Trial reportBMJ open2025
Stepped-care programme of brief psychological interventions for adults affected by adversity in Jordan: lessons from a pilot randomised controlled trial.
Trial report in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- System-Level Tensions in Scaling Digital Mental Health: A Qualitative Study of STARS in Jordan.Healthcare (Basel, Switzerland) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo pilot test a stepped care intervention and examine trial procedures in advance of a definitive randomised controlled trial (RCT). We aimed to evaluate safety, acceptability and adherence to interventions.
participantsAdults with significant psychological distress (K10 (Kessler Psychological Distress Scale) score ≥20) were recruited in Jordan between September 2022 and February 2023.
interventionsParticipants were randomised to one of two arms. The intervention arm received a stepped care programme consisting of a guided self-help programme (Doing What Matters; DWM), followed by a more intensive group programme (group Problem Management Plus; gPM+). The control arm received a guided self-help programme alone. Both intervention arms also received Enhanced Treatment as Usual that comprised referral to available community support services. PRIMARY AND SECONDARY OUTCOME MEASURES: A mixed methods approach was used to examine trial procedures in preparation for a definitive RCT, evaluate safety, acceptability and adherence to interventions and examine the pattern of quantitative outcomes. The primary clinical outcome was assessor-reported depression and anxiety symptoms (Hopkins Symptom Checklist-25) at week 12.
results145 distressed adults (meeting Kessler Distress Score-10 score of ≥20) were randomised to either the stepped care or the single intervention arm (86% female) on a 1:1 allocation basis. DWM was delivered over 5 weeks by trained non-specialist helpers, where participants attended on average 2.6 support calls. Those randomised to gPM+attended on average 3.3 sessions. The study demonstrated feasibility and acceptability for DWM and gPM+interventions as delivered by trained non-specialists. Although the trial was not powered to detect clinical effectiveness, the stepped care arm relative to the single intervention arm demonstrated significantly lower depression symptoms immediately after and at 3 months following intervention delivery. The study and trial procedures were acceptable to participants, non-specialists and programme staff and demonstrated feasibility of implementing such a framework in Jordan.
conclusionsFindings from this trial informed a fully powered definitive RCT seeking to evaluate the clinical and cost-effectiveness of a stepped model of care in Jordan. TRIAL REGISTRATION NUMBER: ACTRN12621000189820p.
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