Effectiveness of a stepped-care programme of WHO psychological interventions in a population of migrants: results from the RESPOND randomized controlled trial

Migrant populations - including labour migrants, undocumented migrants, asylum seekers, refugees, internationally displaced persons, and other populations on the move - are exposed to a variety of stressors that affect their mental health. We designed and tested the effectiveness of a stepped-care p...

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Autores: Purgato M, Tedeschi F, Turrini G, Cadorin C, Compri B, Muriago G, Ostuzzi G, Pinucci I, Prina E, Serra R, Tarsitani L, Witteveen AB, Roversi A, Melchior M, McDaid D, Park AL, Petri-Romão P, Kalisch R, Underhill J, Bryant R, Mediavilla Torres R, Ayuso-Mateos JL, Felez Nobrega M, Haro JM, Sijbrandij M, Nosè M, Barbui C
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p27334
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=27334
Access Level:acceso abierto
Palabra clave:Migrants
psychological distress
WHO psychosocial interventions
Problem Management Plus
anxiety
depression
stepped-care model
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spelling Effectiveness of a stepped-care programme of WHO psychological interventions in a population of migrants: results from the RESPOND randomized controlled trialPurgato MTedeschi FTurrini GCadorin CCompri BMuriago GOstuzzi GPinucci IPrina ESerra RTarsitani LWitteveen ABRoversi AMelchior MMcDaid DPark ALPetri-Romão PKalisch RUnderhill JBryant RMediavilla Torres RAyuso-Mateos JLFelez Nobrega MHaro JMSijbrandij MNosè MBarbui CMigrantspsychological distressWHO psychosocial interventionsProblem Management Plusanxietydepressionstepped-care modelMigrant populations - including labour migrants, undocumented migrants, asylum seekers, refugees, internationally displaced persons, and other populations on the move - are exposed to a variety of stressors that affect their mental health. We designed and tested the effectiveness of a stepped-care programme consisting of two scalable psychological interventions developed by the World Health Organization (WHO) and locally adapted for migrant populations. A parallel-group randomized controlled trial was conducted in Italy. We recruited migrant adults (>= 18 years) with psychological distress (score of at least 16 on the Kessler Psychological Distress Scale, K10). The experimental arm received psychological first aid (PFA) and a stepped-care programme consisting of two WHO interventions adapted for this population group: first, Doing What Matters in Times of Stress (DWM) and, for participants who still reported significant levels of psychological distress after DWM, Problem Management Plus (PM+). Each intervention lasted 5-6 weeks and was delivered remotely by lay facilitators. The control arm received PFA and care as usual (CAU). The primary outcome was the change in symptoms of depression and anxiety from baseline to week 21 after randomization, measured by the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). Between December 14, 2021 and April 18, 2023, 108 migrants were randomized to the stepped-care intervention and 109 to CAU. Analysis of the primary outcome revealed that participants receiving the stepped-care programme showed a greater reduction in anxiety and depression symptoms compared to those receiving CAU (coefficient: -3.460, standard error, SE: 1.050, p=0.001) at week 21. The same difference was observed at week 7 (coefficient: -3.742, SE=1.008, p<0.001) and week 14 (coefficient: -6.381, SE=1.039, p<0.001). The stepped-care programme was also associated with a greater improvement of depression and anxiety symptoms assessed separately at all timepoints, of post-traumatic stress disorder symptoms at weeks 14 and 21, and of self-assessed problems, function and well-being at all timepoints. No serious adverse events occurred. This study provides evidence supporting the stepped-care delivery of DWM and PM+ for migrant population groups with elevated distress. As these interventions are low-intensity, transdiagnostic and task-shifting, they are highly scalable. Existing evidence-based guidelines and implementation packages should be updated accordingly.WILEY2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=27334World PsychiatryISSN: 17238617ISSNe: 20515545reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p273342026-05-27T12:37:41Z
dc.title.none.fl_str_mv Effectiveness of a stepped-care programme of WHO psychological interventions in a population of migrants: results from the RESPOND randomized controlled trial
title Effectiveness of a stepped-care programme of WHO psychological interventions in a population of migrants: results from the RESPOND randomized controlled trial
spellingShingle Effectiveness of a stepped-care programme of WHO psychological interventions in a population of migrants: results from the RESPOND randomized controlled trial
Purgato M
Migrants
psychological distress
WHO psychosocial interventions
Problem Management Plus
anxiety
depression
stepped-care model
