Multifamily Healing Spaces for Family Resilience in Rwanda (MFHS-CRT)
2026년 5월 29일 업데이트: Alexandros Lordos, PhD
The Effectiveness of Multi-Family Healing Spaces on Family Resilience and Mental Health Outcomes: A Multi-Site Cluster-Randomized Waitlist-Control Trial in Rwanda
This cluster-randomized waitlist-control trial evaluated Multifamily Healing Spaces (MFHS), a culturally adapted behavioral family intervention for genocide-affected communities in Rwanda.
Community members across five districts were screened through a staged triage process.
Individuals with acute or severe clinical concerns were routed to clinical referral, those with individual mental-health needs were prioritized for Resilience-Oriented Therapy, and families were invited to MFHS when at least one screened family member met criteria for family communication difficulties.
Twenty eligible clusters were randomly selected and then allocated to MFHS or waitlist control.
The baseline cohort included 319 family members aged 12 years or older.
The trial tested whether MFHS improved family resilience, parenting, couple and youth family-system outcomes, and secondary mental health, psychosocial, community, and livelihood outcomes from baseline to immediate post-intervention endline.
연구 개요
상세 설명
MFHS is a group-based, trauma-informed, family-systems intervention developed for post-genocide Rwanda. It combines psychoeducation, structured dialogue, family communication and problem-solving exercises, parenting and couple-relational work, and youth voice and identity activities. The intervention was delivered in intergenerational, whole-family, parent-only, and youth-only formats. MFHS comprised 18 core 3-hour meeting occasions, with parent-only and youth-only sessions delivered in parallel, plus four planned follow-up sessions where relevant.
Participants were identified through a broader Rwanda societal-healing screening process. Screening was conducted at the individual level, but MFHS invitation occurred at the family level: if any screened individual met the MFHS family-communication criterion, that person's family was invited. The audited screening workbook contained 4,214 adult/community screening records. After referral/triage for severe clinical flags and other staged interventions, 839 screened individuals were staged to MFHS. At the cell level, 56 eligible cells had enough staged MFHS-screened individuals to form a group; those cells contained 794 staged MFHS-screened individuals. Twenty trial clusters were randomly selected from the eligible cells and then allocated to MFHS or waitlist control. The final baseline cohort included 319 family members in 20 clusters: 167 in MFHS clusters and 152 in waitlist-control clusters.
The primary manuscript analysis is a baseline-cohort intention-to-treat analysis. All baseline-assessed participants were retained in their final fielded cluster allocation. Missing endline outcomes for 36 participants were handled through multiple imputation. Effects were estimated with baseline-adjusted cluster-level Analysis of Covariance (ANCOVA) weighted by baseline cluster size, with complete-case and unweighted analyses retained as sensitivity checks.
연구 유형
중재적
등록 (실제)
319
단계
- 해당 없음
연락처 및 위치
이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.
연구 장소
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Eastern Province
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Ngoma, Eastern Province, 르완다
- Community and Health-Centre Settings, Ngoma District
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Nyagatare, Eastern Province, 르완다
- Community and Health-Centre Settings, Nyagatare District
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Northern Province
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Ruhengeri, Northern Province, 르완다
- Community and Health-Centre Settings, Musanze District
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Southern Province
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Nyamagabe, Southern Province, 르완다
- Community and Health-Centre Settings, Nyamagabe District
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Western Province
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Nyabihu, Western Province, 르완다
- Community and Health-Centre Settings, Nyabihu District
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참여기준
연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.
자격 기준
공부할 수 있는 나이
- 어린이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
아니
설명
Inclusion Criteria:
- Member of a family living in or connected to a selected MFHS-eligible cluster/cell in one of the five study districts in Rwanda.
- Aged 12 years or older.
- Family invited because at least one screened family member met the staged MFHS criterion for family communication difficulties after higher-priority clinical and individual mental-health triage.
- Able and willing to participate in baseline assessment and, if allocated to MFHS, family/group sessions.
- Written informed consent, assent, and/or caregiver permission obtained according to age and local ethics requirements.
Exclusion Criteria:
- Individuals with suicidality, psychosis, or severe substance-use flags were routed for clinical interview or hospital referral rather than MFHS as first-line allocation.
- Individuals meeting higher-priority individual mental-health criteria were routed to Resilience-Oriented Therapy before the MFHS screening stage.
