{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T18:26:31Z","timestamp":1786991191356,"version":"build-2736575974"},"reference-count":60,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010676","name":"H2020 Societal Challenges","doi-asserted-by":"publisher","award":["101016127"],"award-info":[{"award-number":["101016127"]}],"id":[{"id":"10.13039\/100010676","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosmedicine.org"],"crossmark-restriction":false},"short-container-title":["PLoS Med"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Many international migrant workers (IMWs) in the Netherlands experience symptoms of anxiety and depression, often linked to adverse work and living conditions, yet underutilise mental healthcare. Stepped-care approaches may improve access by offering low-intensity support, followed by more intensive treatment if needed. We evaluated the effectiveness of a culturally adapted, remotely delivered, scalable stepped-care intervention combining guided online self-help (Doing What Matters in Times of Stress; DWM; step 1) and individual psychological support via videoconferencing (Problem Management Plus; PM+; step 2) both delivered by non-professional helpers, among Polish migrant workers living in the Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and findings<\/jats:title>\n                    <jats:p>\n                      In this parallel-group, two-arm, superiority randomised controlled trial, conducted in the Netherlands, Polish-speaking migrant workers aged 18 years or older with elevated psychological distress (Kessler Psychological Distress Scale; K10\u2009\u2265\u200916) were recruited between May 2022 and January 2024 via social media and Polish community spaces. All participants received Psychological First Aid (PFA) before being informed about their allocation. Participants were randomly assigned 1:1 to care-as-usual or stepped-care (DWM, followed by PM+ if distress persisted; K10\u2009\u2265\u200916) using computer-generated randomisation with permuted blocks in Castor Electronic Data Capture (Castor EDC). Participants and the main researcher were not blinded after allocation; outcomes were self-reported, and research assistants handling later incidental follow-up contact remained blinded. Assessments occurred at four timepoints: baseline (week 1), post-DWM (week 7), post-PM+ (week 13), and 2-month follow-up (week 21). The primary outcome was a composite measure of anxiety and depression (Patient Health Questionnaire-Anxiety and Depression Scale; PHQ-ADS), measured at all timepoints, with the primary endpoint at follow-up. Primary analyses followed the intention-to-treat (ITT) principle using linear mixed models adjusted for baseline PHQ-ADS values. In total, 218 participants were randomised and included in the ITT analysis (109 in each group); PHQ-ADS data at the primary endpoint were available for 94 participants in the intervention group and 101 in the control group. At follow-up, adjusted mean PHQ-ADS scores were lower in the intervention group than in the control group (14.8 versus 21.3), with a between-group mean difference adjusted for baseline PHQ-ADS score of \u22126.52 (95% confidence interval [CI] [\u22128.73, \u22124.31];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; Cohen\u2019s\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.57), reflecting a moderate effect. Significant between-group differences adjusted for baseline PHQ-ADS were also observed post-DWM (\u22125.90; 95% CI [\u22128.12, \u22123.69];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001;\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.56) and post-PM+ (\u22124.87; 95% CI [\u22127.18, \u22122.56];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001;\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.44). Most participants in the intervention group who completed the post-DWM assessment still met criteria for PM+ (85\/95, 89.5%). Eight serious adverse events occurred (intervention:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092; control:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), and none were considered related to the intervention. The main limitations were limited generalisability, as most participants were women and had lived in the Netherlands for several years, and limited conclusions about longer-term effects due to the short follow-up period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The DWM\/PM+ stepped-care intervention significantly reduced symptoms of anxiety and depression among Polish migrant workers in the Netherlands. These findings support the use of a remotely delivered stepped-care model combining scalable psychological interventions for migrant workers with elevated psychological distress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pmed.1005197","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:28:51Z","timestamp":1786987731000},"page":"e1005197","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmed.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of a scalable, remotely delivered stepped-care intervention for psychological distress among Polish migrant workers in the Netherlands: The RESPOND randomised controlled trial"],"prefix":"10.1371","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2245-1169","authenticated-orcid":true,"given":"Rinske","family":"Roos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9636-7522","authenticated-orcid":true,"given":"Anke B.","family":"Witteveen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Ayuso-Mateos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1073-9282","authenticated-orcid":true,"given":"Corrado","family":"Barbui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9607-819X","authenticated-orcid":true,"given":"Richard A.","family":"Bryant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zlata","family":"Dontsova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireia","family":"Felez-Nobrega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6863-5859","authenticated-orcid":true,"given":"Zofia","family":"G\u0142owacka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3984-277X","authenticated-orcid":true,"given":"Josep Maria","family":"Haro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffael","family":"Kalisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2663-332X","authenticated-orcid":true,"given":"Vincent","family":"Lorant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0744-2664","authenticated-orcid":true,"given":"David","family":"McDaid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6411-9439","authenticated-orcid":true,"given":"Roberto","family":"Mediavilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2377-619X","authenticated-orcid":true,"given":"Maria","family":"Melchior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5637-5766","authenticated-orcid":true,"given":"Pablo","family":"Nicaise","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8271-6343","authenticated-orcid":true,"given":"Emilia","family":"Olechno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4704-4874","authenticated-orcid":true,"given":"A-La","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4675-170X","authenticated-orcid":true,"given":"Papoula","family":"Petri-Rom\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3783-8195","authenticated-orcid":true,"given":"Marianna","family":"Purgato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3542-6698","authenticated-orcid":true,"given":"Aleksandra M.","family":"Sobolewska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6875-2215","authenticated-orcid":true,"given":"Annemieke","family":"van Straten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0437-3018","authenticated-orcid":true,"given":"Andrea","family":"Tortelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6254-8868","authenticated-orcid":true,"given":"James","family":"Underhill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5430-9810","authenticated-orcid":true,"given":"Marit","family":"Sijbrandij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the RESPOND Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"pmed.1005197.ref001","doi-asserted-by":"crossref","DOI":"10.54394\/ESKI5420","volume-title":"ILO global estimates on international migrant workers: international migrants in the labour force","author":"International Labour Organization","year":"2024"},{"key":"pmed.1005197.ref002","volume-title":"ILO global estimates on international migrant workers: results and methodology","author":"International Labour Organization","year":"2021","edition":"3"},{"key":"pmed.1005197.ref003","author":"CBS","year":"2022"},{"key":"pmed.1005197.ref004","author":"CBS","year":"2022"},{"key":"pmed.1005197.ref005","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1146\/annurev-publhealth-040617-013714","article-title":"Migrant Workers and Their Occupational Health and Safety","volume":"39","author":"SC Moyce","year":"2018","journal-title":"Annu Rev Public Health"},{"key":"pmed.1005197.ref006","article-title":"Psychosocial problems, daily functioning and help-seeking behaviour of international migrant workers in the Netherlands: a qualitative study to inform the adaptation of a scalable stepped-care intervention","volume":"13","author":"R Roos","year":"2025","journal-title":"Glob Ment Health (Camb)"},{"issue":"2","key":"pmed.1005197.ref007","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2023-013521","article-title":"\u201cThey treat us like machines\u201d: migrant workers\u2019 conceptual framework of labour exploitation for health research and policy","volume":"9","author":"S Boufkhed","year":"2024","journal-title":"BMJ Glob Health"},{"issue":"6","key":"pmed.1005197.ref008","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1007\/s10903-022-01330-y","article-title":"The health of migrant agricultural workers in Europe: a scoping review","volume":"24","author":"HN Urrego-Parra","year":"2022","journal-title":"J Immigr Minor Health"},{"issue":"1","key":"pmed.1005197.ref009","doi-asserted-by":"crossref","first-page":"120","DOI":"10.3390\/su12010120","article-title":"Migrant workers and psychological health: a systematic review","volume":"12","author":"N Mucci","year":"2019","journal-title":"Sustainability"},{"issue":"12","key":"pmed.1005197.ref010","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0260221","article-title":"Prevalence of common mental health issues among migrant workers: a systematic review and meta-analysis","volume":"16","author":"SI Hasan","year":"2021","journal-title":"PLoS One"},{"issue":"6","key":"pmed.1005197.ref011","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0252651","article-title":"Health service use and health outcomes among international migrant workers compared with non-migrant workers: a systematic review and meta-analysis","volume":"16","author":"F Pega","year":"2021","journal-title":"PLoS One"},{"key":"pmed.1005197.ref012","volume-title":"A vulnerable workforce: migrant workers in the COVID-19 pandemic","author":"F Fasani","year":"2020"},{"key":"pmed.1005197.ref013","author":"LE Berntsen","year":"2021"},{"key":"pmed.1005197.ref014","author":"World Health Organization","year":"2020"},{"issue":"3","key":"pmed.1005197.ref015","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1002\/wps.20255","article-title":"Problem Management Plus (PM+): a WHO transdiagnostic psychological intervention for common mental health problems","volume":"14","author":"KS Dawson","year":"2015","journal-title":"World Psychiatry"},{"issue":"3","key":"pmed.1005197.ref016","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1002\/wps.20355","article-title":"Self-Help Plus (SH+): a new WHO stress management package","volume":"15","author":"JE Epping-Jordan","year":"2016","journal-title":"World Psychiatry"},{"key":"pmed.1005197.ref017","doi-asserted-by":"crossref","DOI":"10.2139\/ssrn.5191106","article-title":"World Health Organization\u2019s Scalable Psychological Interventions for Syrian Refugees: an individual participant data meta-analysis of problem management plus and step-by-step","author":"M Sijbrandij","year":"2025"},{"issue":"1","key":"pmed.1005197.ref018","doi-asserted-by":"crossref","DOI":"10.1136\/bmjment-2023-300672","article-title":"Self-Help Plus for refugees and asylum seekers: an individual participant data meta-analysis","volume":"26","author":"E Karyotaki","year":"2023","journal-title":"BMJ Ment Health"},{"issue":"2","key":"pmed.1005197.ref019","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1017\/S0033291714000701","article-title":"Stepped care treatment delivery for depression: a systematic review and meta-analysis","volume":"45","author":"A van Straten","year":"2015","journal-title":"Psychol Med"},{"issue":"12","key":"pmed.1005197.ref020","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.1017\/S0033291710000772","article-title":"Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies","volume":"40","author":"P Cuijpers","year":"2010","journal-title":"Psychol Med"},{"issue":"1","key":"pmed.1005197.ref021","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1002\/wps.21281","article-title":"Effectiveness of a stepped-care programme of WHO psychological interventions in a population of migrants: results from the RESPOND randomized controlled trial","volume":"24","author":"M Purgato","year":"2025","journal-title":"World Psychiatry"},{"issue":"1","key":"pmed.1005197.ref022","doi-asserted-by":"crossref","DOI":"10.1136\/bmjment-2023-300697","article-title":"Effectiveness of a mental health stepped-care programme for healthcare workers with psychological distress in crisis settings: a multicentre randomised controlled trial","volume":"26","author":"R Mediavilla","year":"2023","journal-title":"BMJ Ment Health"},{"issue":"1","key":"pmed.1005197.ref023","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1186\/s12888-023-05288-5","article-title":"Effectiveness of a scalable, remotely delivered stepped-care intervention to reduce symptoms of psychological distress among Polish migrant workers in the Netherlands: study protocol for the RESPOND randomised controlled trial","volume":"23","author":"R Roos","year":"2023","journal-title":"BMC Psychiatry"},{"issue":"4","key":"pmed.1005197.ref024","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004587","article-title":"CONSORT 2025 statement: updated guideline for reporting randomised trials","volume":"22","author":"S Hopewell","year":"2025","journal-title":"PLoS Med"},{"issue":"6","key":"pmed.1005197.ref025","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1017\/S0033291702006074","article-title":"Short screening scales to monitor population prevalences and trends in non-specific psychological distress","volume":"32","author":"RC Kessler","year":"2002","journal-title":"Psychol Med"},{"key":"pmed.1005197.ref026","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1186\/1756-0500-3-237","article-title":"Selecting instruments for assessing psychological wellbeing in Afghan and Kurdish refugee groups","volume":"3","author":"CM Sulaiman-Hill","year":"2010","journal-title":"BMC Res Notes"},{"key":"pmed.1005197.ref027","author":"Castor Electronic Data Capture"},{"key":"pmed.1005197.ref028","author":"World Health Organization, War Trauma Foundation, World Vision International","year":"2011"},{"key":"pmed.1005197.ref029","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1037\/a0016401","article-title":"Cultural adaptation of treatments: a resource for considering culture in evidence-based practice","volume":"40","author":"G Bernal","year":"2009","journal-title":"Prof Psychol Res Pract"},{"key":"pmed.1005197.ref030","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9","volume":"16","author":"K Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"issue":"10","key":"pmed.1005197.ref031","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"RL Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"issue":"3","key":"pmed.1005197.ref032","doi-asserted-by":"crossref","first-page":"420","DOI":"10.26444\/aaem\/99246","article-title":"Validation of the Polish language version of the Patient Health Questionnaire-9 in a population of adults aged 35-64","volume":"26","author":"BJ \u015alusarska","year":"2019","journal-title":"Ann Agric Environ Med"},{"key":"pmed.1005197.ref033","doi-asserted-by":"crossref","DOI":"10.31234\/osf.io\/9njps","article-title":"Safe but lonely? Loneliness, mental health symptoms and COVID-19","author":"\u0141 Okruszek","year":"2020"},{"issue":"1","key":"pmed.1005197.ref034","doi-asserted-by":"crossref","first-page":"1860356","DOI":"10.1080\/20008198.2020.1860356","article-title":"Adjustment disorder, traumatic stress, depression and anxiety in Poland during an early phase of the COVID-19 pandemic","volume":"12","author":"M Dragan","year":"2021","journal-title":"Eur J Psychotraumatol"},{"key":"pmed.1005197.ref035","doi-asserted-by":"crossref","first-page":"152222","DOI":"10.1016\/j.comppsych.2020.152222","article-title":"Generalized anxiety and depressive symptoms in various age groups during the COVID-19 lockdown in Poland. Specific predictors and differences in symptoms severity","volume":"105","author":"M Gambin","year":"2021","journal-title":"Compr Psychiatry"},{"key":"pmed.1005197.ref036","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.psychres.2016.03.014","article-title":"Investigation of abbreviated 4 and 8 item versions of the PTSD Checklist 5","volume":"239","author":"M Price","year":"2016","journal-title":"Psychiatry Res"},{"issue":"3","key":"pmed.1005197.ref037","doi-asserted-by":"crossref","DOI":"10.1503\/cmaj.110829","article-title":"Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): a meta-analysis","volume":"184","author":"L Manea","year":"2012","journal-title":"CMAJ"},{"key":"pmed.1005197.ref038","first-page":"287","article-title":"Polish adaptation of the PTSD checklist for DSM-5 - PCL-5. A preliminary communication","volume":"61","author":"N Ogi\u0144ska-Bulik","year":"2018","journal-title":"Przegl Psychol"},{"key":"pmed.1005197.ref039","author":"P Schnurr","year":"1999"},{"key":"pmed.1005197.ref040","author":"World Health Organization","year":"2018"},{"issue":"2","key":"pmed.1005197.ref041","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0295562","article-title":"Self-report assessment of Positive Appraisal Style (PAS): development of a process-focused and a content-focused questionnaire for use in mental health and resilience research","volume":"19","author":"P Petri-Rom\u00e3o","year":"2024","journal-title":"PLoS One"},{"issue":"2","key":"pmed.1005197.ref042","doi-asserted-by":"crossref","DOI":"10.2196\/14566","article-title":"Assessment of microstressors in adults: questionnaire development and ecological validation of the mainz inventory of microstressors","volume":"7","author":"A Chmitorz","year":"2020","journal-title":"JMIR Ment Health"},{"issue":"1","key":"pmed.1005197.ref043","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1038\/s41398-020-01150-4","article-title":"Psycho-social factors associated with mental resilience in the Corona lockdown","volume":"11","author":"IM Veer","year":"2021","journal-title":"Transl Psychiatry"},{"issue":"10","key":"pmed.1005197.ref044","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"M Herdman","year":"2011","journal-title":"Qual Life Res"},{"key":"pmed.1005197.ref045","first-page":"163","article-title":"Costing psychiatric interventions","volume-title":"Measuring mental health needs","author":"J