Applying the intervention mapping protocol to a multimodal physical activity intervention for trauma-afflicted refugees

Abstract

Background: Refugees with prolonged and repeated experiences of trauma, often in combination with post-migration living difficulties, are subjected to very high levels of perceived stress and stress-related ill health. Posttraumatic stress disorder (PTSD) constitutes a frequently diagnosed disorder in this context. Inactivity/avoidance has been examined as reciprocal maintenance factors of PTSD and associated mental and physical distress, suggesting that Physical Activity (PA) interventions may alleviate symptoms of PTSD and improve general health and well-being. The objective of the current study is to apply Intervention Mapping (IM) to a multimodal PA intervention, and to examine the efficacy of the intervention among trauma-afflicted refugees. Methods: Step 1, needs assessment, is conducted on basis of a structured literature review and clinical observations. Methods for application of steps 2-4 are currently being examined based on clinical experience, literature review, and planned focus group discussions (n=24). Steps 5-6 are preliminary designed to be carried on on basis of a single subject design (AB) with repeated measures (n=38). Preliminary results: Progress of step 1-4 has resulted in a preliminary intervention program, comprising practical strategies based on multiple theory-based treatment modalities and intervention methods, e.g. psychoeducation, semi-structured program of exercises and physical activity, guided by experienced physiotherapists. Currents stage of work: Step 5-6, implementation and evaluation plans, are currently in progress. Continuous elaboration of program materials and protocols, reviewing determinants and change objectives. Discussion: Increasing need of theory and evidence-based interventions in the study population. Possible further reaching implications beyond clinical settings, e.g. psycho-social adjustment and integration.