- Individuals or families unable to provide consent/assent or safely participate in group family sessions were not enrolled.
- Remaining individuals with social-conflict indicators after earlier stages were routed to sociotherapy rather than MFHS.
공부 계획
이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 지지 요법
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
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실험적: Multifamily Healing Spaces
Clusters allocated to Multifamily Healing Spaces (MFHS) received the behavioral family intervention during the trial evaluation period.
MFHS was delivered to families in group formats using intergenerational, whole-family, parent-only, and youth-only sessions.
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MFHS is a culturally adapted, group-based family intervention for genocide-affected communities in Rwanda.
It includes 18 core 3-hour meeting occasions in intergenerational, whole-family, parent-only, and youth-only formats.
Sessions focus on trauma-informed psychoeducation, family communication and problem solving, shared meaning-making, parenting, couple relationships, youth voice, and family and community resilience.
Groups were facilitated by trained facilitators, including a therapist and community volunteer, with facilitator training and supervision.
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간섭 없음: Waitlist Control
Clusters allocated to waitlist control did not receive MFHS during the baseline-to-endline evaluation period.
Families were invited to receive MFHS after the evaluation period.
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Change in Family Resilience
기간: Baseline to immediate post-intervention endline, up to 5 months
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Family resilience was measured with the Walsh Family Resilience Questionnaire.
The local version included 32 items forming belief systems, organization patterns, and communication/problem solving subscales.
Subscale scores range from 1 to 5, with higher scores indicating stronger family resilience processes.
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Baseline to immediate post-intervention endline, up to 5 months
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Change in Parenting Practices
기간: Baseline to immediate post-intervention endline, up to 5 months
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Parenting practices were measured with the Parenting Practices Questionnaire.
The local version included 20 items forming authoritative warmth/involvement, authoritative democratic participation, and authoritarian verbal hostility subscales.
Subscale scores range from 1 to 5, with higher scores indicating more of the named parenting behavior.
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Baseline to immediate post-intervention endline, up to 5 months
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Change in Parent Couple Functioning
기간: Baseline to immediate post-intervention endline, up to 5 months
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Parent couple functioning was measured with parent-only measures of dyadic adjustment, dyadic happiness, sexual relationship decision-making power, and preference for boys over girls.
Dyadic adjustment domains range from 0 to 3 and dyadic happiness ranges from 1 to 5, with higher scores indicating better couple functioning.
Sexual relationship decision-making power ranges from 1 to 3, with higher scores indicating more respondent decision-making authority.
Preference for boys over girls ranges from 1 to 4, with higher scores indicating stronger preference for boys over girls.
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Baseline to immediate post-intervention endline, up to 5 months
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Change in Youth Family-System Functioning
기간: Baseline to immediate post-intervention endline, up to 5 months
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Youth family-system functioning was measured with youth-only family enmeshment and personal accountability scores.
Family enmeshment was measured with seven items ranging from 1 to 5, with higher scores indicating greater over-involvement or lower differentiation.
Personal accountability was measured with eight items ranging from 1 to 4, with higher scores indicating greater youth responsibility and accountability.
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Baseline to immediate post-intervention endline, up to 5 months
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Change in Post-Traumatic Stress Symptoms
기간: Baseline to immediate post-intervention endline, up to 5 months.
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Post-traumatic stress symptoms were measured with four genocide-adapted items from the Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
Items were rated from 0 to 4, with higher scores indicating greater post-traumatic stress symptoms.
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Baseline to immediate post-intervention endline, up to 5 months.
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Change in Borderline Traits
기간: Baseline to immediate post-intervention endline, up to 5 months.
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Borderline traits were measured with the McLean Screening Instrument for Borderline Personality Disorder.
The 10 yes/no items are summed to a total score ranging from 0 to 10, with higher scores indicating more borderline-personality features.
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Baseline to immediate post-intervention endline, up to 5 months.
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Change in Aggression
기간: Baseline to immediate post-intervention endline, up to 5 months.
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Aggression was measured with physical and verbal aggression items from the Aggression Questionnaire.
Items were averaged to scores ranging from 1 to 5, with higher scores indicating greater aggression.
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Baseline to immediate post-intervention endline, up to 5 months.
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Change in Forgiveness and Community Relations
기간: Baseline to immediate post-intervention endline, up to 5 months.
