Context, implementation and mechanisms of impact of a stepped-care WHO psychological intervention for migrants with psychological distress
Por:
Compri B, Turrini G, Purgato M, Bryant R, Cristobal P, Haro JM, Kalisch R, Lorant V, David McDaid, McGreevy KR, Mediavilla R, Nosè M, Park AL, Petri-Romão P, Roversi A, Sijbrandij M, Tortelli A, Witteveen A and Barbui C
Publicada:
9 jun 2025
Ahead of Print:
9 jun 2025
Resumen:
Migrants often experience psychological distress due to pre-, peri- and post-migration stressors. Scalable interventions like Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+) have been developed to address these challenges. This study evaluates a stepped-care program combining DWM and PM+ for migrants in Italy, examining its context, implementation, and mechanisms of impact. A mixed-methods process evaluation was conducted alongside a randomized controlled trial (RCT), following the Medical Research Council (MRC) framework. Post-trial qualitative data were collected through individual interviews with intervention participants (n = 10) and stakeholders (n = 10), as well as a focus group with intervention providers (n = 8). Thematic analysis was performed using NVivo. Cultural stigma and practical barriers influenced engagement, while community leaders fostered trust and participation. Interventions were feasible and acceptable. Digital delivery improved accessibility for some but posed challenges for those with low technological literacy or private spaces. The stepped-care approach supported gradual engagement with mental health strategies, enhancing self-care and emotional awareness, while provider relationships were key to sustaining motivation. The stepped-care model alleviated psychological distress and was well-received. Findings underscore the need for cultural sensitivity, digital accessibility and community engagement to optimize migrant mental health support.
Filiaciones:
Compri B:
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy. ROR: https://ror.org/039bp8j42
Turrini G:
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy. ROR: https://ror.org/039bp8j42
Purgato M:
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy. ROR: https://ror.org/039bp8j42
Bryant R:
School of Psychology, University of New South Wales, Sydney, NSW, Australia. ROR: https://ror.org/03r8z3t63
Cristobal P:
Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Deu (IRSJD), Sant Boi de Llobregat, Barcelona, Spain
Haro JM:
Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Deu (IRSJD), Sant Boi de Llobregat, Barcelona, Spain
Kalisch R:
Leibniz Institute for Resilience Research, Mainz, Germany. ROR: https://ror.org/00q5t0010
Lorant V:
Institute of Health and Society, UCLouvain, Belgium
David McDaid:
Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
McGreevy KR:
School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
Mediavilla R:
School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
Nosè M:
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy. ROR: https://ror.org/039bp8j42
Park AL:
Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
Petri-Romão P:
Leibniz Institute for Resilience Research, Mainz, Germany. ROR: https://ror.org/00q5t0010
Roversi A:
INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, Sorbonne Université, Paris, France. ROR: https://ror.org/02en5vm52
Sijbrandij M:
Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Tortelli A:
GHU Paris, Psychiatrie & Neurosciences - Pôle Psychiatrie Précarité, Paris, France
Witteveen A:
Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Barbui C:
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy. ROR: https://ror.org/039bp8j42
Green Submitted, gold
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