Development of a non-specialist worker delivered psychological intervention to address alcohol use disorders and psychological distress among conflict-affected populations in Uganda and Ukraine

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dc.contributor.authorNadkarni, Abhijit;
dc.contributor.authorMassazza, Alessandro;
dc.contributor.authorTol, Wietse A ;
dc.contributor.authorBogdanov, Sergiy;
dc.contributor.authorAndersen, Lena S;
dc.contributor.authorMoore, Quincy;
dc.contributor.authorRoberts, Bayard;
dc.contributor.authorWeiss, Helen A;
dc.contributor.authorSingh, Soumya;
dc.contributor.authorNeuman, Melissa;
dc.contributor.authorMay, Carl;
dc.contributor.authorFuhr, Daniela C
dc.date.accessioned2025-01-21T07:56:13Z
dc.date.available2025-01-21T07:56:13Z
dc.date.issued2025-01
dc.description.abstractDespite the significant burden of alcohol use disorders (AUD), there is a large treatment gap, especially in settings and populations affected by armed conflict. A key barrier to care is the lack of contextually relevant interventions and adequately skilled human resources to deliver them. This paper describes the systematic development of the CHANGE intervention, a potentially scalable psychological intervention for people with co-existing AUD and psychological distress in conflict-affected populations, delivered by non-specialist workers (NSWs).BACKGROUNDDespite the significant burden of alcohol use disorders (AUD), there is a large treatment gap, especially in settings and populations affected by armed conflict. A key barrier to care is the lack of contextually relevant interventions and adequately skilled human resources to deliver them. This paper describes the systematic development of the CHANGE intervention, a potentially scalable psychological intervention for people with co-existing AUD and psychological distress in conflict-affected populations, delivered by non-specialist workers (NSWs).CHANGE was developed in sequential steps: (1) identifying potential treatment strategies through a meta-review and Delphi survey with international experts; (2) in-depth interviews (IDIs) with key stakeholders from the study settings in Uganda and Ukraine; and (3) three consultative workshops with international experts and experts from Uganda and Ukraine to develop a theoretical framework for the intervention informed by outputs of the Delphi and IDIs.METHODSCHANGE was developed in sequential steps: (1) identifying potential treatment strategies through a meta-review and Delphi survey with international experts; (2) in-depth interviews (IDIs) with key stakeholders from the study settings in Uganda and Ukraine; and (3) three consultative workshops with international experts and experts from Uganda and Ukraine to develop a theoretical framework for the intervention informed by outputs of the Delphi and IDIs.In the Delphi survey, experts reached agreement on the acceptability, feasibility and potential effectiveness of the following components: identify high-risk situations, problem solving skills, assessment, handling drinking urges, communication skills, pros and cons of drinking, and identifying high-risk situations. From the IDIs we identified (a) causal attributions for using alcohol e.g., psychosocial stressors; (b) cultural norms related to alcohol consumption such as patriarchal stereotypes; and (c) coping strategies to deal with drinking problems such as distraction. The CHANGE intervention developed through the consultative workshops can be delivered in three sequential phases focussed on assessment, feedback, and information (Phase 1); providing the client with need-based skills for dealing with high-risk situations related to alcohol use (Phase 2), and relapse prevention and management (Phase 3).RESULTSIn the Delphi survey, experts reached agreement on the acceptability, feasibility and potential effectiveness of the following components: identify high-risk situations, problem solving skills, assessment, handling drinking urges, communication skills, pros and cons of drinking, and identifying high-risk situations. From the IDIs we identified (a) causal attributions for using alcohol e.g., psychosocial stressors; (b) cultural norms related to alcohol consumption such as patriarchal stereotypes; and (c) coping strategies to deal with drinking problems such as distraction. The CHANGE intervention developed through the consultative workshops can be delivered in three sequential phases focussed on assessment, feedback, and information (Phase 1); providing the client with need-based skills for dealing with high-risk situations related to alcohol use (Phase 2), and relapse prevention and management (Phase 3).CHANGE is a contextually relevant and potentially scalable treatment for co-existing AUD and psychological distress to be delivered by NSWs to conflict-affected populations. Effectiveness and cost-effectiveness of CHANGE will be tested in Uganda and Ukraine.CONCLUSIONSCHANGE is a contextually relevant and potentially scalable treatment for co-existing AUD and psychological distress to be delivered by NSWs to conflict-affected populations. Effectiveness and cost-effectiveness of CHANGE will be tested in Uganda and Ukraine. MEDLINE - Academic
dc.description.sponsorshipThis work was supported by the National Institute for Health Research (NIHR) (using the UK’s Ofcial Development Assistance (ODA) Funding) and Wellcome (grant reference number 219468/Z/19/Z) under the NIHR-Wellcome Partnership for Global Health Research.
dc.identifier.citationNadkarni, Abhijit, Alessandro Massazza, Wietse A. Tol, et al. 'Development of a Non-Specialist Worker Delivered Psychological Intervention to Address Alcohol use Disorders and Psychological Distress among Conflict-Affected Populations in Uganda and Ukraine', International Journal of Mental Health Systems, vol. 19/no. 1, (2025), pp. 2-12.
dc.identifier.issnISSN 1752-4458
dc.identifier.issnEISSN 1752-4458
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/9824
dc.language.isoen
dc.publisherBioMed Central Ltd
dc.titleDevelopment of a non-specialist worker delivered psychological intervention to address alcohol use disorders and psychological distress among conflict-affected populations in Uganda and Ukraine
dc.typeArticle
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