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

Figures & data

Figure 1. Study design

Figure 2. Flow diagram illustrating participant recruitment and retention

Table 1. Sample demographic data

Demographic characteristics	Funafuti	Nui
Age**	M = 34.12; Range: 18–71	M = 50.02; Range: 20–74
Female*	N = 38 (76%)	N = 28 (57%)
Currently married**	N = 28 (56%)	N = 44 (90%)
Number of children*	M = 2.60; Range: 0–6	M = 3.71; Range: 0–11
Number of people per household**	M = 11.02; Range: 3–31	M = 6.31; Range: 1–19
EKT Church members*	N = 36 (43%)	N = 49 (100%)
Years of formal schooling**	M = 10.82; Range: 7–13	M = 7.92; Range: 0–13
Vocational or tertiary training**	N = 21 (42%)	N = 2 (4%)
Receiving remittances*	N = 16 (32%)	N = 26 (53%)
Level of subsistence activity**	M = 2.04	M = 2.59
Level of difficulty meeting basic household needs**	M = 2.22; Range: 1–4; 1 = not difficult, 4 = extremely difficult	M = 2.78; Range: 1–4; 1 = not difficult, 4 = extremely difficult
Cyclone experience
Level of fear experienced during cyclone**	M = 2.86; Range: 1–4; 1 = not at all, 4 = extremely	M = 3.82; Range: 1–4; 1 = not at all, 4 = extremely
Damage to personal property or land**	N = 26 (38%)	N = 49 (100%)
Level of increase in day-to-day difficulties following cyclone**	M = 2.46; Range: 1–4; 1 = no more difficult than usual, 4 = extremely difficult	M = 3.16; Range: 1–4; 1 = no more difficult than usual, 4 = extremely difficult

*p < .05; **p < .01.

Table 2. Results of Johnson–Neyman procedure

Model	Crossover		SROS				n Int group	n Control group
	Cent	Uncent	Cent Lower	Cent Upper	Uncent Lower	Uncent Upper
HSCL-25	−0.902	1.052	−2.356	−0.447	0.616	1.43	46	44
PCL-5	−28.259	8.629	−55.874	−17.02	4.85	18.084	44	40
Impairment	−0.458	0.112	−0.837	−0.204	−0.95	0.85	44	50

Note. HSCL-25 = Hopkins Symptom Checklist; PCL-5 = Post-traumatic stress disorder checklist for DSM-5; Impairment = Tuvalu Impairment Checklist; SROS = simultaneous regions of significance; Cent = centred; Uncent = Uncentred; n = sample size of cases falling within the lower and upper SROS regions.

Table 3. Group comparisons for scores falling with the SROS regions of the Johnson–Neyman procedure

Model	AdjM Intervention group	AdjM Control group	Mean difference with 95% CI	Effect size with 95% CI
HSCL-25	1.291	1.812	0.520 [0.646, 0.395]	1.106 [0.839, 1.373]^a
PCL-5	12.357	34.075	21.718 [18.484, 24.953]	1.575 [1.341, 1.810]^a
Impairment	1.315	2.269	0.955 [0.810, 1.099]	1.316 [1.117, 1.516]^a
PSYCHLOPS	4.687	12.84	8.153 [7.088, 9.218]	2.403 [1.987, 2.819]^b

Note. HSCL-25 = Hopkins Symptom Checklist; PCL-5 = Post-traumatic stress disorder checklist for DSM-5; Impairment = Tuvalu Impairment Checklist; SROS = simultaneous regions of significance; AdjM = adjusted means on the post-test measure for participants who are at the mean on the pretest measure; ^a Glass’ delta; ^bCohen’s d.

Table 4. Mean aggregate scores at each assessment point and paired sample t-tests comparing changes over time by sample

	Pre-control	Pre-intervention		Post-intervention	6-month follow-up	Pre-to-post change							Post-to-follow-up change							Pre-to-follow-up change
	M (SE)	M (SE)		M (SE)	M (SE)			95% CI								95% CI						95% CI
						dRM			Lower	Upper	p		dRM		Lower		Upper	p		dRM			Lower	Upper	p
Funafuti
HSCL-25 Tuvalu	1.89 (0.07)	1.75 (0.07)		1.29 (0.03)	1.51 (0.07)	−2.66			−3.60	−1.72	<0.001		1.88		0.98		2.79	0.010		−1.12			−1.93	−0.31	0.020
PCL-5	33.88 (1.95)	31.12 (1.88)		14.03 (1.25)	21.97 (2.95)	−0.13			−0.17	−0.10	<0.001		0.04		0.02		0.06	0.020		−0.04			−0.07	−0.01	0.050
TIC	2.32 (0.10)	2.27 (0.10)		1.37 (0.05)	1.75 (0.10)	−2.51			−3.20	−1.82	<0.001		1.56		0.84		2.29	<0.001		−1.26			−1.89	−0.63	0.001
PSYCHLOPS	15.04 (0.52)	12.84 (0.49)		5.26 (0.45)	5.32 (0.73)	−0.77			−1.02	−0.53	<0.001		−0.77		−1.02		−0.53	<0.001		−0.52			−0.80	−0.26	0.001
Nui
HSCL-25 Tuvalu		2.28 (0.12)		1.29 (0.03)	1.17 (0.05)	−2.14			−2.51	−1.77	<0.001		−1.68		−2.59		−0.77	0.010		−2.39			−2.84	−1.94	<0.001
PCL-5		43.74 (2.72)		12.91 (1.14)	13.60 (0.68)	−0.12			−0.15	−0.09	<0.001		0.02		−0.03		0.07	0.590		−0.12			−0.15	−0.09	<0.001
TIC		2.40 (0.10)		1.314 (0.03)	1.58 (0.04)	−3.10			−4.03	−2.17	<0.001		6.42		4.12		8.72	<0.001		−2.32			−3.10	−1.54	<0.001
PSYCHLOPS		13.14 (0.45)		4.68 (0.44)	5.81 (0.44)	−0.92			−1.25	−0.59	<0.001		0.15		0.02		0.28	0.110		−0.90			−1.32	−0.49	<0.001

Data availability statement

Participants of this study did not agree for their data to be shared publicly, so supporting data is not available.