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Posttraumatic stress moderates return intentions: a factorial survey experiment with internally displaced persons in Nigeria.

ABSTRACT: Background: Persons displaced by conflict often consider returning to their area of origin. Lack of reliable information about conditions in the area of origin makes this decision more difficult. Displaced persons address this by seeking information from other sources, but must then assess the credibility of these sources.Objective: This study examines the role of symptoms of posttraumatic stress as a moderator of how information from a trustworthy source influences return intentions among displaced persons.Method: We test our hypotheses with a factorial survey experiment, drawing participants (N = 822) from residents of internally displaced person (IDP) camps in northeastern Nigeria.Results: Information from a more trustworthy source led to increased return intentions. However, the more participants reported symptoms of posttraumatic stress, the smaller the effect source trustworthiness had on their return intentions.Conclusions: Findings highlight how traumatic experiences during wartime can undermine the effectiveness of the provision of information from a trustworthy source about good conditions in displaced persons' areas of origin, and suggest that interventions addressing posttraumatic stress could have downstream effects on safe, durable, and dignified return.

SUBMITTER: Thompson PO

PROVIDER: S-EPMC10990440 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Posttraumatic stress moderates return intentions: a factorial survey experiment with internally displaced persons in Nigeria.

Thompson Peter Onah PO Hall Jonathan J Hecker Tobias T Walsh James Igoe JI

European journal of psychotraumatology 20231127 2

<b>Background:</b> Persons displaced by conflict often consider returning to their area of origin. Lack of reliable information about conditions in the area of origin makes this decision more difficult. Displaced persons address this by seeking information from other sources, but must then assess the credibility of these sources.<b>Objective:</b> This study examines the role of symptoms of posttraumatic stress as a moderator of how information from a trustworthy source influences return intentio ...[more]

PMID: 38010165

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Project description:Internally displaced persons (IDPs) are at high risk for COVID-19 transmission because of congested and unsanitary living conditions. COVID-19 vaccination is essential to build population immunity and prevent severe disease among this population. We determined the prevalence and factors associated with intention to accept COVID-19 vaccine among IDPs in Northeast Nigeria. This cross-sectional study, conducted during July-December 2022, included 1,537 unvaccinated IDPs from 18 IDPs camps. We performed a complex sample survey analysis and described participants' characteristics and vaccination intention with weighted descriptive statistics. We fitted weighted logistic regression models and computed adjusted odds ratios with 95% confidence intervals to identify factors associated with intention to accept COVID-19 vaccine. Of 1,537 IDPs, 55.4% were 18-39 years old, 82.6% were females, and 88.6% had no formal education. Among them, 63.5% (95% CI: 59.0-68.1) expressed intention to accept COVID-19 vaccine. Among the IDPs who intended to reject vaccine, 42.8% provided no reason, 35.3% had COVID-19 misconceptions, 9.5% reported vaccine safety concerns, and 7.4% felt no need. IDPs who perceived COVID-19 as severe (Adjusted Odds Ratio (AOR) = 2.31, [95% CI: 1.35-3.96]), perceived COVID-19 vaccine as effective (AOR = 4.28, [95% CI: 2.46-7.44]) and resided in official camps (AOR = 3.29, [95% CI: 1.94-5.56]) were more likely to accept COVID-19 vaccine. However, IDPs who resided 2 kilometers or farther from the nearest health facility (AOR = 0.34, [95% CI: 0.20-0.58]) were less likely to accept vaccine. Intention to accept COVID-19 vaccine among the IDPs was suboptimal. To improve vaccination acceptance among this population, health education and risk communication should be intensified to counter misinformation, strengthen vaccine confidence, and shape perception of COVID-19 severity, focusing on IDPs in unofficial camps. Appropriate interventions to deliver vaccines to remote households should be ramped up.

