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Systematic Literature
Review
P r o m ot i ng P s ych os oc i al Wel l - B ei n g an d
E m p ow e r m en t o f I m m i g r an t Wom e n: A
Systematic Review of Interventions
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1. Introduction
Significant inequalities between men and women persist
Reduced opportunities, pay gaps for equal or similar work, limited
access to educational and cultural resources, unequal distribution of Increase in isolation and stress and decreased
domestic and family care work, and denial of fundamental rights levels of self-esteem, which consequently may
Additional challenges regarding gender inequalities lead to poorer psychosocial well-being for
These women handle these different challenges while they must also immigrant women and negatively affect their
adjust to the new environment empowerment process
Language barriers
These barriers can lead to a range of difficulties
Immigrant women scored worse on
assessments of mental health and
psychosocial well-being
Empowerment can involve accessing resources and skills to overcome
inequalities and vulnerabilities, as well as actively participating in making
decisions that affect their lives, including their careers, bodies,
relationships, and rights

lack of access to resources and
opportunities, prejudice, and
discrimination
In this sense, it is essential to implement actions aimed at
promoting the PWE of women, especially those who are in a
more vulnerable situation, such as immigrant women.
These actions can decrease gender disparity and increase
women’s participation in society and in the world
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Study Aims
However, despite relevant research in this field, there are few review studies to enable a
comparison between studies and provide a baseline for future research. Hence, this study
aims to develop an SLR to centralize current knowledge on research that has used
interventions to promote PWE in immigrant women by comparing pre-post intervention
outcomes. It is hoped that this SLR will present an update of the theoretical framework of
interventions, methods, outcomes, benefits, and limitations. Consequently, this study can
be a useful guide for public policies and future strategies for this population. It also can be
used as a starting point for further research in this field
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2. Materials and Methods

This SLR was conducted following the
guidelines of the PRISMA 2020 statement: an
updated guideline for reporting systematic
reviews

2.1 Data Collection Strategies
The reason why choose Scopus and
WOS
Scopus and Web of Science
studies included were published
from 2010 until the final data
collection date, on 24 March 2023
The multidisciplinary and comprehensive scope of
these databases allows for research in different areas
of knowledge that are related to our topic, such as
psychology, sociology, migration studies, public health,
and others
Both databases are recognized for their rigorous
selection of scientific journals, maintaining a robust
editorial selection process to include only high-
quality studies

This method can help discover studies

We started with the identified body of
that the database search may have
articles in the databases. Then, the
Snowball literature search missed. Ultimately, it aims to reduce
reference lists of these articles were
selection bias and identify a larger
analyzed to find additional studies
number of relevant studies on a topic.

These languages are considered among the

most spoken worldwide and are particularly
prevalent in countries with high rates of
immigration. This fact increases the probability
of finding studies on the topic.

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2.2 Criteria for Inclusion and Exclusion of Studies

Comparisons
Participants
Results had to present a comparison between the
P The population was composed of immigrant
women over 18 years old living in a foreign
C initial and final phases of the intervention through a
quantitative design or a mixed design
country (quantitative and qualitative methodology), if they
evaluated the effectiveness of the intervention

Outcomes
Interventions
Results had to promote the PWE of the
We included all interventions specifically
I designed to improve PWE. However, they were
o participants. Studies contained measures and
analyses that made it possible to verify significant
only included if they were clearly identified and
improvement in the empowerment and
protocolled --- 2 criteria
psychosocial well-being in the population assisted
2.3 Article Selection Process

