Community-based participatory design of a psychosocial intervention for migrant women in Ecuador and Panama

Strategies to improve the implementation and effectiveness of community-based psychosocial support interventions for displaced, migrant and host community women in Latin America

“…Most participants had a primary school education or higher (89.5%) and were unemployed (63.2%). Process evaluation participant demographics (age, education, employment, country of origin and current location) as well as baseline levels of psychological distress were comparable to the full feasibility trial sample ( p > 0.05) (Greene et al, 2023). Forty percent of the 30 facilitators were from Tulcán (40.0%; n = 12), followed by Guayaquil (33.3%; n = 10) and Panamá (26.7%; n = 8).…”

“…The facilitators received weekly group supervision throughout the implementation period and were in regular contact with the study staff. A detailed description of the training and supervision as well as the results of the feasibility trial are published elsewhere (Greene et al, 2022b; 2023). Strategy 5.…”

“…An analysis of the psychometric properties of the Kessler-6 in this sample revealed that, with modifications, the Kessler-6 displayed adequate internal and external construct validity. However, the Kessler-6 had low internal consistency, which was largely due to the low item-rest correlation of the fifth item (‘feeling like everything was an effort’) (Greene et al, 2023).…”

“…The intervention, Entre Nosotras , is a five-session group intervention co-designed with refugee, migrant and host community members from the study communities to improve mental health, sense of safety, community connectedness and social support. The intervention combined elements of psychoeducation, stress management, individual and community problem solving and other participatory methodologies focused on promoting well-being ( Figure 1a ) (Greene et al, 2022b ). Implementation of the intervention involved five strategies that were designed based on formative research and intended to improve the reach, effectiveness, adoption, implementation and maintenance (Glasgow et al, 1999 ) of Entre Nosotras, which are described below ( Box 1 ; Figure 1b ).…”

“…Populations affected and displaced by humanitarian emergencies experience an elevated risk of mental health problems (Kirmayer et al, 2011 ; Charlson et al, 2019 ; Mesa-Vieira et al, 2022 ). Recent quantitative and qualitative research on mental health among migrants and refugees in Latin America, including migrants in Ecuador and Panamá, has identified symptoms of depression (Carroll et al, 2020 ; Greene et al, 2022b ), generalized anxiety disorder (Carroll et al, 2020 ), post-traumatic stress disorder (Espinel et al, 2020 ) and general psychological distress, including feelings of fear, anger and stress (Greene et al, 2022b ; Mougenot et al, 2021 ). Migrants and forcibly displaced populations in Latin America face a range of risk factors for mental health problems across the phases of migration, including exposure to potentially traumatic events, discrimination and xenophobia, social isolation, lack of integration and socioeconomic adversity (Keller et al, 2017 ; Carroll et al, 2020 ; Mougenot et al, 2021 ; Morales et al, 2022 ; Salas-Wright et al, 2022 ).…”