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Addressing Behavioral Health Disparities for Somali Immigrants Through Group Cognitive Behavioral Therapy Led by Community Health Workers

Journal of Immigrant and Minority Health volume 19, pages 187–193 (2017)Cite this article

Abstract

To test the feasibility and acceptability of implementing an evidence-based, peer-delivered mental health intervention for Somali women in Minnesota, and to assess the impact of the intervention on the mental health of those who received the training. In a feasibility study, 11 Somali female community health workers were trained to deliver an 8-session cognitive behavioral therapy intervention. Each of the trainers recruited 5 participants through community outreach, resulting in 55 participants in the intervention. Self-assessed measures of mood were collected from study participants throughout the intervention, and focus groups were conducted. The 55 Somali women who participated recorded significant improvements in mood, with self-reported decreases in anxiety and increases in happiness. Focus group data showed the intervention was well received, particularly because it was delivered by a fellow community member. Participants reported gaining skills in problem solving, stress reduction, and anger management. Participants also felt that the intervention helped to address some of the stigma around mental health in their community. Delivery of cognitive behavioral therapy by a community health workers offered an acceptable way to build positive mental health in the Somali community.

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References

  1. Sheikh Omar Y. Social integration and the sense of hope among Somali youth in Australia and the United States. Bildhaan Int J Somali Stud. 2013;12(1):34–52.

    Google Scholar 

  2. Halcón LL, Robertson CL, Savik K, et al. Trauma and coping in Somali and Oromo refugee youth. J Adolesc Health. 2004;35(1):17–25.

    Article  PubMed  Google Scholar 

  3. Elmi AS. A study on the mental health needs of the Somali community in Toronto. Toronto: York Community Services and Rexdale Community Health Centre Toronto; 1999.

    Google Scholar 

  4. Johnsdotter S, Ingvarsdotter K, Östman M, Carlbom A. Koran reading and negotiation with jinn: strategies to deal with mental ill health among Swedish Somalis. Mental Health Relig Cult. 2011;14(8):741–55.

    Article  Google Scholar 

  5. Venters H, Gany F. African immigrant health. J Immigr Minor Health. 2011;13(2):333–44.

    Article  PubMed  Google Scholar 

  6. Greenberg PE, Kessler RC, Birnbaum HG, et al. The economic burden of depression in the United States: how did it change between 1990 and 2000? J Clin Psychiatry. 2003;64(12):1465–75.

    Article  PubMed  Google Scholar 

  7. Katon W, Schulberg H. Epidemiology of depression in primary care. Gen Hosp Psychiatry. 1992;14(4):237–47.

    Article  CAS  PubMed  Google Scholar 

  8. Shah A. The burden of psychiatric disorder in primary care. Int Rev Psychiatry. 1992;4(3–4):243–50.

    Article  Google Scholar 

  9. Ostler K, Thompson C, Kinmonth AL, Peveler RC, Stevens L, Stevens A. Influence of socio-economic deprivation on the prevalence and outcome of depression in primary care: the Hampshire depression project. Br J Psychiatry. 2001;178(1):12–7.

    Article  CAS  PubMed  Google Scholar 

  10. Lasser KE, Himmelstein DU, Woolhandler S. Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey. Am J Public Health. 2006;96(7):1300–7.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ellis BH, Lincoln AK, Charney ME, Ford-Paz R, Benson M, Strunin L. Mental health service utilization of Somali adolescents: religion, community, and school as gateways to healing. Transcult Psychiatry. 2010;47(5):789–811.

    Article  PubMed  Google Scholar 

  12. Hill N, Hunt E, Hyrkas K. Somali immigrant women’s health care experiences and beliefs regarding pregnancy and birth in the United States. J Transcult Nurs. 2012;23(1):72–81.

    Article  PubMed  Google Scholar 

  13. Pavlish CL, Noor S, Brandt J. Somali immigrant women and the American health care system: discordant beliefs, divergent expectations, and silent worries. Soc Sci Med. 2010;71(2):353–61.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Robertson CL, Halcon L, Savik K, et al. Somali and Oromo refugee women: trauma and associated factors. J Adv Nurs. 2006;56(6):577–87.

    Article  PubMed  Google Scholar 

  15. Krug EG, Mercy JA, Dahlberg LL, Zwi AB. The world report on violence and health. Lancet. 2002;360(9339):1083–8.

    Article  PubMed  Google Scholar 

  16. Dahlberg LL, Krug EG. Violence—a global public health problem. In: Krug EG, et al., editors. World report on violence and health. Geneva: World Health Organization; 2002. p. 3–21.

