PDF(Pubmed)
Abstract：
Community-based psychosocial support group (CB-PSS) interventions using task-shifting approaches are well suited to provide culturally appropriate services in low- and middle-income countries. However, contextual barriers and facilitators must be considered to tailor interventions effectively, particularly considering the challenges introduced by the COVID-19 pandemic. We explore the barriers, facilitators, and psychosocial changes associated with implementing a CB-PSS group intervention delivered by local lay providers to conflict-affected adults in Quibdó, Colombia, using both in-person and remote modalities. Data were analyzed from 25 individual interviews with participants and a focus group discussion involving staff members, including 7 community psychosocial agent facilitators and 2 mental health professional supervisors. The analysis used a thematic approach grounded in a descriptive phenomenology to explore the lived experiences of participants and staff members during implementation. Participant attendance in the in-person modality was compromised by factors such as competing work and family responsibilities and disruption caused by the COVID-19 pandemic. Participants in the remote modality faced challenges concerning unstable Internet connectivity, recurrent power outages caused by heavy rain, distractions, interruptions, and threats to confidentiality by family and coworkers. Despite these challenges, data revealed key contextual facilitators, including the community-based knowledge of facilitators and integration of traditional practices, such as the comadreo (informal talks and gatherings). Respondents shared that the CB-PSS groups promoted stronger community relationships and created opportunities for participants to exchange peer support, practice leadership skills, develop problem-solving skills based on peers\' experiences, and enhance emotional regulation skills. Differences and similarities across in-person and remote modalities are discussed, as are key considerations for practitioners and policymakers.
摘要：
使用任务转移方法的基于社区的社会心理支持小组（CB-PSS）干预措施非常适合在低收入和中等收入国家提供文化上适当的服务。然而,必须考虑背景障碍和促进者，以有效地调整干预措施，特别是考虑到COVID-19大流行带来的挑战。我们探索障碍，主持人，以及与实施CB-PSS团体干预相关的心理社会变化，由当地非专业提供者向Quibdó受冲突影响的成年人提供干预，哥伦比亚,使用面对面和远程模式。对来自参与者的25次个人访谈和涉及工作人员的焦点小组讨论的数据进行了分析，包括7名社区心理社会代理人促进者和2名心理健康专业监督员。分析使用基于描述性现象学的主题方法来探索参与者和工作人员在实施过程中的生活经验。参加面对面方式的参与者受到工作和家庭责任竞争以及COVID-19大流行造成的干扰等因素的影响。远程模式的参与者面临着互联网连接不稳定的挑战，暴雨造成的经常性停电，分心，中断,以及家人和同事对保密的威胁。尽管面临这些挑战,数据揭示了关键的上下文促进者，包括促进者的社区知识和传统做法的整合，例如comadreo（非正式会谈和聚会）。受访者表示，CB-PSS小组促进了更牢固的社区关系，并为参与者提供了交流同伴支持的机会，练习领导技能，根据同龄人的经验培养解决问题的能力，增强情绪调节技能。讨论了面对面和远程模式之间的差异和相似之处，从业者和决策者的关键考虑因素也是如此。
