Evaluation of an integrated intervention to reduce psychological distress and intimate partner violence in refugees: Results from the Nguvu cluster randomized feasibility trial

• Published in: PloS one 2021-06, Vol.16 (6), p.e0252982-e0252982
• Main Authors: Greene, M Claire, Likindikoki, Samuel, Rees, Susan, Bonz, Annie, Kaysen, Debra, Misinzo, Lusia, Njau, Tasiana, Kiluwa, Shangwe, Turner, Rachael, Ventevogel, Peter, Mbwambo, Jessie K K, Tol, Wietse A
• Format: Article
• Language: English
• Subjects: Aggression; Biology and Life Sciences; Colleges & universities; Congo - ethnology; Displaced persons; Domestic violence; Drug abuse; Editing; Emotional abuse; Estimates; Family violence; Feasibility Studies; Female; Gender-based violence; Health aspects; Health problems; Human rights; Humanitarianism; Humans; Integrative Medicine; Internet; Intervention; Intimate Partner Violence - psychology; Intimate Partner Violence - statistics & numerical data; Management; Medicine and Health Sciences; Mental disorders; Mental health; Mental health services; Methodology; Migration; Nurses; Oppression; People and Places; Population; Post traumatic stress disorder; Posttraumatic stress disorder; Poverty; Program Evaluation; Psychiatry; Psychological aspects; Psychological Distress; Psychological factors; Psychological stress; Public administration; Public health; Refugee camps; Refugees; Refugees - psychology; Refugees, African; Reviews; Risk analysis; Risk factors; Risk sharing; Scholarship; Self esteem; Social Sciences; Substance abuse; Supervision; Tanzania - ethnology; Trauma; Victimization; Violence; War; Women; World War II
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0252982

The complex relationship between intimate partner violence and psychological distress warrants an integrated intervention approach. In this study we examined the relevance, acceptability, and feasibility of evaluating a multi-sectoral integrated violence- and mental health-focused intervention (Nguvu). We enrolled 311 Congolese refugee women from Nyarugusu refugee camp in Tanzania with past-year intimate partner violence and elevated psychological distress in a feasibility cluster randomized trial. Women were recruited from local women's groups that were randomized to the Nguvu intervention or usual care. Participants from women's groups randomized to Nguvu received 8 weekly sessions delivered by lay refugee incentive workers. Psychological distress, intimate partner violence, other wellbeing, and process indicators were assessed at baseline and 9-weeks post-enrollment to evaluate relevance, acceptability, and feasibility of implementing and evaluating Nguvu in refugee contexts. We found that Nguvu was relevant to the needs of refugee women affected by intimate partner violence. We found reductions in some indicators of psychological distress, but did not identify sizeable changes in partner violence over time. Overall, we found that Nguvu was acceptable and feasible. However, challenges to the research protocol included baseline imbalances between study conditions, differential intervention completion related to intimate partner violence histories, differences between Nguvu groups and facilitators, and some indication that Nguvu may be less beneficial for participants with more severe intimate partner violence profiles. We found evidence supporting the relevance of Nguvu to refugee women affected by partner violence and psychological distress and moderate evidence supporting the acceptability and feasibility of evaluating and implementing this intervention in a complex refugee setting. A definitive cluster randomized trial requires further adaptations for recruitment and eligibility screening, randomization, and retention. ISRCTN65771265, June 27, 2016.