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Forgiveness and community relations were measured with forgiveness of others, social cohesion, perceived community threat, and intergenerational harmony scores.
Forgiveness of others used retained items derived from the Heartland Forgiveness Scale and ranges from 1 to 4, with higher scores indicating greater forgiveness.
Social cohesion ranges from 1 to 4, with higher scores indicating greater social cohesion.
Perceived community threat ranges from 1 to 4, with higher scores indicating greater perceived threat.
Intergenerational harmony ranges from 1 to 4, with higher scores indicating stronger intergenerational harmony.
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Baseline to immediate post-intervention endline, up to 5 months.
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Change in Socioemotional Skills
기간: Baseline to immediate post-intervention endline, up to 5 months.
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Socioemotional skills were measured with locally developed emotional wellbeing, collaboration, and self-management subscales.
Subscale scores range from 1 to 4. In the scoring, higher scores indicate greater socioemotional difficulty, so lower scores indicate improvement.
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Baseline to immediate post-intervention endline, up to 5 months.
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Change in Livelihood and Household Economic Functioning
기간: Baseline to immediate post-intervention endline, up to 5 months.
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Livelihood and household economic functioning were measured with parent-only economic security, partner economic support, and food-insecurity indicators.
Economic security and partner economic support scores range from 0 to 3, with higher scores indicating greater economic security or partner support.
Short-term Food Security Consumption Coping Strategy Index scores range from 0 to 84 and long-term scores range from 0 to 12, with higher scores indicating worse food insecurity.
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Baseline to immediate post-intervention endline, up to 5 months.
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공동 작업자 및 조사자
여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
수사관
- 수석 연구원: Alexandros Lordos, PhD, University of Cyprus
간행물 및 유용한 링크
연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.
일반 간행물
- Lordos, A., Interayamahanga, R., Kayitare, F., Dukuzumuremyi, E., Mahoro, M., Mwiza, J., & Mbanda, J. (2026). Establishing multi-stakeholder alliances to promote societal healing and resilience in post-genocide Rwanda. In S. Clarke-Habibi & C. Reimann (Eds.), The Routledge International Handbook of Trauma-Responsive Peacebuilding (pp. 411-424). Routledge. https://doi.org/10.4324/9781003536970-33
- Nikolaou, K., Lordos, A., Rutembesa, E., Ioannou, M., Dukuzumuremyi, E., Christou, G., Meade, A., Karayianni, E., Anastasiou, E., Guest, A., Sezibera, V., Panayiotou, O., Throstur, B., & Kayitare, F. (2025). Multifamily Healing Spaces: Development of a family-based intervention for recovery and resilience in Rwanda. Intervention, 23(1), 52-62. https://doi.org/10.4103/intv.intv_16_24
연구 기록 날짜
이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.
연구 주요 날짜
연구 시작 (실제)
2023년 4월 28일
기본 완료 (실제)
2023년 9월 15일
연구 완료 (실제)
2023년 9월 15일
연구 등록 날짜
최초 제출
2026년 5월 20일
QC 기준을 충족하는 최초 제출
2026년 5월 29일
처음 게시됨 (실제)
2026년 6월 2일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2026년 6월 2일
QC 기준을 충족하는 마지막 업데이트 제출
2026년 5월 29일
마지막으로 확인됨
2026년 5월 1일
추가 정보
이 연구와 관련된 용어
키워드
추가 관련 MeSH 약관
기타 연구 ID 번호
- MFHS-CRT-RWA-2023
- 122/RNEC/2023 (기타 식별자: Rwanda National Research Ethics Committee approval/reference number)
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
예
IPD 계획 설명
De-identified participant-level data underlying the manuscript analyses may be shared with qualified researchers on reasonable request to the first author, subject to ethics, data-protection, and partner-organization approvals.
IPD 공유 기간
Available after publication, with no predetermined end date.
IPD 공유 액세스 기준
Researchers must submit a methodologically sound proposal to the first author.
Access will be subject to approval by the study team and any applicable ethics, data-protection, and partner-organization requirements.
Shared data will be de-identified.
IPD 공유 지원 정보 유형
- 연구_프로토콜
- 수액
- ANALYTIC_CODE
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
아니
미국 FDA 규제 기기 제품 연구
아니
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .