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Women’s circles as a culturally safe psychosocial intervention in Guatemalan indigenous communities: a community-led pilot randomised trial

Research output: Contribution to journalArticlepeer-review

Anne Marie Chomat, Aura Isabel Menchu, Neil Andersson, Manuel Ramirez-Zea, Duncan Pedersen, Alexandra Bleile, Paola Letona, Ricardo Araya

Original languageEnglish
Article number53
Number of pages15
JournalBMC Women's Health
Issue number1
Accepted/In press14 Mar 2019
Published3 Apr 2019


King's Authors


Background: Indigenous Maya women in Guatemala show some of the worst maternal health indicators worldwide.
Our objective was to test acceptability, feasibility and impact of a co-designed group psychosocial intervention
(Women’s Circles) in a population with significant need but no access to mental health services.
Methods: A parallel group pilot randomised study was undertaken in five rural Mam and three periurban K’iche’
communities. Participants included 84 women (12 per community, in seven of the communities) randomly allocated to
intervention and 71 to control groups; all were pregnant and/or within 2 years postpartum. The intervention consisted
of 10 sessions co-designed with and facilitated by 16 circle leaders. Main outcome measures were: maternal
psychosocial distress (HSCL-25), wellbeing (MHC-SF), self-efficacy and engagement in early infant stimulation activities.
In-depth interviews also assessed acceptability and feasibility.
Results: The intervention proved feasible and well accepted by circle leaders and participating women. 1-month postintervention, wellbeing scores (p-value 0.008) and self-care self-efficacy (0.049) scores were higher among intervention
compared to control women. Those women who attended more sessions had higher wellbeing (0.007), self-care and
infant-care self-efficacy (0.014 and 0.043, respectively), and early infant stimulation (0.019) scores.
Conclusions: The pilot demonstrated acceptability, feasibility and potential efficacy to justify a future definitive
randomised controlled trial. Co-designed women’s groups provide a safe space where indigenous women can
collectively improve their functioning and wellbeing.
Trial registration: ISRCTN13964819. Registered 26 June 2018, retrospectively registered

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