Beecham","year":"1992"},{"key":"pmed.1005197.ref046","first-page":"22","article-title":"The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10","volume":"59","author":"DV Sheehan","year":"1998","journal-title":"J Clin Psychiatry"},{"issue":"8","key":"pmed.1005197.ref047","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002371","article-title":"Effectiveness of a brief behavioural intervention on psychological distress among women with a history of gender-based violence in urban Kenya: a randomised clinical trial","volume":"14","author":"RA Bryant","year":"2017","journal-title":"PLoS Med"},{"issue":"24","key":"pmed.1005197.ref048","doi-asserted-by":"crossref","first-page":"2609","DOI":"10.1001\/jama.2016.17165","article-title":"Effect of a multicomponent behavioral intervention in adults impaired by psychological distress in a conflict-affected area of Pakistan: a randomized clinical trial","volume":"316","author":"A Rahman","year":"2016","journal-title":"JAMA"},{"issue":"4","key":"pmed.1005197.ref049","first-page":"682","article-title":"Assessing alternative imputation strategies for infrequently missing items on multi-item scales","volume":"8","author":"PH Rezvan","year":"2022","journal-title":"Commun Stat Case Stud Data Anal Appl"},{"key":"pmed.1005197.ref050","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v045.i03","article-title":"mice: multivariate imputation by chained equations in R","volume":"45","author":"Sv Buuren","year":"2011","journal-title":"J Stat Softw"},{"key":"pmed.1005197.ref051","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s12966-015-0162-z","article-title":"Testing for baseline differences in randomized controlled trials: an unhealthy research behavior that is hard to eradicate","volume":"12","author":"MR de Boer","year":"2015","journal-title":"Int J Behav Nutr Phys Act"},{"key":"pmed.1005197.ref052","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1037\/10109-042","article-title":"Clinical significance: a statistical approach to defining meaningful change in psychotherapy research","volume-title":"Methodological issues & strategies in clinical research","author":"NS Jacobson","year":"1992"},{"key":"pmed.1005197.ref053","volume-title":"The Kessler Psychological Distress Scale (K10)","author":"R Kessler","year":"1996"},{"issue":"3","key":"pmed.1005197.ref054","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1002\/wps.21129","article-title":"World Health Organization\u2019s low-intensity psychosocial interventions: a systematic review and meta-analysis of the effects of Problem Management Plus and Step-by-Step","volume":"22","author":"SK Sch\u00e4fer","year":"2023","journal-title":"World Psychiatry"},{"issue":"1","key":"pmed.1005197.ref055","doi-asserted-by":"crossref","DOI":"10.1136\/bmjment-2022-300637","article-title":"Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management Plus","volume":"26","author":"AM de Graaff","year":"2023","journal-title":"BMJ Ment Health"},{"key":"pmed.1005197.ref056","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.cpr.2018.08.004","article-title":"A systematic review of therapist effects: a critical narrative update and refinement to review","volume":"67","author":"RG Johns","year":"2019","journal-title":"Clin Psychol Rev"},{"issue":"4","key":"pmed.1005197.ref057","doi-asserted-by":"crossref","DOI":"10.1136\/gpsych-2023-101355","article-title":"Assessing the effectiveness of internet-based interventions for mental health outcomes: an umbrella review","volume":"37","author":"M Zhang","year":"2024","journal-title":"Gen Psychiatr"},{"key":"pmed.1005197.ref058","doi-asserted-by":"crossref","DOI":"10.2196\/43727","article-title":"Assessing patient adherence to and engagement with digital interventions for depression in clinical trials: systematic literature review","volume":"25","author":"A Forbes","year":"2023","journal-title":"J Med Internet Res"},{"key":"pmed.1005197.ref059","author":"S Krieg","year":"2018"},{"key":"pmed.1005197.ref060","doi-asserted-by":"crossref","first-page":"314","DOI":"10.2519\/jospt.2021.0701","article-title":"Per-protocol, intention-to-treat, and complier average causal effects analyses in randomized controlled trials: linking evidence to practice","volume":"51","author":"SJ Kamper","year":"2021","journal-title":"J Orthop Sports Phys Ther"}],"container-title":["PLOS Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pmed.1005197","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:28:59Z","timestamp":1786987739000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pmed.1005197"}},"subtitle":[],"editor":[{"given":"Lloyd D.","family":"Balbuena","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":60,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,17]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pmed.1005197","relation":{},"ISSN":["1549-1676"],"issn-type":[{"value":"1549-1676","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]}}}