The Feasibility and Acceptability of Project POWER: A Cognitive-Behavioral Mindfulness-Infused Group-Based Mental and Sexual Health Intervention Among Young Pregnant Women in Liberia

Background: Following 14 years of civil war in Liberia, war-exposure, gender-based violence, and extreme poverty have been identified as key challenges to the mental and sexual health of young pregnant women, and the health of their unborn children. Despite ongoing efforts to rebuild the country’s healthcare infrastructure, empirical research and interventions focused on addressing the consequences of war on the mental and sexual health of young pregnant women in Liberia are severely limited. To address these concerns, we developed Project POWER (P rogressing O ur W ell-being , E motions, and R elationships ) (POWER), a mindfulness-infused cognitive-behavioral intervention for young adult pregnant women. This study sought to: 1) assess the feasibility and acceptability of POWER; and (2) determine the preliminary efficacy of POWER for improving mental and sexual health outcomes among Liberian war-exposed pregnant young adult women. Methods Eighty-seven women ages 18-25 years were recruited from three catchment areas in Monrovia, Liberia. Participants participated in one of two ten-session programs delivered over 5-weeks: POWER or a control group (a health education program). Feasibility and acceptability of POWER were examined using program log (e.g., the number of participants screened and enrolled, facilitator satisfaction, etc.) data from an exit interview. Results Preliminary efficacy of POWER’s effects on mental and sexual health outcomes was assessed using a series of four one-way repeated measures ANOVA with time and group as predictors. Analyses provided preliminary support for the feasibility and acceptability of POWER. Preliminary efficacy of POWER showed significant reductions in depression symptoms, PTSD symptoms, prenatal distress, and transactional sex over time. Conclusions Findings suggest that POWER may be a feasible and acceptable intervention to promote mental and sexual health for young adult pregnant women in Liberia. Future research is needed to determine the efficacy of POWER on a larger scale in Liberia.