A Self-Help App for Syrian Refugees With Posttraumatic Stress (Sanadak): Randomized Controlled Trial

Simple item page
dc.citation.issue1
dc.citation.volume9
dc.contributor.authorRöhr S
dc.contributor.authorJung FU
dc.contributor.authorPabst A
dc.contributor.authorGrochtdreis T
dc.contributor.authorDams J
dc.contributor.authorNagl M
dc.contributor.authorRenner A
dc.contributor.authorHoffmann R
dc.contributor.authorKönig H-H
dc.contributor.authorKersting A
dc.contributor.authorRiedel-Heller SG
dc.coverage.spatialCanada
dc.date.accessioned2023-11-22T01:51:59Z
dc.date.accessioned2024-07-25T06:44:02Z
dc.date.available2021-01-13
dc.date.available2023-11-22T01:51:59Z
dc.date.available2024-07-25T06:44:02Z
dc.date.issued2021-01
dc.description.abstractBackground: Syrian refugees residing in Germany often develop posttraumatic stress as a result of the Syrian civil war, their escape, and postmigration stressors. At the same time, there is a lack of adequate treatment options. The smartphone-based app Sanadak was developed to provide cognitive behavioral therapy–based self-help in the Arabic language for Syrian refugees with posttraumatic stress. Objective: The aim of this study was to evaluate the effectiveness and cost-effectiveness of the app. Methods: In a randomized controlled trial, eligible individuals were randomly allocated to the intervention group (IG; app use) or control group (CG; psychoeducational reading material). Data were collected during structured face-to-face interviews at 3 assessments (preintervention/baseline, postintervention/after 4 weeks, follow-up/after 4 months). Using adjusted mixed-effects linear regression models, changes in posttraumatic stress and secondary outcomes were investigated as intention-to-treat (ITT) and per-protocol (PP) analysis. Cost-effectiveness was evaluated based on adjusted mean total costs, quality-adjusted life years (QALYs), and cost-effectiveness acceptability curves using the net benefit approach. Results: Of 170 screened individuals (aged 18 to 65 years), 133 were eligible and randomized to the IG (n=65) and CG (n=68). Although there was a pre-post reduction in posttraumatic stress, ITT showed no significant differences between the IG and CG after 4 weeks (Posttraumatic Diagnostic Scale for DSM-5, Diff –0.90, 95% CI –0.24 to 0.47; P=.52) and after 4 months (Diff –0.39, 95% CI –3.24 to 2.46; P=.79). The same was true for PP. Regarding secondary outcomes, ITT indicated a treatment effect for self-stigma: after 4 weeks (Self-Stigma of Mental Illness Scale/SSMIS–stereotype agreement: d=0.86, 95% CI 0.46 to 1.25; stereotype application: d=0.60, 95% CI 0.22 to 0.99) and after 4 months (d=0.52, 95% CI 0.12 to 0.92; d=0.50, 95% CI 0.10 to 0.90), the IG showed significantly lower values in self-stigma than the CG. ITT showed no significant group differences in total costs and QALYs. The probability of cost-effectiveness was 81% for a willingness-to-pay of €0 per additional QALY but decreased with increasing willingness-to-pay. Conclusions: Sanadak was not more effective in reducing mild to moderate posttraumatic stress in Syrian refugees than the control condition nor was it likely to be cost-effective. Therefore, Sanadak is not suitable as a standalone treatment. However, as the app usability was very good, no harms detected, and stigma significantly reduced, Sanadak has potential as a bridging aid within a stepped and collaborative care approach. Trial Registration: German Clinical Trials Register DRKS00013782; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00013782 International Registered Report Identifier (IRRID): RR2-10.1186/s12888-019-2110-y
dc.format.paginatione24807-
dc.identifier.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/33439140
dc.identifier.citationRöhr S, Jung FU, Pabst A, Grochtdreis T, Dams J, Nagl M, Renner A, Hoffmann R, König H-H, Kersting A, Riedel-Heller SG. (2021). A Self-Help App for Syrian Refugees With Posttraumatic Stress (Sanadak): Randomized Controlled Trial.. JMIR Mhealth Uhealth. 9. 1. (pp. e24807-).
dc.identifier.doi10.2196/24807
dc.identifier.eissn2291-5222
dc.identifier.elements-typejournal-article
dc.identifier.issn2291-5222
dc.identifier.piiv9i1e24807
dc.identifier.urihttps://mro.massey.ac.nz/handle/10179/70769
dc.languageeng
dc.publisherJMIR Publications
dc.relation.isPartOfJMIR Mhealth Uhealth
dc.rights(c) 2021 The Author/s
dc.rightsCC BY 4.0
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectPTSD
dc.subjectSyrian refugees
dc.subjectapp
dc.subjectcost-utility analysis
dc.subjectmHealth
dc.subjectposttraumatic stress
dc.subjectquality-adjusted life years
dc.subjectrandomized controlled trial
dc.subjectrefugees
dc.subjectstimga
dc.subjectusability
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectGermany
dc.subjectHumans
dc.subjectMiddle Aged
dc.subjectMobile Applications
dc.subjectRefugees
dc.subjectStress Disorders, Post-Traumatic
dc.subjectSyria
dc.subjectYoung Adult
dc.titleA Self-Help App for Syrian Refugees With Posttraumatic Stress (Sanadak): Randomized Controlled Trial
dc.typeJournal article
pubs.elements-id455102
pubs.organisational-groupOther
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
455102.pdf
Size:
831.89 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Journal Articles