ALCOHOL AND OTHER DRUG INTERVENTIONS IN REFUGEE SETTINGS

Refugees are at risk for unhealthy alcohol and other drug (AOD) use, yet few receive treatment. This research will evaluate the effectiveness and implementation of stepped-care AOD services (screening, brief intervention, and referral to evidence-based psychotherapy) for Congolese refugees and host community members in Mantapala, an integrated settlement in northern Zambia. We will first explore the types, correlates, and patterns of AOD use, validate measures for AOD use, and adapt the interventions and research procedures to be locally relevant and acceptable in the study context. Refugee incentive workers will be trained to deliver the intervention to 200 persons reporting unhealthy AOD use. Using a hybrid effectiveness-implementation trial and mixed-methods data collection, we will evaluate the feasibility, cost, barriers and facilitators to implementation of the intervention, as well as its effectiveness in reducing unhealthy AOD use and co-occurring mental health problems 12-months after baseline relative to those receiving treatment-as-usual.