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Depression and loneliness among Sub-Saharan immigrants living in the greater Paris area: results from the MAKASI empowerment stepped wedge cluster randomised controlled trial

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Abstract

Purpose

The MAKASI intervention aimed to empower Sub-Saharan African immigrants living in precarious situations in the Paris metropolitan area. Because there are factors specifically related to immigration that may increase the risk for common mental disorders, the present study aimed to examine participants’ levels of depression and loneliness and analyze the effect of the intervention on depression and loneliness.

Methods

The MAKASI study was designed as a stepped wedge cluster randomized trial. Study participants were recruited through an outreach program led by a nongovernmental organization and randomly assigned to two clusters, with an intervention delay of 3 months between them. Participants were assessed for 6 months after inclusion and the effect of the intervention on depression and loneliness was assessed using generalized linear mixed models. The study was conducted from 2018 to 2021 and took in consideration whether being interviewed during one of the Covid-19 confinement had an effect on the results.

Results

Between 2018 and 2021 a total of 821 subjects participated in the Makasi study. High levels of depression and loneliness were found in the study population. We found no effect of the intervention on depression [95% CI 0.77 to 2.40]. Similarly, no effect of the intervention was found on loneliness [95% CI 0.87 to 2.54].

Conclusions

The intervention tested did not appear to improve the level of depression and loneliness among participants. However, the high prevalence of mental and emotional problems in the study population suggests a public health crisis among immigrants in the greater Paris area.

Clinical Trial Registration Number: Trial registration Clinicaltrials.gov, NCT04468724 (July 13, 2020).

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Data availability

Data requests will be reviewed internally and will be available subject to a written proposal and a signed data sharing agreement.

Notes

  1. Intervention sites in Paris greater area: Rosa Parks, Marcadet, Château Rouge, Flandres, Montreuil, Aubervilliers, Sevran Beaudottes, Saint Denis, Sarcelles, Pierrefitte-Stains and Gare de Grigny.

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Acknowledgements

This study was supported by the French National Agency for research on AIDS and Viral hepatitis (ANRS) and Health regional agency (ANRS 14057). The sponsor of the study had no role in study design, data collection, data analysis, data interpretation or writing of the paper. We would also like to thank the contributions given by Véronique Sébille and Myriam Blanchin from Nantes University. The MAKASI Study Group included Annabel Desgrées du Loû, Nicolas Derche, Flore Gubert, Romain Mbiribindi, Maria Melchior (scientific coordinators), Ny Sata Andrianirina, Marwân-al-Qays Bousmah, Séverine Carillon, Virginie Comblon, Karna Coulibaly, Angèle Delbe, Jacques Ebongue, Ruth Foundje Notemi, Charles Gaywahali, Anne Gosselin, Veroska Kohou, France Lert, Jean Lusilu-Voza, Belinda Lutonadio, Yves Nyemeck, Patricia Mbiribindi, Thierry Miatti, Jean-Paul Ngueya, Andrainolo Ravalihasy, Valéry Ridde, Jean-Noël Senne, Oumar Sissoko, Corinne Taéron, Faya Tess, and Iris Zoumenouand the Makasi group of peers.

Funding

The MAKASI study received funding from the French National Agency of Research on HIV/Aids and Viral Hepatitis (ANRS). The mentioned sponsor did not participate in the elaboration, data collection or analysis of the study.

Author information

Authors and Affiliations

  1. Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie Et de Santé Publique (IPLESP), Équipe de Recherche en Épidémiologie Sociale (ERES), Paris, France

    Bianca Gonçalves Tasca & Maria Melchior

  2. Université Paris Cité, IRD, Inserm, Ceped, 75006, Paris, France

    Marwân-al-Qays Bousmah, Karna Coulibaly, Anne Gosselin, Andrainolo Ravalihasy & Annabel Desgrées du Loû

  3. CNRS, French Collaborative Institute On Migrations, Aubervilliers, France

    Marwân-al-Qays Bousmah, Karna Coulibaly, Anne Gosselin, Andrainolo Ravalihasy & Annabel Desgrées du Loû

  4. IRD, UMR LEDa-DIAL, PSL, Université Paris-Dauphine, CNRS, Paris, France

    Marwân-al-Qays Bousmah

  5. Ined, National Institute for Demographic Studies, Aubervilliers, France

    Anne Gosselin

Authors
  1. Bianca Gonçalves Tasca
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  3. Karna Coulibaly
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  5. Andrainolo Ravalihasy
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  6. Annabel Desgrées du Loû
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  7. Maria Melchior
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Consortia

Makasi Study Group

  • Nicolas Derche
  • , Flore Gubert
  • , Romain Mbiribindi
  • , Ny Sata Andrianirina
  • , Bianca Gonçalves Tasca
  • , Séverine Carillon
  • , Virginie Comblon
  • , Angèle Delbe
  • , Jacques Ebongue
  • , Ruth Foundje Notemi
  • , Bianca Gonçalves Tasca
  • , Charles Gaywahali
  • , Veroska Kohou
  • , France Lert
  • , Jean Lusilu-Voza
  • , Belinda Lutonadio
  • , Yves Nyemeck
  • , Patricia Mbiribindi
  • , Thierry Miatti
  • , Jean-Paul Ngueya
  • , Valéry Ridde
  • , Jean-Noël Senne
  • , Oumar Sissoko
  • , Corinne Taéron
  • , Faya Tess
  •  & Iris Zoumenouand

Contributions

ADDL was responsible for securing the funding for the study. ADDL and MM designed the study. ADDL, AG, KC, MQB and AR collected and prepared the data. BGT, MQB and KC conducted statistical analysis. BGT conducted the literature review and wrote the first draft of the paper. All authors have read and approved the manuscript.

Corresponding author

Correspondence to Bianca Gonçalves Tasca.

Ethics declarations

Conflict of interest

All authors declare that they have no competing interests concerning the present study.

Ethical approval

The MAKASI study was performed in line with the principles of the Declaration of Helsinki. This study was approved by the French Data Protection Authority (Commission Nationale de l’Informatique et des Libertés, CNIL, declaration n°2215270) and the Committee for Persons’ Protection (Comité de protection des personnes, ID RCB 2018-A02129-46). Written informed consent was obtained from all participants.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Additional information

The Members of the Makasi Study Group are listed in Acknowledgements.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 548 KB)

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Gonçalves Tasca, B., Bousmah, MaQ., Coulibaly, K. et al. Depression and loneliness among Sub-Saharan immigrants living in the greater Paris area: results from the MAKASI empowerment stepped wedge cluster randomised controlled trial. Soc Psychiatry Psychiatr Epidemiol (2024). https://doi.org/10.1007/s00127-024-02665-7

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