02947nas a2200373 4500000000100000008004100001260001600042100001400058700001100072700001300083700001600096700001100112700001600123700001300139700001400152700001500166700001600181700001300197700001300210700001300223700001300236700001300249700001600262700001200278700001400290700001500304700001100319245011200330856015300442300001100595490000600606520194700612022001402559 2022 d bElsevier BV1 aGreene MC1 aBonz A1 aIsaacs R1 aCristobal M1 aVega C1 aAndersen LS1 aAngulo A1 aArmijos A1 aGuevara ME1 aBenavides L1 aCruz ADL1 aLopez MJ1 aMoyano A1 aMurcia A1 aNoboa MJ1 aRodriguez A1 aSolis J1 aVergara D1 aWainberg M1 aTol WA00aCommunity-based participatory design of a psychosocial intervention for migrant women in Ecuador and Panama uhttps://www.sciencedirect.com/science/article/pii/S2666560322000925/pdfft?md5=4601e066dbf7c0d12c76ceeeeb103706&pid=1-s2.0-S2666560322000925-main.pdf a1001520 v23 a

There is increasing evidence supporting the effectiveness of scalable mental health and psychosocial support (MHPSS) interventions delivered by non-specialists for improving wellbeing among migrant populations in humanitarian settings. Balancing fidelity in the implementation of evidence-based MHPSS interventions with their fit to the needs and preferences of new populations and contexts remains a challenge when introducing MHPSS interventions in new settings. This paper describes a community-based participatory approach to MHPSS intervention design incorporating processes to promote local adaptability and fit while maintaining standardized elements of existing MHPSS interventions. We conducted a mixed-methods study to design a community-based MHPSS intervention that fit the mental health and psychosocial needs of migrant women in three sites in Ecuador and Panama. Drawing from a set of community-based participatory research methods, we identified the priority mental health and psychosocial needs among migrant women, co-developed intervention mechanisms that aligned with those needs, matched mechanisms to existing psychosocial intervention components, and iteratively piloted and refined the intervention with community stakeholders. The resulting intervention was a five-session, lay facilitator-delivered group intervention titled, Entre Nosotras (‘among/between us’). The intervention combined elements of individual and community problem solving, psychoeducation, stress management, and social support mobilization to address prioritized problems including psychological distress, safety, community connectedness, xenophobia and discrimination, and social support. This research outlines an emphasis on the social dimension of psychosocial support, as well as a process for balancing fit and fidelity in intervention design and implementation.

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