained community members. Patterns in moderation effects showed that participants in more stable, less marginalized positions improved the most. Results from linear regression models showed that Group PM+-related skill acquisition was not a significant mediator of the association between session attendance and mental health outcomes. Participants and facilitators reported additional possible mediators and community-level moderators that warrant future research. Further studies are needed to examine mediators and moderators contributing to the effectiveness of task-shared, scalable, psychological interventions in diverse contexts.

Keywords: Colombia; Group PM+; Venezuelans; forced migration; mediators; mental health; migrants; moderators; refugees.

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Conflict of interest statement

P.V. is a staff member of the United Nations. The views expressed in this editorial are those of the authors and do not necessarily reflect the views of the United Nations. All other authors maintain that there are no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Study design and participant flow diagram.
Figure 2
Figure 2
Mediation model diagram. C: total effect, C’: direct effect, A and B: indirect effect.
See this image and copyright information in PMC

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