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Addressing Stress Among Women Entrepreneurs in Ethiopia - Scale up

Not Applicable
Recruiting
Conditions
Stress, Job
Violence, Gender-Based
Economic Problems
Stress
Mental Stress
Emotion Regulation
Interventions
Behavioral: Stress managment
Registration Number
NCT05888272
Lead Sponsor
World Bank
Brief Summary

The objective of this study is to examine the impact of the "Doing What Matters in Times of Stress" guided self-help handbook, along with phone-based lay helpers sessions, on the psychological well-being, business performance, and incidence of intimate partner violence among women entrepreneurs in Ethiopia.

Detailed Description

This study aims to evaluate the impact of the "Doing What Matters in Times of Stress Guided" self-help manual on mental distress, business performance, and intimate partner violence experienced by women entrepreneurs in Ethiopia. The study will be conducted in four cities - Addis Ababa, Hawassa, Bahir Dar, and Adama - using a randomized controlled trial (RCT) design. The investigators will screen 5000 potential participants via phone and enroll 1200 eligible women, who will be equally distributed across the four cities. After an in-person baseline survey, the women will be stratified by marital status and city and randomized into the intervention or waitlist control group using a computer-generated random assignment. The intervention group will receive seven phone-based sessions over ten weeks to review the self-help manual materials with a lay helper. Two follow-up surveys will be conducted after the intervention, the first one a month after the completion of the intervention, and the second one twelve months after completion.

This study is a continuation of a pilot study conducted between July 2021 and August 2022 (PRS registration ID - NCT05208723). The current study seeks to build on the pilot study in the following dimensions:

1. Increase the sample size to 1200 women entrepreneurs to improve the power of the study to detect the impact of the intervention on business performance outcomes,

2. Widen the geographical and contextual coverage,

3. Allow entrepreneurs to invite a household member to attend the self-help phone sessions with them,

4. Capture the impact on intimate partner violence,

5. Introduce a short conflict module to capture the direct and indirect effects of conflict on mental health outcomes, business performance, and intimate partner violence.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
1200
Inclusion Criteria
  • Age ≥18;
  • Those who plan to live in the study city in the next six months;
  • Those who can read and speak Amharic and can understand the study questionnaire;
  • Those who have the capacity to provide informed consent;
  • Score 8 or above on the Ethiopian adaptation of Kessler-6
Exclusion Criteria
  • Kessler 6 score >20;
  • Those who have recent or current suicidal thoughts or plans;
  • Those who have limitations in understanding the study questionnaire;
  • Those who do not have the capacity to provide informed consent;
  • Do not have access to a phone;
  • Not interested in receiving the intervention

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Experimental - Stress ManagmentStress managmentA locally adapted self-help guidebook originally developed by the World Health Organization (WHO), 'Doing what matters in times of stress' for managing disruptive emotions and psychological distress, will be delivered to women entrepreneurs at their residences, followed by 7 phone calls from a trained mental health helper to reinforce the materials over a 10-week period. The intervention is intended to help people manage their psychological distress associated with a range of adversities but is not intended for participants with severe mental health problems such as psychosis or imminent risk of suicide
Primary Outcome Measures
NameTimeMethod
Depression using the Patient Health Questionnaire (PHQ-9)Time Frame: 12 months post intervention

Minimum score 0 and a maximum score of 27. Higher scores indicate increased levels of depressive symptoms (worse outcome).

Stress using the Perceived Stress ScaleTime Frame: 12 months post intervention

Minimum score of 0 and a maximum of 40. Higher scores indicate high levels of perceived stress (worse outcome). Investigators will reverse code items 4,5, 7 and 8

Mental Distress using the Kessler Psychological Distress Scale (K-6)Time Frame:12 months post intervention

Minimum value of 0 and a maximum value of 24. Higher scores indicate high levels of psychological distress (worse outcome)

Self-Esteem using the Rosenberg Self-esteem ScaleTime Frame:12 months post intervention

Minimum score 10 and a maximum score of 40. Investigators will reverse code items 3,5,8,9 and 10 . Higher scores indicate high levels of self-esteem (better outcome)

Functional Impairment using the World Health Organization Disability Assessment Schedule (WHODAS-2.0 -12 item version)Time Frame: 12 months post intervention

Minimum score of 12 and a maximum of 60. Higher scores indicate high levels of disability (worse outcome)

World Health Organisation- Five Well-Being Index (WHO-5)Time Frame: 12 months post intervention

Minimum score of 0 and a maximum of 25. Higher scores mean better wellbeing (better outcome). Scores are transformed to 0-100 (by multiplying by 4.

Secondary Outcome Measures
NameTimeMethod
Business Performance 3Time Frame: 12 months post intervention

Business size measured using number of employees

Intimate Partner Violence 1Time Frame: 12 months post intervention

Experience of at least one form of Physical Violence measured using the Demographic and Health Survey module for the experience of physical intimate partner violence.

Business Performance 2Time Frame: 12 months post intervention

Monthly Sales

Business Performance 1Time Frame: 12 months post intervention

Monthly Profits

Intimate Partner Violence 2Time Frame: 12 months post intervention

Experience of at least one form of Emotional Violence measured using the Demographic and Health Survey module for the experience of emotional intimate partner violence.

Trial Locations

Locations (1)

Policy Studies Institute

🇪🇹

Addis Ababa, Ethiopia

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