Piloting a scalable, post-trauma psychosocial intervention in Tuvalu: the Skills for Life Adjustment and Resilience (SOLAR) program

Abstract

Background: The Skills for Life Adjustment and Resilience (SOLAR) programme is a brief, scalable, psychosocial skill-building programme designed to reduce distress and adjustment difficulties following disaster. Objectives: We tested the feasibility, acceptability, efficacy and safety of a culturally adapted version of SOLAR in two remote, cyclone-affected communities in the Pacific Island nation of Tuvalu. Method: This pilot adopted a quasi-experimental, control design involving 99 participants. SOLAR was administered to the treatment group (n = 49) by local, non-specialist facilitators (i.e. ‘Coaches’) in a massed, group format across 5 consecutive days. The control group (n = 50) had access to Usual Care (UC). We compared group differences (post-intervention vs. post-control) with psychological distress being the primary outcome. We also examined whether changes were maintained at 6-month follow-up. Results: Large, statistically significant group differences in psychological distress were observed after controlling for baseline scores in favour of the SOLAR group. Mean group outcomes were consistently lower at 6-month follow-up than at baseline. SOLAR was found to be acceptable and safe, and programme feedback from participants and Coaches was overwhelmingly positive. Conclusions: Findings contribute to emerging evidence that SOLAR is a flexible, culturally adaptable and scalable intervention that can support individual recovery and adjustment in the aftermath of disaster. RCTs to strengthen evidence of SOLAR’s efficacy are warranted.