We evaluated the effectiveness of community-based rehabilitation (CBR) in reducing depressive symptoms, alcohol use disorder, food insecurity and underweight in people with schizophrenia. This cluster-randomised controlled trial was conducted in a rural district of Ethiopia. Fifty-four sub-districts were allocated in a 1:1 ratio to the facility-based care [FBC] plus CBR arm and the FBC alone arm. Lay workers delivered CBR over 12 months. We assessed food insecurity (self-reported hunger), underweight (BMI< 18.5 kg/m2), depressive symptoms (PHQ-9) and alcohol use disorder (AUDIT ≥ 8) at 6 and 12 months. Seventy-nine participants with schizophrenia in 24 sub-districts were assigned to CBR plus FBC and 87 participants in 24 sub-districts were assigned to FBC only. There was no evidence of an intervention effect on food insecurity (aOR 0.52, 95% CI 0.16–1.67; p = 0.27), underweight (aOR 0.44, 95% CI 0.17–1.12; p = 0.08), alcohol use disorder (aOR 0.82, 95% CI 0.24–2.74; p = 0.74) or depressive symptoms (adjusted mean difference − 0.06, 95% CI −1.35, 1.22; p = 0.92). Psychosocial interventions in low-resource settings should support access to treatment amongst people with schizophrenia, and further research should explore how impacts on economic, physical and mental health outcomes can be achieved.

The aim of this study was to explore aspects contributing to experiences of safety in everyday life for older adults who have received modification services. Qualitative interviews were conducted with eight people. Data were analysed using a comparative approach. Three main categories emanated in the analysis: prerequisites that enable a feeling of safety, strategies that enable safety in everyday life, and use of and reliance on technology impacts on safety. The findings revealed that to feel safe in everyday life was based on three prerequisites: feeling healthy, having someone to rely on and feeling at home. The fulfilment of these prerequisites further impacted on the participants' strategies for handling problems in everyday life but also on the ability to use and benefit from technology such as home modifications. In conclusion, the findings indicated that interventions provided to increase safety for older adults should primarily be focused on the presence and fulfilment of prerequisites and later on other interventions such as technology. Technology such as home modifications and assistive devices was not found in this study to facilitate the feeling of safety unless supported by the fulfilled prerequisites. Implications of these findings for clinical practice are discussed.