Self-help Group Interventions Research Articles

Protocol for a cluster randomised controlled trial to evaluate effectiveness of a self-help group intervention to encourage smoke-free homes in slums of Kochi(Kochi Intervention for tobacco smoke free homes-KIFT)

Background Exposure to second hand smoke (SHS) is a cause for heart disease and lung cancer among non- smokers. This cluster randomized control trial will evaluate the effectiveness of a tobacco smoke free home intervention in reducing exposure to second hand smoke. Protocol The intervention will be conducted among 30 clusters in urban and peri-urban areas of Kochi, India. The sample size is 300 per arm and 15 clusters to detect a minimal difference of 0.03ng/ml in cotinine levels between groups, at 80% power with a two-sided alfa of 0.05 considering variable cluster size. A baseline survey will be undertaken to identify smokers. Data related to smoking, indoor smoking, nicotine dependence, blood pressure (BP) of smokers, morbidity experienced, and lung volume Fev1/Fev6 of smokers will be measured. Urine cotinine, morbidity, BP of spouse and child will be assessed. Air quality monitors measuring PM2.5 will be placed in homes. Trained self-help group women and frontline health workers will implement the intervention. The intervention will consist of monthly home visits to educate the smoker on the harms of second-hand smoke using 3 A’s. The circle of influencers around the smoking men will also be contacted by the members of self-help group to provide support to stop smoking within homes and to quit. They will then organize two-three meetings of community leaders and heads of women’s groups, present data on harms of SHS, and explain the rationale for establishing smoke free homes in their community for a duration of six months. After the intervention a post assessment will be conducted and this will be repeated after six months. Ethics and dissemination The trial protocol was approved by the Institutional Ethical Committee of Amrita Institute of Medical Sciences. Results will be submitted to open access peer reviewed journals and shared with other stakeholders. Trial registration CTRI/2021/06/034478

Protocol for a cluster randomised controlled trial to evaluate effectiveness of a self-help group intervention to encourage smoke-free homes in slums of Kochi(Kochi Intervention for tobacco smoke free homes-KIFT)

Background Exposure to second hand smoke (SHS) is a cause for heart disease and lung cancer among non- smokers. This cluster randomized control trial will evaluate the effectiveness of a tobacco smoke free home intervention in reducing exposure to second hand smoke. Protocol The intervention will be conducted among 30 clusters in urban and peri-urban areas of Kochi, India. The sample size is 300 per arm and 15 clusters to detect a minimal difference of 0.03ng/ml in cotinine levels between groups, at 80% power with a two-sided alfa of 0.05 considering variable cluster size. A baseline survey will be undertaken to identify smokers. Data related to smoking, indoor smoking, nicotine dependence, blood pressure (BP) of smokers, morbidity experienced, and lung volume Fev1/Fev6 of smokers will be measured. Urine cotinine, morbidity, BP of spouse and child will be assessed. Air quality monitors measuring PM2.5 will be placed in homes. Trained self-help group women and frontline health workers will implement the intervention. The intervention will consist of monthly home visits to educate the smoker on the harms of second-hand smoke using 3 A’s. The circle of influencers around the smoking men will also be contacted by the members of self-help group to provide support to stop smoking within homes and to quit. They will then organize two-three meetings of community leaders and heads of women’s groups, present data on harms of SHS, and explain the rationale for establishing smoke free homes in their community for a duration of six months. After the intervention a post assessment will be conducted and this will be repeated after six months. Ethics and dissemination The trial protocol was approved by the Institutional Ethical Committee of Amrita Institute of Medical Sciences. Results will be submitted to open access peer reviewed journals and shared with other stakeholders. Trial registration CTRI/2021/06/034478

Achieving Sustainable Development Goal of Women Empowerment: A Study among Self-help Groups in India

This study evaluates the impact of self-help group (SHG) intervention and entrepreneurial traits of SHG members on the economic and socio-cultural empowerment of rural women. A purposive sampling method has been used to collect a sum of 344 responses from the SHG of women who are engaged in entrepreneurial income-generating activities in their village. A linear regression model has been used to analyse the data. The study found and argues that SHG interventions have a positive association with the economic and socio-cultural empowerment of rural women. The parameters identified and analysed in the study are helpful to the stakeholders to make policy decisions to strengthen all the factors, which are responsible for the success and growth of SHG in general and the micro-enterprise of SHG women entrepreneurs, in particular.

