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Scalable psychological interventions for Syrian refugees in Europe and the Middle East: STRENGTHS study protocol for a prospective individual participant data meta-analysis

de Graaff, Anne M., Cuijpers, Pim, Acarturk, Ceren, Akhtar, Aemal, Alkneme, Mhd Salem, Aoun, May, Awwad, Manar, Bawaneh, Ahmad, Brown, Felicity L, Bryant, Richard A., Burchert, Sebastian, Carswell, Kenneth, Drogendijk, Annelieke, Engels, Michelle, Fuhr, Daniela C., Hansen, Pernille, van't Hof, Edith, Giardinelli, Luana, Hemmo, Mahmoud, Hessling, Jonas M, Ilkkursun, Zeynep, Jordans, Mark J D, Kiselev, Nikolai, Knaevelsrud, Christine, Kurt, Gülsah, Martinmäki, Saara, McDaid, David ORCID: 0000-0003-0744-2664, Morina, Naser, Naser, Hadeel, Park, A-La ORCID: 0000-0002-4704-4874, Pfaltz, Monique C., Roberts, Bayard, Schick, Matthis, Schnyder, Ulrich, Spaaij, Julia, Steen, Frederik, Taha, Karine, Uygun, Ersin, Ventevogel, Peter, Whitney, Claire, Witteveen, Anke B and Sijbrandij, Marit (2022) Scalable psychological interventions for Syrian refugees in Europe and the Middle East: STRENGTHS study protocol for a prospective individual participant data meta-analysis. BMJ Open, 12 (4). ISSN 2044-6055

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Identification Number: 10.1136/bmjopen-2021-058101


Introduction The World Health Organization’s (WHO) scalable psychological interventions, such as Problem Management Plus (PM+) and Step-by-Step (SbS) are designed to be cost-effective non-specialist delivered interventions to reduce symptoms of common mental disorders, such as anxiety, depression and post-traumatic stress disorder (PTSD). The STRENGTHS consortium aims to evaluate the effectiveness, cost-effectiveness and implementation of the individual format of PM+ and its group version (gPM+), as well as of the digital SbS intervention among Syrian refugees in seven countries in Europe and the Middle East. This is a study protocol for a prospective individual participant data (IPD) meta-analysis to evaluate (1) overall effectiveness and cost-effectiveness and (2) treatment moderators of PM+, gPM+ and SbS with Syrian refugees. Methods and analysis Five pilot randomised controlled trials (RCTs) and seven fully powered RCTs conducted within STRENGTHS will be combined into one IPD meta-analytic dataset. The RCTs include Syrian refugees of 18 years and above with elevated psychological distress (Kessler Psychological Distress Scale (K10>15)) and impaired daily functioning (WHO Disability Assessment Schedule 2.0 (WHODAS 2.0>16)). Participants are randomised into the intervention or care as usual control group, and complete follow-up assessments at 1-week, 3-month and 12-month follow-up. Primary outcomes are symptoms of depression and anxiety (25-item Hopkins Symptom Checklist). Secondary outcomes include daily functioning (WHODAS 2.0), PTSD symptoms (PTSD Checklist for DSM-5) and self-identified problems (PSYCHLOPS). We will conduct a one-stage IPD meta-analysis using linear mixed models. Quality of evidence will be assessed using the GRADE approach, and the economic evaluation approach will be assessed using the CHEC-list. Ethics and dissemination Local ethical approval has been obtained for each RCT. This IPD meta-analysis does not require ethical approval. The results of this study will be published in international peer-reviewed journals.

Item Type: Article
Official URL:
Additional Information: © 2022 The Authors
Divisions: Personal Social Services Research Unit
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
H Social Sciences > HN Social history and conditions. Social problems. Social reform
Date Deposited: 28 Apr 2022 14:51
Last Modified: 17 May 2024 02:15

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