    Google Scholar 

  17. Levano W, Miller JW, Leonard B, et al. Public education and targeted outreach to underserved women through the national breast and cervical cancer early detection program. Cancer. 2014;120(S16):2591–6.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Padela AI, Killawi A, Forman J, DeMonner S, Heisler M. American Muslim perceptions of healing: key agents in healing, and their roles. Qual Health Res. 2012;22(6):846–58.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Deyo NS. Cultural traditions and the reproductive health of Somali refugees and immigrants. Master’s Thesis, University of San Francisco; 2012.

  20. Guerin P, Hussein Elmi F, Guerin B. Weddings and parties: cultural healing in one community of Somali women. Austr e-J Adv Mental Health. 2006;5(2):105–12.

    Article  Google Scholar 

  21. Bortolotti B, Menchetti M, Bellini F, Montaguti MB, Berardi D. Psychological interventions for major depression in primary care: a meta-analytic review of randomized controlled trials. Gen Hosp Psychiatry. 2008;30(4):293–302.

    Article  PubMed  Google Scholar 

  22. Gellatly J, Bower P, Hennessy S, Richards D, Gilbody S, Lovell K. What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychol Med. 2007;37(09):1217–28.

    Article  PubMed  Google Scholar 

  23. Rahman A. Challenges and opportunities in developing a psychological intervention for perinatal depression in rural Pakistan—a multi-method study. Arch Women’s Mental Health. 2007;10(5):211–9.

    Article  CAS  Google Scholar 

  24. Rahman A, Malik A, Sikander S, Roberts C, Creed F. Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial. Lancet. 2008;372(9642):902–9.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Williams C, Chellingsworth M. CBT: A clinician’s guide to using the five areas approach. Boca Raton: CRC Press; 2010.

    Google Scholar 

  26. Williams C. Overcoming anxiety, stress and panic: a five areas approach. London: Hodder Arnold; 2012.

    Google Scholar 

  27. Williams C, Wilson P, Morrison J, et al. Guided self-help cognitive behavioural therapy for depression in primary care: a randomised controlled trial. PLoS One. 2013;8(1):e52735.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Williams C, Martinez R. Increasing access to CBT: stepped care and CBT self-help models in practice. Behav Cogn Psychother. 2008;36(06):675–83.

    Article  Google Scholar 

  29. Petersen I, Lund C, Bhana A, Flisher AJ. Mental Health and Poverty Research Programme Consortium. A task shifting approach to primary mental health care for adults in South Africa: human resource requirements and costs for rural settings. Health Policy Plan. 2012;27(1):42–51.

    Article  PubMed  Google Scholar 

  30. Patel V. The future of psychiatry in low-and middle-income countries. Psychol Med. 2009;39(11):1759–62.

    Article  CAS  PubMed  Google Scholar 

  31. Gambino C, Trevelyan E, Fitzwater J. The foreign-born population from Africa: 2008–2012. Washington: US Census Bureau; 2014.

    Google Scholar 

  32. Charmaz K. Constructing grounded theory. Thousand Oaks: Sage; 2014.

    Google Scholar 

  33. Morse JM, Stern PN, Corbin J, Bowers B, Clarke AE, Charmaz K. Developing grounded theory: the second generation (developing qualitative inquiry). Walnut Creek: Left Coast Press; 2009.

    Google Scholar 

  34. Ellis BH, MacDonald HZ, Lincoln AK, Cabral HJ. Mental health of Somali adolescent refugees: the role of trauma, stress, and perceived discrimination. J Consult Clin Psychol. 2008;76(2):184–93.

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was made possible with funding from the UCare Research Foundation. Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Program in Health Disparities, Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware Street, Minneapolis, MN, 55414, USA

    Rebekah Pratt

  2. Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware Street, Minneapolis, MN, 55414, USA

    Nimo Ahmed

  3. People’s Centre Health Service, 425 20th Avenue South, Minneapolis, MN, 55454, USA

    Sahra Noor

  4. Department of Nursing, University of Minnesota, 308 SE Harvard Street, Minneapolis, MN, 55455, USA

    Hiba Sharif

  5. Powell Center for Women’s Health, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA

    Nancy Raymond

  6. Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, Scotland, UK

    Chris Williams

Authors
  1. Rebekah Pratt
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  2. Nimo Ahmed
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  3. Sahra Noor
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  4. Hiba Sharif
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  5. Nancy Raymond
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  6. Chris Williams
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Corresponding author

Correspondence to Rebekah Pratt.

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This study was reviewed and approved by the University of Minnesota Institutional Review Board.

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Pratt, R., Ahmed, N., Noor, S. et al. Addressing Behavioral Health Disparities for Somali Immigrants Through Group Cognitive Behavioral Therapy Led by Community Health Workers. J Immigrant Minority Health 19, 187–193 (2017). https://doi.org/10.1007/s10903-015-0338-2

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  • DOI: https://doi.org/10.1007/s10903-015-0338-2

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