Effect of a self-help group intervention using Teaching Recovery Techniques to improve mental health among Syrian refugees in Norway: a randomized controlled trial

BackgroundMental health symptoms among refugees are common, often related to chronic pain disorders, and their management is usually challenging. Studies evaluating the effect of group therapies among adult refugees to improve mental health symptoms are scarce.AimsTo assess the effect of Teaching Recovery Techniques (TRT) on mental health and to reduce pain disorder among adult Syrian refugees.MethodA randomized controlled trial was designed to study the effect of a self-help group intervention using TRT. The outcomes, mental health symptoms measured by Impact of Event Scale-Revised (IES-R) and General Health Questionnaire (GHQ-12) and chronic pain measured by Brief Pain Inventory (BPI), were reported as regression coefficients (B) with 95% confidence intervals.ResultsSeventy-six adults participated: 38 in the intervention and 38 in the control groups. Intention-to-treat analyses showed a significant effect on general mental health as measured by GHQ-12 with B (95% CI) of -3.8 (-7.2, -0.4). There was no effect of TRT on mental health when assessed by IES-R (-1.3 (-8.7, 6.2)) or on pain levels assessed by BPI (-0.04 (-4.0, 3.9)).ConclusionsThis self-help group intervention significantly improved general mental health symptoms among adult refugees but had no effect on trauma symptoms or chronic pain. Higher participation rates might be necessary to achieve the full potential of TRT.Trial registration: The trial was registered with Clinical Trials.gov at https://clinicaltrials.gov/ct2/show/NCT03951909. To include user participation in the design of the interventions, the study was retrospectively registered on 19 February 2019.

‘I was in need of somewhere to release my hurt:’ Addressing the mental health of vulnerable adolescent mothers in Harare, Zimbabwe, through self-help groups

ABSTRACT Background Adolescents experiencing multiple vulnerabilities, including poverty, curtailed education, transactional sex and early childbearing, are at risk of poor mental health. In Zimbabwe, girls who are pregnant or new mothers and involved in selling sex struggle to cope with the combined pressures of parenthood, financial insecurity, and social stigma. A pilot intervention brought such girls together into self-help groups to increase peer support, resources and skills. Objective This study aimed to explore whether and how participation in a self-help group intervention affected vulnerable young mothers’ experiences and perceptions of mental health stressors. Methods Self-help groups received 12 participatory sessions over 6 months. Eighteen semi-structured interviews and three focus group discussions were held with participants and drop-outs. Before and after the intervention, participants completed the locally validated 14-item Shona Symptom Questionnaire tool to indicate the probable prevalence of common mental health disorders. Results Adolescent girls described mutually reinforcing stressors in their lives and reported low self-esteem and anxiety. Key themes emerging from qualitative data centred around girls’ struggles with adverse life events, the burden of new motherhood, social isolation related to sex work and self-help groups as a source of hope. Participants joined groups to obtain support and felt their mental well-being improved due to new social networks, feelings of solidarity with peers, and increased confidence for positive action, that is, seeking health services for themselves and their babies. Prior to enrolment 16% showed signs of possible common mental disorders falling to 2% at follow-up. Conclusions Participants believed involvement in interactive self-help groups improved their mental health by strengthening peer support and engendering hope for the future. Although reduced mental distress cannot be attributed to the programme, the pilot intervention offers a low-cost approach that could be rigorously tested and adapted to a wide range of community settings.

