{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:29:35Z","timestamp":1785403775847,"version":"3.56.0"},"reference-count":69,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"unspecified","delay-in-days":204,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2045796026100742_sec1a\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Refugees bear the highest burden of mental health issues; however, they often underuse available mental health services. Interventions aimed at those with diagnosed conditions frequently do little to prevent the onset of disorders. Problem Management Plus for Immigrants (PMP-I) is a prevention intervention adapted from the World Health Organization\u2019s Problem Management Plus (PMP). PMP-I includes psychoeducation, problem-solving, behavioural activation, social support and networking, and mind-body exercises. This pilot randomized controlled trial (RCT) aimed to evaluate the impact of PMP-I on mental, social and emotional well-being outcomes among Bhutanese refugees resettled in Massachusetts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796026100742_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Bhutanese individuals aged 18 or older who had resettled in Massachusetts and scored \u226414 on the Patient Health Questionnaire-9 (PHQ-9) were randomly assigned to two groups: PMP-I (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a058 families) and a talk programme with a community support services pamphlet (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a058 families). Trained community interventionists delivered five sessions of PMP-I to intervention participants in their family settings. Primary outcomes included scores on measures of stress (Cohen Perceived Stress Scale-10), and anxiety and depression (Hopkins Symptoms Checklist-25), assessed at baseline, 6-week and 3-month post-intervention. Secondary outcomes included hair cortisol, coping, coping self-efficacy, social support, social network, family conflict resolution and family satisfaction. Linear mixed-effects models were used to analyse differences in changes in outcomes between the intervention and control groups, adjusting for baseline scores on the primary outcomes, as well as age, duration of residence, marital status and history of chronic diseases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796026100742_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All 232 participants recruited (116 families) were retained throughout the project. The intervention group evidenced a significantly greater decrease than the control group at both 6-week and 3-month post-intervention assessments on the primary outcomes of stress, anxiety, and depressive symptom scores. Similarly, the intervention group demonstrated significantly higher scores at both the 6-week and 3-month periods after the intervention compared to the control group on measures of coping, family conflict resolution, self-efficacy, family satisfaction and social networking with large effect sizes (Cohen\u2019s\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0&gt;\u00a00.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01). Hair cortisol concentrations did not differ significantly between the intervention and control groups at either baseline or 3-month post-intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796026100742_sec4d\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The PMP-I improved the mental, social and emotional well-being of Bhutanese adults (PHQ-9 score\u00a0\u2264\u00a014) resettled in Massachusetts. Peer-delivered, family-centred PMP-I offers a significant public health benefit; however, a large-scale, RCT involving diverse refugee groups is necessary to replicate its success nationwide and beyond.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s2045796026100742","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:22:33Z","timestamp":1784866953000},"source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of peer-delivered Problem Management Plus for Immigrants (PMP-I) in reducing stress, anxiety, and depressive symptoms among Bhutanese adults resettled in Massachusetts, United States: a pilot randomized controlled trial"],"prefix":"10.1017","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6322-738X","authenticated-orcid":false,"given":"Kalpana","family":"Poudel-Tandukar","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0072zz521","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Massachusetts Amherst"},{"name":"University of Massachusetts Amherst"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Laws","sequence":"additional","affiliation":[{"name":"University of Massachusetts Amherst"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher R.","family":"Martell","sequence":"additional","affiliation":[{"name":"University of Massachusetts Amherst"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Rai","sequence":"additional","affiliation":[{"name":"Bhutanese Christian Society of Western Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razu","family":"Ramdam","sequence":"additional","affiliation":[{"name":"Bhutanese Christian Society of Western Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerrold S.","family":"Meyer","sequence":"additional","affiliation":[{"name":"University of Massachusetts Amherst"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R.","family":"Bertone-Johnson","sequence":"additional","affiliation":[{"name":"University of Massachusetts Amherst"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia S.","family":"Jacelon","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0072zz521","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Massachusetts Amherst"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Hollon","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02vm5rt34","id-type":"ROR","asserted-by":"publisher"}],"name":"Vanderbilt University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"S2045796026100742_ref45","volume-title":"Family Satisfaction Scale","author":"Olson","year":"2010"},{"key":"S2045796026100742_ref25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003621"},{"key":"S2045796026100742_ref16","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796020000724"},{"key":"S2045796026100742_ref57","volume-title":"Hierarchical Linear Models: Applications and Data Analysis Methods. 2nd Ed","author":"Raudenbush","year":"2002"},{"key":"S2045796026100742_ref20","doi-asserted-by":"publisher","DOI":"10.1177\/1078390316663307"},{"key":"S2045796026100742_ref34","doi-asserted-by":"publisher","DOI":"10.1037\/ort0000240"},{"key":"S2045796026100742_ref1","unstructured":"APA (1994) Diagnostic and statistical manual of mental disorder, fourth ed, DSM-IV: APA . 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