Psychosocial interventions for children exposed to traumatic events in low- and middle-income countries: an individual patient data meta-analysis

Article type
Authors
Purgato M1, Barbui C2, Tol W3
1Johns Hopkins University and University of Verona, United States, Italy
2University of Verona, Italy
3Johns Hopkins University, USA
Abstract
Background:
The burden of mental health and psychosocial problems in children exposed to traumatic events in humanitarian settings in low- and middle-income countries (LMICs) is substantial. An increasing number of randomized controlled trials (RCTs) has shown promising effects of psychosocial interventions, but this evidence has shown complexity with regard to setting, conflict-phase, gender, and age. These complex findings raise the need of a detailed evaluation of the specific factors that influence size and direction of intervention effects.
Individual patient data meta-analysis (IPD-MA) is a specific type of meta-analysis that allows for the collection of exact information at an individual patient level, and to examine whether intervention and socio-demographic characteristics, trauma-related variables, and social support may act as moderators/mediators of intervention effect.

Objectives:
The aim of this study is to carry out an IPD-MA using data from all available RCTs comparing psychosocial interventions with waiting list or no intervention arms in children exposed to traumatic events living in LMICs.

Methods:
All RCTs comparing selective preventive psychosocial interventions versus waiting list or no treatment conditions in children (0-18 years) living in LMICs will be included. There will be no restrictions on publication type, status, language or date of publication. The primary outcome will be psychological symptoms (post-traumatic stress disorder, anxiety, depression). Secondary outcomes will be positive mental health outcomes (coping methods, social support, self-esteem), and function impairment.

Results:
We are expecting that some variables, like socio-demographic characteristics, trauma-related variables, and social support will act as moderators/mediators of intervention effect.

Conclusions:
The investigation of the role of these factors on the intervention effects will help in the appropriate selection, development, implementation and dissemination of evidence-based programs in LMICs.

This research is supported by a Marie Curie International Outgoing fellowship within the 7th European Community Framework Programme.