A therapist-guided parent-delivered self-help group for anxiety disorders in children: An effectiveness study

Standard CBT programs for childhood anxiety are costly. Low-intensity self-help treatments may increase access to evidence-based interventions. These interventions are generally promising. We tested the effectiveness of a therapist-guided parent-delivered self-help group intervention based on the “Cool Kids” program at mid-treatment, post-treatment and 6-months follow-up. We enrolled 117 families with children aged 6–12 years. Effect sizes were calculated for mother, father and child reports. Reliable change and change in clinical status were based on mother and child report. We found a significant decrease in both anxiety and depression symptoms. Effect sizes were medium to large for anxiety symptoms following treatment. Mothers reported that 53.8% of the children obtained a reliable change in anxiety symptoms from pre- to post-treatment, and 66.7% from pre- to follow-up. Out of 72.6% children who were classified as having clinical anxiety prior to treatment, 52.9% and 58.8% changed their status to non-clinical at post-treatment and follow-up, respectively. Clinical significant change, involving having achieved both a reliable change and change of status from clinical to non-clinical, was obtained for 49.4% at post-treatment, and 58.8% at follow-up based on mother reports. Our findings indicate that parent-delivered self-help CBT groups may be a valuable asset in improving access to psychological cost-effective evidence-based treatments for anxious children.

Do Self-Help Groups Empower Women? Evidences from Nuh District of Haryana

Men and women complement each other in many aspects of life. Nevertheless, when we talk about empowerment, there is big diversity. There are often pressures and opposition from within the family due to societal stereotypes that force women to take care of the house as her key responsibility. Unequal or unfair treatments marginalized the women and hindered their participation in socio-economic growth of the country. However, the findings of the studies showed that women participation in economic activities produced large gains in economic welfare. This study was an attempt to contribute in the debate about how the self-help groups were helpful to empower the women; as women empowerment overcame the gender disparity (the gap between men and women) and increased the participation of women in economic as politic activities of the country. For this purpose, the primary data was collected from the Nuh district of Haryana, considered the most backward district of India. This study showed that self-help group intervention had a positive role in empowering women.

From social curse to social cure: A self‐help group community intervention for people affected by leprosy in Nepal

Leprosy is endemic in Nepal and disproportionately affects the most marginalized. Leprosy related stigma can be characterized as a social curse, because those affected are excluded from group life and social participation which has severe implications for psychological health. The Nepal Leprosy Trust run a community-based self-help group intervention that aims to develop a new empowered identity to re-establish access to multiple group memberships' through social participation. In this applied cross-sectional study, informed by the Social Identity Model of Identity Change, we assess this intervention. Participants (N = 98) were members of self-help groups in 10 rural villages in Nepal, and completed measures of self-help group identification, access to multiple groups, internalized stigma and well-being. Mediation models indicated that self-help group identification was indirectly linked to reduced stigma and increased well-being through access to multiple groups. Supporting the Social Identity Model of Identity Change, we present novel evidence that group-based interventions can offer new valued identities that link to social cure resources, even in the most adverse circumstances. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

Effect Self Help Group On Coping Mechanism Focused Problem Coping In Adolescents SMK Negeri Kediri

Coping mechanism is a method used by someone to reduce the stress level experienced by an individual. One of the problems experienced by adolescents is stress. The impact of stress cause’s problems on physical health and reduce psychological abilities adolescents. One of the supports in improving coping mechanism Problem Focused Coping (PFC) on adolescents used intervention Self Help Group. Purpose in thus study to determine the effect Self Help Group to improved Coping Mechanisms: Problem Focused Coping (PFC) on adolescents. Design in this study by Quasi Experimental Pre-Test and Post-Test With Control Group. Samples in this study with the control and exclusion criteria with the number of respondents 282 students, which were divided into 141 in the control group and the intervention group. Collecting data used the Problem Focused Coping questionnaire from A-COPE. Analysis by used SPSS 16.0 for windows with Corelation Pearson Product Moments Test. Results in this study indicate the coping mechanism problem focused coping control group obtained p value=0.293, and the intervention group p=0.000. The results this study prove the Self-Help Group intervention has an influence increasing positive coping mechanisms towards Problem Focused Coping (PFC). Conclusion Self Help group intervention has a significant effect in increasing the coping mechanism of problem focused coping (PFC) in adolescents.

