Strengthening personal and family resilience: a literature review for the leprosy context

Summary Objective: Promoting psychosocial resilience is a concern of health and wellbeing researchers and practitioners in many fields. Enhanced resilience in settings where people face discrimination may enable them to cope more effectively and deal with exclusionary behaviour and may also enable families to become more inclusive. While there are numerous interventions to build personal and family resilience in areas such as mental health, education and HIV/AIDS, this area of focus has not been well consolidated in leprosy-related research. In response, a review was conducted to identify core elements of interventions to promote resilience in individuals and family members in the face of discrimination. Methods: We conducted a multi-phase adapted scoping review of English literature and a narrative review of the Portuguese language literature. All phases comprised the identification of prominent themes across multiple studies and a final synthesis facilitated the identification of key principles to inform and guide leprosy service interventions. Results: We identified three main intervention focus areas in our review: individual level, social/community level and system level. We found that in the face of discrimination, resilience can be strengthened through information provision, counselling and assisting people through coping skills acquisition. Multi-pronged interventions focusing on increasing knowledge and improving self-esteem appear particularly worthwhile. Conclusions: The current review indicated that interventions should be tailored to the audience and should acknowledge the need for sustainability of interventions and durability of outcomes. We concluded that interventions for resilience would be beneficial in the context of leprosy, and potentially other neglected tropical diseases.