Strengthening Community Mental Health

This Community-Based Participatory Research (CBPR) study will follow a multiphase mixed-methods design to adapt, deliver, and assess the efficacy of the Communities Organizing for Power through Empathy (COPE) intervention model. We will partner with a broad-based community organization, Together Baton Rouge, to adapt the intervention model to fit the context of East Baton Rouge Parish (EBRP) and deliver it to members of religious and non-profit institutions.

The objectives of the multi-level COPE intervention model are twofold: (1) reduce psychological distress and amplify protective factors among individuals and communities at risk of experiencing disasters; and (2) build individual and community psychological support response capacity. The intervention will be delivered by trained Community Facilitators (CFs) at community institutions (i.e., churches) to their institutional members. We will conduct a stepped wedge cluster randomized controlled trial (SWCRCT) to examine the impact of the COPE intervention. Measures of mental health, coping, social support and community resilience will be assessed at four timepoints (see timeline for data collection timepoints). We will conduct interviews and group reflections with CFs and participants to gain insight into their experiences with the intervention.

• COPE: Communities Organizing for Power through Empathy (Behavioral): A three session brief group psychoeducational intervention. Session 1 is 4 hours, Session 2 and 3 are 1.5 hours. It is delivered in groups of 8-15 people with sessions spaced 1 month apart.

Primary outcomes

• Change in perceived stress from baseline [T1 (pre-intervention), T2 (1 month post-intervention), T3 (2 months post-intervention), T4 (3 months post-intervention)]: Measured using Perceived Stress Scale, a 10-item scale that measures the degree to which a person appraises situations in their life as stressful.
• Change in depression symptoms from baseline [T1 (pre-intervention), T2 (1 month post-intervention), T3 (2 months post-intervention), T4 (3 months post-intervention)]: Measured using The Depression, Anxiety, and Stress Scale (DASS), a set of three self-report scales designed to measure depression, anxiety and stress.
• Change in anxiety symptoms from baseline [T1 (pre-intervention), T2 (1 month post-intervention), T3 (2 months post-intervention), T4 (3 months post-intervention)]: Measured using The Depression, Anxiety, and Stress Scale (DASS), a set of three self-report scales designed to measure depression, anxiety and stress.
• Change in stress symptoms from baseline [T1 (pre-intervention), T2 (1 month post-intervention), T3 (2 months post-intervention), T4 (3 months post-intervention)]: Measured using The Depression, Anxiety, and Stress Scale (DASS), a set of three self-report scales designed to measure depression, anxiety and stress.
• Change in perceived social support from baseline [T1 (pre-intervention), T2 (1 month post-intervention), T3 (2 months post-intervention), T4 (3 months post-intervention)]: Measured using the Multidimensional Scale of Perceived Social Support (MSPSS) is a 12 item scale, assessing perceived social support and connection.
• Change in coping from baseline [T1 (pre-intervention), T2 (1 month post-intervention), T3 (2 months post-intervention), T4 (3 months post-intervention)]: Measured using the Coping Self-Efficacy Scale (CSES) short form, a 12-item measure of confidence in managing stressors.
• Change in community resilience from baseline [T1 (pre-intervention), T2 (1 month post-intervention), T3 (2 months post-intervention), T4 (3 months post-intervention)]: Measured using the Communities Advancing Resilience Toolkit (CART), a 21-item measure of community resilience items across 4 interrelated domains that both reflect and contribute to community resilience: (1) Connection and Caring; (2) Resources; (3) Transformative Potential; and (4) Disaster Management.

Secondary outcomes

• Intervention acceptibility [After delivery of 3rd session]: Measured using the Acceptability of Intervention Measure (AIM), a 4 item measure of agreement with intervention.
• Intervention appropriateness [After delivery of 3rd session]: Measured using the Appropriateness Measure (IAM), a 4 item measure of agreement with the appropriateness of the intervention.
• Intervention feasibility [After delivery of 3rd session]: Measured using the Feasibility of Intervention Measure (FIM), a 4 item measure of agreement with the feasibility of implementing the intervention.

Other outcomes

• Interviews [From date of first intervention delivery until 3 months post-date of delivery of final intervention session]: Semi-structured interviews about experience with participating in or facilitating the intervention
• Focus groups [From date of first intervention delivery until 3 months post-date of delivery of final intervention session]: Periodic reflections conducted with community facilitators.
• Intervention fidelity [At each intervention session.]: Assessed via facilitator observation using a structured fidelity questionnaire/form.

Sex: All, ages: 18 Years to any, accepts healthy volunteers

Inclusion Criteria:

* Individuals 18 years of age or older who are staff or members of an organization that is part of Together Baton Rouge and who participate in the intervention or are/were involved in the adaptation or implementation of the brief intervention in any capacity

Exclusion Criteria:

* Persons who are not 18 years of age or older and persons who are not staff or members of an organization that is part of Together Baton Rouge and/or not involved with the intervention

• Results publication: Scott J, Powell T, Lee-Johnson NM. The Communities Organizing for Power Through Empathy (COPE) Community-Based Intervention to Improve Adult Mental Health During Disasters and Crises: Protocol for a Stepped-Wedge Cluster Randomized Trial. JMIR Res Protoc. 2025 May 20;14:e63723. doi: 10.2196/63723. PMID 40392582

• Jennifer L Scott, PhD, LCSW, Principal investigator, Louisiana State University Health Sciences Center in New Orleans