Health layering of self-help groups: impacts on reproductive, maternal, newborn and child health and nutrition in Bihar, India

Background Self-help group (SHG) interventions have been widely studied in low and middle income countries. However, there is little data on specific impacts of health layering, or adding health education modules upon existing SHGs which were formed primarily for economic empowerment. We examined three SHG interventions from 2012-2017 in Bihar, India to test the hypothesis that health-layering of SHGs would lead to improved health-related behaviours of women in SHGs. Methods A model for health layering of SHGs - Parivartan - was developed by the non-governmental organisation (NGO), Project Concern International, in 64 blocks of eight districts. Layering included health modules, community events and review mechanisms. The health layering model was adapted for use with government-led SHGs, called JEEViKA+HL, in 37 other blocks of Bihar. Scale-up of government-led SHGs without health layering (JEEViKA) occurred contemporaneously in 433 other blocks, providing a natural comparison group. Using Community-based Household Surveys (CHS, rounds 6-9) by CARE India, 62 reproductive, maternal, newborn and child health and nutrition (RMNCHN) and sanitation indicators were examined for SHGs with health layering (Pavivartan SHGs and JEEViKA+HL SHGs) compared to those without. We calculated mean, standard deviation and odds ratios of indicators using surveymeans and survey logistic regression. Results In 2014, 64% of indicators were significantly higher in Parivartan members compared to non-members residing in the same blocks. During scale up, from 2015-17, half (50%) of indicators had significantly higher odds in health layered SHG members (Parivartan or JEEViKA+HL) in 101 blocks compared to SHG members without health layering (JEEViKA) in 433 blocks. Conclusions Health layering of SHGs was demonstrated by an NGO-led model (Parivartan), adapted and scaled up by a government model (JEEViKA+HL), and associated with significant improvements in health compared to non-health-layered SHGs (JEEViKA). These results strengthen the evidence base for further layering of health onto the SHG platform for scale-level health change. Study registration ClinicalTrials.gov number NCT02726230.

Health layering of self-help groups: impacts on reproductive, maternal, newborn and child health and nutrition in Bihar, India.

BackgroundSelf-help group (SHG) interventions have been widely studied in low and middle income countries. However, there is little data on specific impacts of health layering, or adding health education modules upon existing SHGs which were formed primarily for economic empowerment. We examined three SHG interventions from 2012-2017 in Bihar, India to test the hypothesis that health-layering of SHGs would lead to improved health-related behaviours of women in SHGs.MethodsA model for health layering of SHGs – Parivartan – was developed by the non-governmental organisation (NGO), Project Concern International, in 64 blocks of eight districts. Layering included health modules, community events and review mechanisms. The health layering model was adapted for use with government-led SHGs, called JEEViKA+HL, in 37 other blocks of Bihar. Scale-up of government-led SHGs without health layering (JEEViKA) occurred contemporaneously in 433 other blocks, providing a natural comparison group. Using Community-based Household Surveys (CHS, rounds 6-9) by CARE India, 62 reproductive, maternal, newborn and child health and nutrition (RMNCHN) and sanitation indicators were examined for SHGs with health layering (Pavivartan SHGs and JEEViKA+HL SHGs) compared to those without. We calculated mean, standard deviation and odds ratios of indicators using surveymeans and survey logistic regression.ResultsIn 2014, 64% of indicators were significantly higher in Parivartan members compared to non-members residing in the same blocks. During scale up, from 2015-17, half (50%) of indicators had significantly higher odds in health layered SHG members (Parivartan or JEEViKA+HL) in 101 blocks compared to SHG members without health layering (JEEViKA) in 433 blocks.ConclusionsHealth layering of SHGs was demonstrated by an NGO-led model (Parivartan), adapted and scaled up by a government model (JEEViKA+HL), and associated with significant improvements in health compared to non-health-layered SHGs (JEEViKA). These results strengthen the evidence base for further layering of health onto the SHG platform for scale-level health change.Study registrationClinicalTrials.gov number NCT02726230

