GBV, Primary Trauma & Trauma Resilience & Understanding Self-help Therapy Utilization in Uganda
Condition: Domestic Violence; Psychological Distress; Post-Traumatic Stress Disorder; Suicidality
MeSH terms: Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic
Study type: Interventional

Summary: 
      The goal of this community-based interventional study was to determine the effectiveness of
      the 'Trauma Resilience & Understanding Self-help Therapy' (TRUST) in managing domestic
      violence & primary trauma among formerly Internally Displaced Persons (fIDPs) in northern
      Uganda. The main questions it aimed to answer were:

        -  What was the level of utilization and short-term effects of the TRUST intervention on
           the experiences of domestic violence and high levels of primary trauma among fIDPs
           living in northern Uganda who would have been using TRUST within their communities after
           completing the training in the community-based TRUST utilization?

        -  What were the clinical indications of the TRUST intervention and psychological operators
           among fIDPs living in northern Uganda who would have been using TRUST within their
           communities to manage their experiences of domestic violence and high levels of primary
           trauma? Participants found to have experienced domestic violence in the last one year
           and were having high levels of primary trauma were randomly assigned to the intervention
           group that was trained in the utilization of the TRUST within their communities and then
           followed up for 12 weeks (TRUST group).

      The investigators then compared the results obtained from the TRUST group with those attained
      from an age and gender cross-matched control group of fIDPs who were not trained in the
      utilization of the TRUST within their communities (Control group). This was done to see if
      the community-based utilization of the TRUST intervention changed the levels of primary
      trauma & experiences of domestic violence among its users (TRUST group) when compared to the
      non-users (Control group).
    

Detailed description: 
      An indigenous rebel outfit waged a decades' civil war in eastern and northern Uganda until
      the early 2000s. This rebellion resulted in forceful internal displacement of most of the
      local population leading to unwarranted misery. In the aftermath of this rebellion, the
      internally displaced returned to their areas of origin. However, a significant proportion of
      these formerly internally displaced persons (fIDPs) have since then been plagued with a
      plethora of adversities including high levels of primary trauma, frequent experiences of
      domestic violence and impaired social economic resilience (SER) levels. A newly developed
      psychosocial therapeutic intervention called the 'trauma resilience & understanding self-help
      therapy' (TRUST) was revealed to be qualitatively effective in managing high levels of
      primary trauma, experiences of domestic violence and poor SER levels among refugees and
      fIDPs. However, the quantitative effectiveness of TRUST and the psychological operators among
      the fIDPs and refugees within which it is grounded still remain a scientific mystery. Hence,
      an appropriate prospective community-based cohort research study was conducted to this
      effect. The investigators carried out a descriptive community-based prospective study from
      November 2022 to March 2023 among 284 randomly recruited adults who were fIDPs living in
      northern Uganda using quantitative data collection techniques in natural experiments
      conducted via repeated assessments. The resultant data were analyzed using univariate,
      bivariate and multivariate linear, logistic and Poisson regression as well as determining the
      effect sizes of the community-based utilization of TRUST on the high levels of primary
      trauma, experiences of domestic violence and poor SER levels among fIDPs living in northern
      Uganda. These findings were compared with those obtained among a randomly selected control
      group of fIDPs living in northern Uganda who were cross-matched according to their age and
      gender, were experiencing high levels of primary trauma and domestic violence as well as poor
      SER levels and had not been trained in the community-based utilization of TRUST.
    

Intervention name(s): Trauma Resilience & Understanding Self-help Therapy
Intervention type(s): Behavioral
Intervention description(s): A self-help psychosocial therapeutic intervention requiring one to undergo a basic training in its community-based utilization.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: formerly Internally Displaced Persons; Gender Based Violence; Trauma Resilience & Understanding Self-help Therapy; Uganda