The Impact of Livelihood and Psychosocial Training on Livelihood Outcomes

INTERVENTION: There are two arms to this trial. Arm 1: Livelihood Program/Problem Management Plus. Arm 2: Livelihood Program. The Livelihood Program/Problem Management Plus involves training farmers individually in Iraq in farming and business practices. The training will involve provision of farming aid in terms of produce and technical training for a period of 1 year, followed by training in budgeting and utilising markets for 1 year. This livelihood training will be delivered to small groups of 3‐5 farmers on 4 occasions, with each lasting 5‐hour sessions. Adherence will be assessed by monitoring participants' attendance at the Livelihood sessions. Prior to the farming training, farmers will receive will receive Problem Management Plus, which involves 5 X120‐minute weekly group sessions teach the following stress coping strategies: anxiety reduction, problem solving, behavioral activation, and accessing social support. This will occur will in a face‐to‐face format, using educational sessions that teach cognitive behavioural strategies, using flipcharts and group discussions in groups of 8‐10 farmers. The duration of the study for any participant will conclude after a 48‐month follow‐up assessment, resulting in participation duration of 214 weeks. Adherence will be assessed by monitoring participants' attendance at the Problem Management Plus sessions via a checklist maintained by the group facilitator. CONDITION: Mental Health ‐ Anxiety Mental Health ‐ Depression Poor livelihood;Anxiety;Depression; ; Poor livelihood ; Anxiety ; Depression PRIMARY OUTCOME: Livelihood gains as measured by a composite measure of economic outcomes that includes annual yield of produce and annual income.[Pretreatment (week 0), week 52, week 104, week 156, and week 208 (primary timepoint) post‐intervention commencement . ] SECONDARY OUTCOME: Anxiety and depression as measured by the Hospital and Anxiety Depression Scale.[Pretreatment (week 0), week 52, week 104, week 156, and week 208 post‐intervention commencement . ] Disciplinary parenting as measured by the Alabama Parenting Questionnaire discipline subscale.[Pretreatment (week 0), week 52, week 104, week 156, and week 208 post‐intervention commencement . ] Social integration as measured by the Practitioner Assessment of Network Type.[Pretreatment (week 0), week 52, week 104, week 156, and week 208 post‐intervention commencement . ] INCLUSION CRITERIA: • Adults aged 18 years or above • Residents in Iraq • Farmers agreeing to receive farming training • Arabic speaking