Effects of self-help groups intervention on coping strategies of parents of children with Autism Spectrum Disorder (ASD)

Coping strategies were significant predictors of psychosocial adaptation in parents of children with autism spectrum disorder (ASD). Self-help groups could be effective resources for parents in dealing with problems wile caring for children with ASD. The purpose of this study was to analyze the effects of self-help groups on coping strategies in parents of children with ASD. This study used pre and post quasi-experimental tests without a control group using self-help group interventions. There were thirty-three participants taken from the Malang City Autism Service Center using purposive sampling. Coping strategies based on cognitive and psychomotor abilities were measured using a questionnaire. The results showed paired t-test in all groups, at 5% significance level, statistically significant difference between mean score before and after self-help group interventions. Coping strategies in groups that received two supervised sessions and four times independently reached higher score compared to other groups. It can be concluded that it is important to implement self-help groups for parents who care for children with special needs.

Neoliberal crises of social work in the Global South: Ethnography of individualizing disability and empowerment practice in India

This article examines the World Bank’s disability and development projects in rural South India and illuminates neoliberalism’s dangers for social work theory and practice in the Global South. Based on a multi-year ethnographic study involving participant observation and interviews with multiple stakeholders, it critically examines the individualized model of empowerment promoted by self-help groups in light of the structural and cultural realities of rural disability. It highlights the dangers of individualization and responsibilization of self-help group interventions and traces how disabled subjectivities are shaped in line with neoliberal governmentality. Foregrounding disability and global south perspectives on neoliberalism – often overlooked in social work scholarship – this article contributes an intersectional and transnational perspective to social work.

Improved Health Status and Life Satisfaction among Older People following Self-Help Group Intervention in Jakarta.

Although self-help group for older people gains the effectiveness, the effect of a nursing intervention using a self-help group model as a guideline for self-monitoring and intervention on the health status and life satisfaction among older people still remains. To determine the effectiveness of this nursing intervention, an experimental design using multistage sampling method was used for this study. The self-help intervention included a single 50–70-minute session once a week for 12 weeks done, using the Life Satisfaction Inventory-A (LSI-A) questionnaire, and SF-36 shows a significant difference. Self-help intervention could be implemented by nurses for older people in the community to improve health and well-being.

Measuring empowerment in rural India using vignettes

Many development projects aim at empowering women. Yet, the measurement of empowerment has proved difficult and is riddled with technical and conceptual problems. Current approaches rely on long questionnaires and, to some extent, on subjective perceptions which are not comparable across groups. This article proposes a method for measuring empowerment based on vignettes and provides an application to a sample of rural women in Andhra Pradesh. The method is simple to administer and addresses biases in subjective perceptions. The empirical analysis shows how perceptions vary systematically across groups and how they can be corrected for. It is also shown how the impact of a project on empowerment can be tested. In this application, it is found that differences in self-reported empowerment are perceptual and that a self-help group intervention does not increase women empowerment.

PROTOCOL: The Effects Of Economic Self‐Help Group Programs On Women's Empowerment: A Systematic Review

PROTOCOL: The Effects Of Economic Self‐Help Group Programs On Women's Empowerment: A Systematic Review