Project description:BackgroundOwing to crowded and unsanitary conditions, internally displaced persons (IDPs) have an increased risk of COVID-19 infection. Adoption of COVID-19 preventive measures among this population is premised on accurate information, adequate knowledge, and risk perception. We assessed COVID-19 knowledge and risk perception and investigated the association between risk perception and COVID-19 preventive measures, including vaccination among IDPs in Northeast Nigeria.MethodsWe conducted a cross-sectional study during July-December 2022 and sampled 2,175 IDPs using stratified sampling. We utilized a 12-point assessment tool to evaluate COVID-19 knowledge. Participants who scored ≥ 6 points were considered to have adequate knowledge. We used a 30-item Risk Behavior Diagnosis Scale to assess COVID-19 risk perception and evaluated each item on a 5-point Likert scale. Participants were divided into risk perception categories by the median of Likert scale scores. We performed weighted logistic regression analysis to identify factors associated with risk perception. Pearson's chi-squared with Rao-Scott adjustment was used to determine the relationship between risk perception and COVID-19 preventive measures.ResultsOf 2,175 participants, 55.7% were 18-39 years old, 70.9% were females, and 81.7% had no formal education. Among the IDPs, 32.0% (95% CI: 28.8 - 35.0) were considered to have adequate COVID-19 knowledge, and 51.3% (95% CI: 47.8 - 54.8) perceived COVID-19 risk as high. Moreover, 46.3% (95% CI: 42.8 - 50.0) had received one dose of COVID-19 vaccine, and 33.1% (95% CI: 29.8 - 36.0) received two doses. Adequate knowledge (Adjusted Odds Ratio (AOR) = 2.10, [95% CI: 1.46 - 3.03]) and post-primary education (AOR = 3.20, [95% CI: 1.59 - 6.46]) were associated with risk perception. Furthermore, high risk perception was significantly associated with wearing face masks (χ2 = 106.32, p-value < .001), practicing hand hygiene (χ2 = 162.24, p-value < .001), physical distancing (χ2 = 60.84, p-value < .001) and vaccination uptake (χ2 = 46.85, p-value < .001).ConclusionsThis study revealed gaps in COVID-19 knowledge, risk perception, and vaccination uptake but demonstrated a significant relationship between risk perception and COVID-19 preventive practices. Health education and risk communication should be intensified to improve knowledge, elicit stronger risk perception, and enhance COVID-19 preventive practices.

Project description:BackgroundCurrently, over two million persons are internally displaced because of the complex humanitarian emergency in Nigeria's northeast region. Due to crowded and unsanitary living conditions, the risk of communicable disease transmission, morbidity, and mortality among this population is high. This study explored patterns and factors associated with health-seeking among internally displaced persons (IDPs) in northeast Nigeria to inform and strengthen disease surveillance and response activities.MethodsIn a cross-sectional study conducted during June-October 2022, we employed stratified sampling technique to select 2,373 IDPs from 12 IDPs camps. A semi-structured tool was used to collect data on health-seeking patterns, socio-demographics, households, and IDPs camps characteristics. We classified health-seeking patterns into three outcome categories: 'facility care' (reference category), 'non-facility care' (patent medicine vendors, chemists, traditional healers, religious centers), and 'home care/no care'. We performed complex survey data analysis and obtained weighted statistical estimates. Univariate analysis was conducted to describe respondents' characteristics and health-seeking patterns. We fitted weighted multivariable multinomial logistic regression models to identify factors associated with health-seeking patterns.ResultsOf 2,373 respondents, 71.8% were 18 to 39 years old, 78.1% were females, and 81.0% had no formal education. Among the respondents, 75.7% (95% CI: 72.9-78.6) sought 'facility care', 11.1% (95% CI: 9.1-13.1) sought 'non-facility care', while 13.2% (95% CI: 10.9-15.4) practiced 'home care/no care'. Respondents who perceived illness was severe (Adjusted Odds Ratio (AOR) = 0.15, [95% CI: 0.08-0.30]) and resided in officially-recognized camps (AOR = 0.26, [95% CI: 0.17-0.39]) were less likely to seek 'non-facility care' compared to 'facility care'. Similarly, respondents who resided in officially-recognized camps (AOR = 0.58, [95% CI: 0.36-0.92]), and received disease surveillance information (AOR = 0.42, [95% CI: 0.26-0.67) were less likely to practice 'home care/no care' rather than seek 'facility care'.ConclusionsThis population exhibited heterogeneous patterns of health-seeking at facility and non-facility centers. Perception of illness severity and camps' status were major factors associated with health-seeking. To enhance surveillance, non-facility care providers should be systematically integrated into the surveillance network while ramping up risk communication to shape perception of illness severity, prioritizing unofficial camps.

