Challenges and Innovations in a Community-Based Participatory Randomized Controlled Trial

Area of Science:

• Public Health
• Mental Health Research
• Community-Based Participatory Research

Background:

• Randomized controlled trials (RCTs) are crucial for health intervention effectiveness but face challenges in external validity and participant experience.
• Community-based interventions require careful design to address social determinants of health and build trust, especially in refugee populations.

Purpose of the Study:

• To test the effectiveness of a community-based advocacy, learning, and social support intervention for refugee adults.
• To address mental health disparities and improve engagement in trauma-focused treatment among Afghan, African, and Iraqi refugees.
• To identify and address challenges in conducting community-based RCTs within refugee communities.

Main Methods:

• A mixed-methods study involving a randomized controlled trial (RCT) with 93 adult refugees.
• Intervention focused on social determinants of health, trust-building, and connection to mental health services.
• Data collected through four research interviews per participant (pre-, mid-, post-intervention, and follow-up).

Main Results:

• Several challenges emerged during the RCT, including interviewer assistance in the control group and resource diffusion.
• Community and staff concerns regarding the RCT design and meaningful evidence were identified.
• Innovations were developed to overcome these methodological and ethical challenges in community-based RCTs.

Conclusions:

• Conducting community-based RCTs with refugee populations presents unique epistemological, methodological, and ethical considerations.
• The study highlights the importance of addressing social determinants of health and building trust for effective interventions.
• Developed innovations offer valuable insights for future community-academic partnerships undertaking RCTs in similar settings.