219086 Lessons Learnt: A Community-Based Randomized Trial to enhance Reproductive/Mental Health among internally displaced disadvantaged women in the southern suburbs of Beirut, Lebanon- The value of Community Based Participatory Research

Monday, November 8, 2010

Loulou Kobeissi, DrPH , Community Health Sciences Department, School of Public Health- University of California, Los Angeles, Los Angeles, CA
Rima Nakkash, DrPH , Health Behavior and Education Department, American University of Beirut, Beirut, Lebanon
Zeina Ghantous, MPH , Center for Research on Population and Health, Faculty of Health Sciences-American University of Beirut, Beirut, Lebanon
Nasser Yassine, PhD , Epidemiology and Population Health Department, Faculty of Health Sciences-American University of Beirut, Beirut, Lebanon
  
We aim to present the outcome of a community-based randomized trial geared towards enhancing both reproductive and mental health; among internally displaced women (aged 18-54, currently married) residing in Hey el Selloum (a southern disadvantaged suburb community of Beirut, the capital of Lebanon).

The geographic area chosen –Hey el Selloum-is suitable for assessing the impact of internal displacement among disadvantaged population.

Specifically, the trial sought to test the impact of a psycho-social intervention package (12 sessions (twice per week) of 75 minutes of social support groups and 30 minutes relaxation exercises package) on the reporting of medically unexplained vaginal discharge (MUVD) and common mental distress (CMD: anxiety and/or depression)- using a community based participatory approach.

The implemented community participation framework followed Wilcox's- five rung ladder of participation- guidelines. A multi-disciplinary team of researchers, community stakeholders, and an established local women committee was formed to ensure technical relevance, feasibility, cultural adequacy, as well as acceptable representation of community and women's needs.

Results of the current trial indicated favourable outcomes for both MUVD and CMDs. Process evaluation results revolved around 90% for: attendance rates, satisfaction rates and trainers' compliance with guiding manuals.

Our work witnessed many challenges and lessons. Challenges included: maintaining a just balance between ethical acceptability and the trial's internal validity, political instability, and the trial's research question (balancing the subjective burden of morbidity with more pressing life events). We learnt that definitions of concepts/terms such as: community representation, effective participation, engagement and empowerment are rather flaccid and broad-ended.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Epidemiology
Public health or related research
Social and behavioral sciences

Learning Objectives:
1- To assess the impact of a psychocosocial intervention (12 sessions of combined relaxation exercise and structured social support sessions over 12 weeks) on medically unexplained vaginal discharge 2-To assess the impact of a psychocosocial intervention(12 sessions of combined relaxation exercise and structured social support sessions over 12 weeks)on common mental distress (anxiety and depression) 3- To discuss the usefulness of a community based particiaptory approach as a tool that enhanced the implementation of this community based randomized trial, and consequently identify lessons learnt.

Keywords: Reproductive Health Research, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I served as the trial manager of this community based trial. I was involved in the proposal write up as well as the supervision of both the development and implementation of this trial. Iam also currently involved in supervising the data management, analysis and dissimination.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3018.0: Serving Minority and Marginalized Populations with CBPR