The Evolution of Sport Psychiatry, Circa 2009

Over the past three decades, the world of both amateur and professional sports has expanded greatly and become more complex. In part related to these changes - and relatively unknown to sports medicine practitioners - the field of sport psychiatry has steadily evolved and grown. This paper focuses on what these changes have been. A sport psychiatrist is a physician-psychiatrist who diagnoses and treats problems, symptoms and/or disorders associated with an athlete, with their family/significant others, with their team, or with their sport, including spectators/fans. The primary aims of the specialty are to (i) optimize health, (ii) improve athletic performance, and (iii) manage psychiatric symptoms or disorders. The training includes medical training to provide knowledge and skills unique to physicians; psychiatric training to provide knowledge and skills inherent in that field, and training and/or experience in sport psychiatry to provide knowledge and skills about psychiatric aspects of sports. The sport psychiatrist first makes an individual, family-systems and phenomenological diagnosis of the clinical situation. Based on this evaluation, he sets goals for not only the athlete, but also for significant others involved. He delivers treatment based on the psychiatric disorder or problem using a combination of medication, psychotherapy or self-help group interventions plus strategies targeted to specific sport performance issues. Evolution of the International Society of Sport Psychiatry as well as the field, including incorporation into school and professional team sports, is described along with a 'typical day' for a sport psychiatrist. Case examples, a training curriculum and core literature are included.

Cost-effectiveness analysis of cognitive behaviour therapy for treatment of minor or mild-major depression in elderly patients with type 2 diabetes: study protocol for the economic evaluation alongside the MIND-DIA randomized controlled trial (MIND-DIA CEA)

BackgroundDepression and elevated depression symptoms are more prevalent in patients with type 2 diabetes than in those without diabetes and are associated with adverse health outcomes and increased total healthcare utilization. This suggests that more effective depression treatment might not only improve health outcome, but also reduce costs. However, there is a lack of evidence on (cost-) effectiveness of treatment options for minor and mild-major depression in patients with type 2 diabetes. In this paper we describe the design and methods of the economic evaluation, which will be conducted alongside the MIND-DIA trial (Cognitive behaviour therapy in elderly type 2 diabetes patients with minor or mild-major depression). The objective of the economic evaluation (MIND-DIA CEA) is to examine incremental cost-effectiveness of a diabetes specific cognitive behaviour group therapy (CBT) as compared to intensified treatment as usual (TAU) and to a guided self-help group intervention (SH).Methods/DesignPatients will be followed for 15 months. During this period data on health sector costs, patient costs and societal productivity/time costs will be collected in addition to clinical data. Person-years free of moderate/severe major depression, quality adjusted life years (QALYs), and cumulative costs will be estimated for each arm of the trial (CBT, TAU and SH). To determine cost-effectiveness of the CBT, differences in costs and effects between the CBT group and TAU/SH group will be calculated.DiscussionCBT is a potentially effective treatment option to improve quality of life and to avoid the onset of a moderate/severe major depression in elderly patients with type 2 diabetes and minor or mild-major depression. This hypothesis will be evaluated in the MIND-DIA trial. Based on these results the associated economic evaluation will provide additional evidence on the cost-effectiveness of CBT in this target population. Methodological strengths and weaknesses of the planned economic evaluation are discussed.Trial registrationThe MIND-DIA study has been registered at the Current Controlled Trials Register (ISRCTN58007098).

Combining Professional and Self-Help Group Intervention: Collaboration in Co-Leadership

The Elders Health Program established a treatment program for chemically dependent seniors using a peer and professional co-leadership approach. This paper describes the development of this treatment approach, and the results. With chemically dependent seniors, the peer co-leader provided a role model by offering not only hope and optimism, but also ideas to assist them with maintaining abstinence. The E.H.P. experience showed that peer co-leadership was effective when working with chemically dependent seniors.

Intrapersonal Resources and the Effectiveness of Self-Help Groups for Bereaved Older Adults

The relative impact of three intrapersonal resources (self-esteem, competencies and life satisfaction) and the duration of a self-help group intervention on levels of depression and grief were examined over time among a sample of 295 recently bereaved older adults. In general, the resources examined had a greater direct influence on outcomes than the intervention. Also, those with lower competencies reported reduced depression and grief with greater meeting attendance, whereas the opposite was at first true for those with high competencies. Depression eventually decreased, however, among those with high competencies who continued to attend self-help group meetings for more than 8 weeks. Although bereavement self-help groups can aid those who may be deficient in selected skills, it is equally important to emphasize ways the bereaved can more effectively use those strengths that they may already possess in order to facilitate adaptation.