Project description:BackgroundGeorgia is leading one of the world's first hepatitis C (HCV) elimination programs alongside interventions to combat a HIV epidemic concentrated among high-risk groups. Although progress has been substantial, neither strategy accounts for the nearly 150,000 internally displaced persons residing in collective centers (CC-IDPs) who are susceptible to deeply integrated risk environments that could promote infection. Achieving dedicated goals for HCV elimination and HIV suppression requires a clear understanding of the risks facing CC-IDPs.ObjectivesThis literature review aims to consolidate what is known about the socio-economic and physical/mental health status of IDPs living in collective centers in Georgia, and to assess their vulnerability to HIV and HCV in light of local and global epidemiological trends.MethodsSources were compiled from journal publications, reports by government ministries and transnational organizations, and the Integrated Household Survey database (2009-2018; updated annually by the National Statistics Office of Georgia) through manual searches in PUBMED, Google Scholar and Search, ProQuest, and digital repositories of government offices.FindingsReports indicate that CC-IDPs are more susceptible to poverty, poor living conditions, mental illness, disability, substance use, and in some cases infectious disease; although, the correlation is not always present and subject to variability. These factors were linked to increased transmission and acquisition of HIV/HCV in both displacement and non-displacement contexts abroad. The geographic concentration of HIV/HCV in areas with greater clusters of CC-IDPs, and shared characteristics with local high-risk groups, indicate the possibility of inordinate transmission among CC-IDPs in Georgia.ConclusionsThe disproportionate prevalence of psychosocial and clinical harms among CC-IDPs testifies to the serious potential of a greater burden of HIV and hepatitis C. Going forward, targeted research is needed to inform interventions and clarify the health status of CC-IDPs in Georgia.

Project description:AimsThere are an estimated 1.5 million internally displaced persons (IDPs) in Ukraine because of the armed conflict in the east of the country. The aim of this paper is to examine utilisation patterns of mental health and psychosocial support (MHPSS) care among IDPs in Ukraine.MethodsA cross-sectional survey design was used. Data were collected from 2203 adult IDPs throughout Ukraine between March and May 2016. Data on mental health care utilisation were collected, along with outcomes including post-traumatic stress disorder (PTSD), depression and anxiety. Descriptive and multivariate regression analyses were used.ResultsPTSD prevalence was 32%, depression prevalence was 22%, and anxiety prevalence was 17%. Among those that likely required care (screened positive with one of the three disorders, and also self-reporting a problem) there was a large treatment gap, with 74% of respondents who likely required MHPSS care over the past 12 months not receiving it. For the 26% (N = 180) that had sought care, the most common sources of services/support were pharmacies, family or district doctor/paramedic (feldsher), neurologist at a polyclinic, internist/neurologist at a general hospital, psychologists visiting communities, and non-governmental organisations/volunteer mental health/psychosocial centres. Of the 180 respondents who did seek care, 163 could recall whether they had to pay for their care. Of these 163 respondents, 72 (44%) recalled paying for the care they received despite government care officially being free in Ukraine. The average costs they paid for care was US$107 over the previous 12 months. All 180 respondents reported having to pay for medicines and the average costs for medicines was US$109 over the previous 12 months. Among the 74% had not sought care despite likely needing it; the principal reasons for not seeking care were: thought that they would get better by using their own medications, could not afford to pay for health services or medications, no awareness of where to receive help, poor understanding by health care providers, poor quality of services, and stigma/embarrassment. The findings from multivariate regression analysis show the significant influence of a poor household economic situation on not accessing care.ConclusionsThe study highlights a high burden of mental disorders and large MHPSS treatment gap among IDPs in Ukraine. The findings support the need for a scaled-up, comprehensive and trauma-informed response to provision of MHPSS care of IDPs in Ukraine alongside broader health system strengthening.

Dataset Information

Posttraumatic stress moderates return intentions: a factorial survey experiment with internally displaced persons in Nigeria.

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Posttraumatic stress moderates return intentions: a factorial survey experiment with internally displaced persons in Nigeria.

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