Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, Massachusetts.
Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, Massachusetts.
J Adolesc Health. 2020 Mar;66(3):336-344. doi: 10.1016/j.jadohealth.2019.08.023. Epub 2019 Nov 5.
There are disparities in mental health of refugee youth compared with the general U.S.
We conducted a pilot feasibility and acceptability trial of the home-visiting Family Strengthening Intervention for refugees (FSI-R) using a community-based participatory research approach. The FSI-R aims to promote youth mental health and family relationships. We hypothesized that FSI-R families would have better psychosocial outcomes and family functioning postintervention compared with care-as-usual (CAU) families. We hypothesized that FSI-R would be feasible to implement and accepted by communities.
A total of 40 Somali Bantu (n = 103 children, 58.40% female; n = 43 caregivers, 79.00% female) and 40 Bhutanese (n = 49 children, 55.30% female; n = 62 caregivers, 54.00% female) families were randomized to receive FSI-R or CAU. Refugee research assistants conducted psychosocial assessments pre- and post-intervention, and home visitors delivered the preventive intervention. Multilevel modeling assessed the effects of FSI-R. Feasibility was measured from retention, and acceptability was measured from satisfaction surveys.
The retention rate of 82.50% indicates high feasibility, and high reports of satisfaction (81.50%) indicate community acceptance. Across communities, FSI-R children reported reduced traumatic stress reactions, and caregivers reported fewer child depression symptoms compared with CAU families (β = -.42; p = .03; β = -.34; p = .001). Bhutanese FSI-R children reported reduced family arguing (β = -1.32; p = .04) and showed fewer depression symptoms and conduct problems by parent report (β = -9.20; p = .04; β = -.92; p = .01) compared with CAU. There were no significant differences by group on other measures.
A family-based home-visiting preventive intervention can be feasible and acceptable and has promise for promoting mental health and family functioning among refugees.
与美国普通人群相比，难民青年的心理健康存在差异。
我们采用社区参与式研究方法，对面向难民的家访家庭强化干预（FSI-R）进行了一项试点可行性和可接受性试验。FSI-R 的目的是促进青年的心理健康和家庭关系。我们假设与常规护理（CAU）家庭相比，FSI-R 家庭在干预后会有更好的社会心理结果和家庭功能。我们假设 FSI-R 实施起来具有可行性，并且社区能够接受。
共有 40 名索马里班图人（n=103 名儿童，58.40%为女性；n=43 名照顾者，79.00%为女性）和 40 名不丹人（n=49 名儿童，55.30%为女性；n=62 名照顾者，54.00%为女性）家庭被随机分配接受 FSI-R 或 CAU。难民研究助理在干预前后进行社会心理评估，家访员提供预防干预。多层次模型评估了 FSI-R 的效果。保留率为 82.50%，表明具有很高的可行性，而满意度的高报告（81.50%）表明社区接受度。在各个社区中，FSI-R 儿童报告的创伤后应激反应减少，照顾者报告的儿童抑郁症状少于 CAU 家庭（β=-.42；p=.03；β=-.34；p=.001）。与 CAU 相比，不丹 FSI-R 儿童报告的家庭争吵减少（β=-1.32；p=.04），并且父母报告的抑郁症状和行为问题较少（β=-9.20；p=.04；β=-.92；p=.01）。在其他措施上，两组之间没有显著差异。
基于家庭的家访预防干预措施是可行和可接受的，有望促进难民的心理健康和家庭功能。
