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Testing a Screening, Brief Intervention, and Referral to Treatment Intervention Approach for Addressing Unhealthy Alcohol and Other Drug Use in Humanitarian Settings: Protocol of the Ukuundapwa Chapamo Randomised Controlled Trial
Jeremy C Kane1, Muzi Kamanga2, Stephanie Skavenski3, Laura K Murray3, Mbaita Shawa2, Bertha Bwalya4, Kristina Metz3, Ravi Paul5, Namuchana Mushabati2, Peter Ventevogel6, Stephanie Haddad1, Grace Kilbane1, Megan Sienkiewicz1, Veronica Chibemba2, Princess Chiluba2, Nkumbu Mtongo2, Mildred Chibwe2, Caleb J Figge3, Michelle Alto3, David Mwanza3, Elizabeth Mupinde3, Shira Kakumbi3, Wietse A Tol7, Kelsey Vaughan8, Zaliwe Banda9, Anja Busse10, Nadine Ezard11, Allan Zulu4, Henry Loongo4, M. Claire Greene1
1 Columbia University Mailman School of Public Health, New York, USA
2 Women in Law and Development in Africa, Lusaka, Zambia
3 Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
4 CARE Zambia, Lusaka, Zambia
5 University of Zambia School of Medicine, University Teaching Hospital, Lusaka, Zambia
6 Public Health Section, United Nations High Commissioner for Refugees, Geneva, Switzerland
7 University of Copenhagen, Copenhagen; Vrije Universiteit Amsterdam, Amsterdam, The Netherlands, Denmark
8 Bang for Buck Consulting, Amsterdam, The Netherlands
9 Zambia Ministry of Health, Lusaka, Zambia
10 United Nations Office on Drug Use and Crime, Vienna, Austria
11 University of New South Wales, Sydney, Australia
Correspondence Address:
PhD, MPH Jeremy C Kane
Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th Street, Room 519, New York, NY, 10032
USA
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/intv.intv_21_22
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Refugees and other displaced persons are exposed to many risk factors for unhealthy alcohol and other drug (AOD) use and concomitant mental health problems. Evidence-based services for AOD use and mental health comorbidities are rarely available in humanitarian settings. In high income countries, screening, brief intervention and referral to treatment (SBIRT) systems can provide appropriate care for AOD use but have rarely been used in low- and middle-income countries and to our knowledge never tested in a humanitarian setting. This paper describes the protocol for a randomised controlled trial to compare the effectiveness of an SBIRT system featuring the Common Elements Treatment Approach (CETA) to treatment as usual in reducing unhealthy AOD use and mental health comorbidities among refugees from the Democratic Republic of the Congo and host community members in an integrated settlement in northern Zambia. The trial is an individually randomised, single-blind, parallel design with outcomes assessed at 6-months (primary) and 12-months post-baseline. Participants are Congolese refugees and Zambians in the host community, 15 years of age or older with unhealthy alcohol use. Outcomes are: unhealthy alcohol use (primary), other drug use, depression, anxiety and traumatic stress. The trial will explore SBIRT acceptability, appropriateness, cost-effectiveness, feasibility, and reach.
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