降低难民心理压力的低成本数字急救工具：乌克兰入侵后头几个月在线自助多国随机对照试验

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine Pub Date : 2024-10-24 DOI:10.1016/j.socscimed.2024.117442

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引用次数: 0

摘要

武装冲突增加了受影响人群的痛苦程度，尤其是难民，他们在获得心理支持方面经常面临障碍。我们在分散在 17 个国家的乌克兰难民、境内流离失所者和非流离失所者中评估了一个在线版本，该在线版本之前经过了现场测试，并得到了世界卫生组织自助加（SH+）项目的认可。这是首次同时对难民、境内流离失所者和非流离失所的受冲突影响人群进行在线心理干预测试的随机对照试验。本研究是一项在线双臂、单独随机对照试验，对象是乌克兰或欧盟国家 18 岁以上的参与者，他们被随机分配接受在线自助（SHO）干预和被动信息资源，或仅接受被动信息资源。我们招募了 652 名参与者，他们于 2022 年 7 月 7 日开始参加该计划。分析的重点是计划结束一周后完成最终调查的 292 名参与者。结果表明，难民（β -2.16，95% CI -4.17至-0.16；p = 0.03；d -0.47）的压力明显减轻，但乌克兰境内流离失所者（β 0.56，95% CI -1.1 至 2.99；p = 0.17；d 0.2）或乌克兰境内非流离失所者（β 0.2，95% CI -0.95至1.35；p = 0.73；d 0.08）的压力减轻效果不明显。难民减压的效果大小与其他类似干预措施相当，但平均成本较低。每名参与者的平均成本为11欧元，每名受益者（难民）的平均成本为46.16欧元，这表明扩大规模具有成本效益。这些研究结果表明，"在线自助 "是一种有效的心理干预措施，能以较低的成本减轻地理位置分散的难民的压力。我们还发现，在线提供心理干预的形式对于国内流离失所者和非流离失所的受冲突影响人群都是可行的。

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A low-cost digital first aid tool to reduce psychological distress in refugees: A multi-country randomized controlled trial of self-help online in the first months after the invasion of Ukraine

Armed conflicts increase distress levels among affected populations, particularly impacting refugees who often face barriers to accessing psychological support. We evaluate an online version of a previously tested in-person and endorsed for online adaptation by the WHO Self-Help Plus (SH+) program among Ukrainian refugees dispersed across 17 countries, internally displaced and not displaced Ukrainians. This is the first randomized controlled trial to test an online psychological intervention simultaneously on refugees, internally displaced, and non-displaced conflict-affected populations. This study is an online two-arm, individually randomized controlled trial among participants above 18 years old in Ukraine or EU countries who were randomly assigned to receive either the Self-Help Online (SHO) intervention and passive informational resource or the passive informational resource alone. We recruited 652 participants starting the program on July 7th, 2022. The analysis focused on 292 participants who completed the final survey one week after the end of the program. Results indicated significant distress reduction among refugees (β −2.16, 95% CI −4.17 to −0.16; p = 0.03; d −0.47) but not among internally displaced in Ukraine (β 0.56, 95% CI −1.1 to 2.99; p = 0.17; d 0.2) or non-displaced participants in Ukraine (β 0.2, 95% CI −0.95 to 1.35; p = 0.73; d 0.08). The effect size in stress reduction for refugees was comparable to other similar interventions but with lower average costs. The average cost per participant was €11, with €46.16 for each benefiting (refugee) participant, suggesting cost-effectiveness for scale-up. These findings suggest that Self-Help Online is an effective psychological intervention for reducing stress among geographically dispersed refugees at a low cost. We also find that the online delivery format of psychological interventions is feasible for internally displaced and non-displaced conflict-affected populations.

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来源期刊

Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

9.10

自引率

5.60%

发文量

762

审稿时长

38 days

期刊介绍： Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.