PRISMA

2.4.1 Design of Studies
2.4.2 Characteristic of Participants
2.4.3 Characteristic of Interventions
2.4.4 Instruments for Data
Collection and Analysis
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2.4 Descriptive Synthesis of the Studies randomized and controlled
experiment with a double-
USA (N=6 blind process (N=1)
Pre/post intervention design
Republic of Korea (N=4)
Published between 2012 and 2021 (N=13)
Spain (N=3) quasi-experiments, divided
into experimental and control
group (N=12)
A total of 584 immigrant women were Women were mostly born in countries Seven studies reported that
evaluated and 433 received some type of in Latin America (32%), Asia (21%), participants should be over 18
intervention for the improvement of their Europe (11%), and Morocco (16%). years old, and in three
psychosocial well-being and/or empowerment. studies, over 21 years old
1. Counseling in various aspects of life
4 main components of interventions
2. Health education/psychoeducation
3. Cognitive therapies with cognitive reconstruction techniques Studies had an average of
4. Behavioral activation 8 sessions, except for
studies [36] and [37],
Five studies were conducted Activities developed in a
Media which had a face-to-face
through computer or Setting group setting, individu- ally Duration session and sent text
telephone resources [or both were also
messages for 26 days. The
mentioned
shortest intervention was
from [38]. The longest
1. The Patient Health Questionnaire (N=6) Test for Data 1. T-Test intervention was from [45]
2. The Center for Epidemiologic Studies Depression (N=4) Analyes 2. ANOVA
3. The Final Questionnaire on Text Messages (N=2) 3. Wilcoxon
4. The Perceived Stress Scale )N=2) 4. Mann-Whitney U test
5. Fisher’s exact test
 2.5 Quality of Studies
The risk of bias in the included
studies was evaluated using the
Joanna Briggs Institute (JBI)
Appraisal Checklist Tools
In our investigation, only those
studies that fulfilled over 50% of the
established requirements were
included. The choice of this cutoff by
our team allowed us to find a balance
between including the studies and
ensuring an acceptable level of
methodological quality and rigor in
our analysis.

Assessed factors that could potentially the provision of payments in exchange

interfere with the performance of the for participation in the study
tests

sample size and/or representativeness, the

Several limitations that may have possibility of response bias, the lack of a control

impacted the reliability and validity of group, the study being conducted with

the finding convenience samples, language issues, and data

collection being self-reported.

Finally, we conducted a Grading of Likert scale ranging from 1 to 4 points,

Recommendations Assessment, and the level of certainty of the
Development and Evaluation (GRADE) to evidence from each study was
assess the level of certainty related to the evaluated as high, moderate, low, or
evidence and identify factors that could very low
contribute to bias in the evidence
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JBI Appraisal Checklist for Randomized Controlled Trial

Non-randomized-JBI Appraisal Checklist for Quasi Experiment Studies

 2.6 Data Analyses to Access PWE

Our analyses aimed to summarize the general effects of the

implementation of the interventions on PWE and to verify the
most suitable approaches for improving the PWE of immigrant
women. To facilitate the identification of results, we defined 2
topics for each synthesis we would conduct.

(1) For the results of the
interventions on the PWE of
immigrant women, studies
were categorized into:
(2) For the evaluation of the
strongest interventions
affecting PWE in immigrant
women, we performed a score
compilation of the best findings
for:

(a) promotion of (a) results in PWE,

psychosocial well- being, (b) quality of studies, and
(b) promotion of (c) descriptive synthesis of
empowerment of the studies
women, and
(c) promotion of both PWE
 3. Results

3.1 Results of the Interventions on PWE of Immigrant Women

Psychosocial well- Empowerment Evaluated of the interventions

being Dynamic process in which
individuals or groups achieve
comprehensive understanding We evaluated the effects of the
and maintain autonomy,
of psychosocial well- interventions on these
independence, and social
being, which encompasses components across studies
participation. This implies, for
various aspects such as mental with experimental groups and
example, being able to manage
health balance, quality of life, studies with experimental and
their own lives and make their
and social interactions. control groups.
own decisions.

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3.1.1 Results of Experimental Studies on PWE of Immigrant Women

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3.1.2 Results of Experimental and Control Studies on PWE of Immigrant Women

 3.2 Strongest Interventions to PWE in Immigrant Women

Psychoeducation Cognitive Restructing Techniques

These interventions were significantly effective in
improving psychosocial well- being related to
improvement of mood and depression levels, general
health, in reducing stress, acculturative stress, post-
traumatic stress, and loneliness.
These interventions were significantly effective in
improving psychosocial well-being in terms of
reducing mood and depression levels, in reducing
stress and post-traumatic stress, and loneliness.

For the empowerment components, the benefits were For the empowerment components, the
related to increased self-esteem, self-efficacy, health benefits were related to increased self-esteem
literacy, general empowerment, safety-related and life purpose
empowerment, active coping, positive reframing, self-
distraction, and planning.