title_short Effectiveness of a stepped-care programme of WHO psychological interventions in a population of migrants: results from the RESPOND randomized controlled trial
title_full Effectiveness of a stepped-care programme of WHO psychological interventions in a population of migrants: results from the RESPOND randomized controlled trial
title_fullStr Effectiveness of a stepped-care programme of WHO psychological interventions in a population of migrants: results from the RESPOND randomized controlled trial
title_full_unstemmed Effectiveness of a stepped-care programme of WHO psychological interventions in a population of migrants: results from the RESPOND randomized controlled trial
title_sort Effectiveness of a stepped-care programme of WHO psychological interventions in a population of migrants: results from the RESPOND randomized controlled trial
dc.creator.none.fl_str_mv Purgato M
Tedeschi F
Turrini G
Cadorin C
Compri B
Muriago G
Ostuzzi G
Pinucci I
Prina E
Serra R
Tarsitani L
Witteveen AB
Roversi A
Melchior M
McDaid D
Park AL
Petri-Romão P
Kalisch R
Underhill J
Bryant R
Mediavilla Torres R
Ayuso-Mateos JL
Felez Nobrega M
Haro JM
Sijbrandij M
Nosè M
Barbui C
author Purgato M
author_facet Purgato M
Tedeschi F
Turrini G
Cadorin C
Compri B
Muriago G
Ostuzzi G
Pinucci I
Prina E
Serra R
Tarsitani L
Witteveen AB
Roversi A
Melchior M
McDaid D
Park AL
Petri-Romão P
Kalisch R
Underhill J
Bryant R
Mediavilla Torres R
Ayuso-Mateos JL
Felez Nobrega M
Haro JM
Sijbrandij M
Nosè M
Barbui C
author_role author
author2 Tedeschi F
Turrini G
Cadorin C
Compri B
Muriago G
Ostuzzi G
Pinucci I
Prina E
Serra R
Tarsitani L
Witteveen AB
Roversi A
Melchior M
McDaid D
Park AL
Petri-Romão P
Kalisch R
Underhill J
Bryant R
Mediavilla Torres R
Ayuso-Mateos JL
Felez Nobrega M
Haro JM
Sijbrandij M
Nosè M
Barbui C
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Migrants
psychological distress
WHO psychosocial interventions
Problem Management Plus
anxiety
depression
stepped-care model
topic Migrants
psychological distress
WHO psychosocial interventions
Problem Management Plus
anxiety
depression
stepped-care model
description Migrant populations - including labour migrants, undocumented migrants, asylum seekers, refugees, internationally displaced persons, and other populations on the move - are exposed to a variety of stressors that affect their mental health. We designed and tested the effectiveness of a stepped-care programme consisting of two scalable psychological interventions developed by the World Health Organization (WHO) and locally adapted for migrant populations. A parallel-group randomized controlled trial was conducted in Italy. We recruited migrant adults (>= 18 years) with psychological distress (score of at least 16 on the Kessler Psychological Distress Scale, K10). The experimental arm received psychological first aid (PFA) and a stepped-care programme consisting of two WHO interventions adapted for this population group: first, Doing What Matters in Times of Stress (DWM) and, for participants who still reported significant levels of psychological distress after DWM, Problem Management Plus (PM+). Each intervention lasted 5-6 weeks and was delivered remotely by lay facilitators. The control arm received PFA and care as usual (CAU). The primary outcome was the change in symptoms of depression and anxiety from baseline to week 21 after randomization, measured by the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). Between December 14, 2021 and April 18, 2023, 108 migrants were randomized to the stepped-care intervention and 109 to CAU. Analysis of the primary outcome revealed that participants receiving the stepped-care programme showed a greater reduction in anxiety and depression symptoms compared to those receiving CAU (coefficient: -3.460, standard error, SE: 1.050, p=0.001) at week 21. The same difference was observed at week 7 (coefficient: -3.742, SE=1.008, p<0.001) and week 14 (coefficient: -6.381, SE=1.039, p<0.001). The stepped-care programme was also associated with a greater improvement of depression and anxiety symptoms assessed separately at all timepoints, of post-traumatic stress disorder symptoms at weeks 14 and 21, and of self-assessed problems, function and well-being at all timepoints. No serious adverse events occurred. This study provides evidence supporting the stepped-care delivery of DWM and PM+ for migrant population groups with elevated distress. As these interventions are low-intensity, transdiagnostic and task-shifting, they are highly scalable. Existing evidence-based guidelines and implementation packages should be updated accordingly.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=27334
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=27334
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv World Psychiatry
ISSN: 17238617
ISSNe: 20515545
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
instname_str Fundació Sant Joan de Déu
reponame_str r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
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