Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jun 27, 2024
Date Accepted: Mar 20, 2025
The Communities Organizing for Power through Empathy (COPE) Community-Based Intervention to Improve Adult Mental Health in Disaster-related Crisis: Protocol for a Stepped Wedge Cluster Randomized Trial
ABSTRACT
Background:
Severe weather events, exacerbated by climate change, lead to significant hardships including displacement, property damage, and resource scarcity, while also disrupting social networks and community structures. Such disasters impact mental health, triggering conditions ranging from anxiety and depression to post-traumatic stress disorder. Challenges from increasingly frequent and compounding disasters point to an urgent need for evidence-based community multi-level interventions to support mental health and psychosocial resilience.
Objective:
This protocol describes the design of a pragmatic mixed methods study to examine the effects of the multi-level community-based intervention, Communities Organizing for Power through Empathy (COPE). Specifically, this study aims to (1) examine factors affecting the implementation, efficacy, and adoption of the COPE intervention, and (2) test its efficacy in reducing mental health distress (perceived stress, depression, anxiety) and strengthening community resilience. We will examine if participants in the COPE intervention experience greater reductions in psychological distress and improvements in protective factors compared to an attention control group.
Methods:
This two-arm Stepped Wedge Cluster Randomized Control Trial (SWCRCT) is being conducted with individuals (n~300) associated with faith-based and secular institutions (n~15) that are members of a broad-based organization in a disaster-prone community in the Gulf Coast of the United States. Assessments measure mental health (stress, anxiety, depression), coping, social support, and community resilience at five timepoints. Additionally, the Consolidated Framework of Implementation Research (CFIR) guides the examination of factors that influence the implementation, efficacy, and adoption of the COPE intervention.
Results:
The trial is being conducted from June 2022 to June 2025. Recruitment began in April 2023 and will conclude in spring 2025, with data analysis and dissemination of results are expected by the spring of 2026.
Conclusions:
This study examines the effects of the COPE multi-level community-based intervention on psychological distress and resilience in disaster-prone communities. This study is among the first to utilize a CBPR approach to examine a multi-level intervention’s efficacy and implementation in a high-risk area, contributing valuable insights into community-based disaster mental health recovery strategies. This protocol outlines the comprehensive mixed-methods study design to assess the effectiveness and implementation of COPE. Clinical Trial: ClinicalTrials.gov - NCT06093737
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Copyright
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