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 4. Discussion
4.1 Effects of Interventions on PWE of Immigrant Women

Psychosocial well- being

self-esteem and self- efficacy
improvements in mood and overall health, reduction of
confident to face new challenges
symptoms of depression, stress, acculturative stress,
anxiety, PTSD, and loneliness social problem-solving skills
these studies were consistent with those that we found
to identify and handle problems and challenges
in our SLR, such as cognitive-behavioral techniques [47–
50], counseling [49], psychoeducation [49,50], art general and safety-related empowerment
therapy [49,50], mindfulness and relaxation [48,49], and
women’s sense of control and security in their
group interpersonal theory [48,49]
live
Empowerment components

counseling, health education/psychoeducation, increase in self-esteem, self-efficacy, general and safety-

and expressive and cognitive therapies delivered related empowerment, health literacy, and life purpose
in groups and/or individually

resulted in significant improvements in active coping,

Psychoeducation and counseling positive reframing, self-distraction, and planning, which
were significantly associated with reduced depressive
symptoms.
 4. Discussion
4.2 Effectiveness of Psychoeducational and Cognitive Restructing Interventions to PWE of
Immigrant Women

Psychoeducational Cognitive Restructing Interventions

Help immigrant women challenge and change negative

Psychoeducation interven- tions sought to provide
thought patterns, promoting a healthier and more
knowledge, skills, and resources to improve immigrant
adaptive perspective on themselves and their
women’s adaptation and well-being.
circumstances

1. Both interventions are accessible and easy to implement, which makes them appropriate for use in clinical and community
settings
2. both are techniques that maintain an objectivity and standardization in their components, which allows for easier measurement,
facilitating the evaluation of their effects on outcomes
3. Both approaches have demonstrated positive results in interventions for migrant and refugee people and their families in different
contexts, such as: health treatment, reproductive health and mental health, detention, or undocumented and empowerment for
migrant groups.
4. Both approaches have found long-lasting effects in the PWE of different populations
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4.3 Limitations and Future Directions

The review identifies a lack of quality in several studies, with only one randomized controlled trial
Lack of Study Quality
being available for inclusion. This limited the ability to perform meta-analyses and obtain reliable
outcomes.

Most of the included studies had low or moderate methodological quality, and there were
Methodological Quality Issues
potential selection and confounding biases present

The heterogeneity among the included studies made it impossible to conduct a meta-analysis,
Heterogeneity in Methods and Results restricting the synthesis of results to a descriptive and qualitative interpretation.

Single-Arm Studies The presence of single-arm studies limited the ability to draw causal inferences from the results

The limited availability of studies on specific interventions for improving PWE in immigrant
Limited Availability of Studies
women contributed to the small number of studies included, making it difficult to generalize the
results to other populations and contexts.

Some studies had very small sample sizes, and the overall sample size of evaluated immigrant
Sample Size and Geographic women was relatively low, which can affect generalizability. The studies were also conducted in
Distribution a limited number of countries, potentially impacting generalizability further.
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4.3 Limitations and Future Directions

Language Barriers Language barriers were present in some studies, affecting participants' ability to understand the
interventions.

Inclusion and Exclusion Inconsistencies in the criteria for including and excluding participants were observed, and the
Criteria Variability allocation of intervention and control groups was not always equivalent.

Limitations related to the restriction of publications to specific languages (English, Spanish,

Publication and Language Bias Portuguese) and the use of specific databases (Scopus and Web of Science) were acknowledged.
Gray literature and unpublished studies were not considered.

The complex and subjective nature of psychosocial well-being and empowerment was noted as a
Complex Nature of PWE
challenge in making objective and comparable assessments across different studies.
 4.3 Limitations and Future Directions

The research suggests several recommendations Recommendations for future research include
for addressing these limitations in future research, adopting a more inclusive approach to language
including using larger and more representative and publication sources, expanding the search to
samples, addressing language barriers include other databases, enhancing search criteria,
comprehensively, establishing clear and considering specific and standardized
inclusion/exclusion criteria, employing randomized assessments or inclusion criteria related to the
allocation methods, and conducting follow-up and PWE construct.
longitudinal studies.

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 4.4 Originality and Implication

1. Our review offers an innovative contribution by providing insights into four types of interventions (counseling,
psychoeducation, cog- nitive therapies, expressive therapies) that have demonstrated efficacy in improving the
psychological well-being of immigrant women
2. Our findings may also contribute to the field, as we provide insights into effective and appropriate interventions for this
population. Through the analysis of the included studies, we found that interventions based on psychoeducation and
cognitive restructuring techniques stood out as the most effective.
3. Our review identified gaps in the literature, which can highlight areas that require further investigation and guide future
studies.

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Thank you!