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To execute a hybrid effectiveness-implementation randomized control trial of Islamic Trauma Healing (ITH) versus delayed ITH to evaluate mental health effects

Research Title: To execute a hybrid effectiveness-implementation randomized control trial of Islamic Trauma Healing (ITH) versus delayed ITH to evaluate mental health effects.
Location: Burao, Hargeisa, and Borama Districts
Donor: University of Washington
Period: 2021-2024
Project Objectives: To execute a hybrid effectiveness-implementation randomized control trial of Islamic Trauma Healing (ITH) versus delayed ITH to evaluate mental health effects.

Background

Somalia has long been in a state of humanitarian crisis; trauma-related mental health needs are extremely high. Access to state-of-the-art mental health care is limited. Islamic Trauma Healing (ITH) is a manualized mosque-based, lay-led group intervention aimed at healing the individual and communal mental wounds of war and refugee trauma.

The 6-session intervention combines Islamic principles with empirically-supported exposure and cognitive restructuring principles for post-traumatic stress disorder (PTSD). ITH reduces training time, uses a train-the-trainers (TTT) model, and relies on local partnerships embedded within the strong communal mosque infrastructure.

Methods: We will conduct a hybrid effectiveness-implementation randomized control trial (RCT) in Somaliland, with implementation in the cities of Hargeisa, Borama, and Burao. In this study, a lay-led, mosque-based intervention, Islamic Trauma Healing (ITH), to promote mental health and reconciliation will be examined in 200 participants, randomizing mosques to either immediate ITH or delayed (waitlist; WL) ITH conditions.

Participants will be assessed by assessors masked to condition at pre, 3 weeks, 6 weeks, and 3-month follow-ups. The primary outcome will be assessor-rated posttraumatic stress symptoms (PTSD), with secondary outcomes of depression, somatic symptoms, and well-being.

A TTT model will be tested, examining the implementation outcomes. Additional measures include potential mechanisms of change and cost-effectiveness.

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