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瑙鲁澳大利亚移民拘留中心寻求庇护的儿童和青少年:一项纵向队列研究。

Asylum seeking children and adolescents in Australian immigration detention on Nauru: a longitudinal cohort study.

作者信息

Zwi Karen, Sealy Louise, Samir Nora, Hu Nan, Rostami Reza, Agrawal Rishi, Cherian Sarah, Coleman Jacinta, Francis Josh, Gunasekera Hasantha, Isaacs David, Larcombe Penny, Levitt David, Mares Sarah, Mutch Raewyn, Newman Louise, Raman Shanti, Young Helen, Norwood Christy, Lingam Raghu

机构信息

School of Women's and Children's Health, University of New South Wales - Randwick Campus, Randwick, New South Wales, Australia.

Community Child Health, Sydney Children's Hospitals Network Randwick and Westmead, Westmead, New South Wales, Australia.

出版信息

BMJ Paediatr Open. 2020 Mar 15;4(1):e000615. doi: 10.1136/bmjpo-2019-000615. eCollection 2020.

Abstract

INTRODUCTION

Immigration detention has a profound and negative impact on the physical health, mental health, development and social-emotional well-being of children, adolescents and their families. Australian clinicians will report results from detailed health and well-being assessments of asylum seeking children and adolescents who have experienced prolonged immigration detention.

METHODS AND ANALYSIS

This is a national, multicentre study with a longitudinal cohort design that will document health and well-being outcomes of the children and adolescents who have been detained in offshore detention on the remote island of Nauru. Outcome measures will be reported from the time arrival in Australia and repeated over a 5-year follow-up period. Measures include demographics, residency history and refugee status, physical health and well-being outcomes (including mental health, development and social-emotional well-being), clinical service utilisation and psychosocial risk and protective factors for health and well-being (eg, adverse childhood experiences). Longitudinal follow-up will capture outcomes over a 5-year period after arrival in Australia. Analysis will be undertaken to explore baseline risk and protective factors, with regression analyses to assess their impact on health and well-being outcomes. To understand how children's outcomes change over time, multilevel regression analysis will be utilised. Structural equation modelling will be conducted to explore the correlation between baseline factors, mediational factors and outcomes to assess trajectories over time.

ETHICS AND DISSEMINATION

This research project was approved by the Sydney Children's Hospitals Network Human Research Ethics Committee. Subsequent site-specific approvals have been approved in 5 of the 11 governing bodies where the clinical consultations took place. In order to ensure this research is relevant and sensitive to the needs of the cohort, our research team includes an asylum seeker who has spent time in Australian immigration detention. Results will be presented at conferences and published in peer-reviewed Medline-indexed journals.

摘要

引言

移民拘留对儿童、青少年及其家庭的身体健康、心理健康、发展以及社会情感幸福有着深远的负面影响。澳大利亚临床医生将报告对经历长期移民拘留的寻求庇护儿童和青少年进行详细健康与幸福评估的结果。

方法与分析

这是一项采用纵向队列设计的全国性多中心研究,将记录被拘留在瑙鲁偏远岛屿境外拘留中心的儿童和青少年的健康与幸福状况。结果指标将从抵达澳大利亚时开始报告,并在5年的随访期内重复测量。测量内容包括人口统计学、居住史和难民身份、身体健康与幸福状况(包括心理健康、发展以及社会情感幸福)、临床服务利用情况以及健康与幸福的心理社会风险和保护因素(例如童年不良经历)。纵向随访将记录抵达澳大利亚后5年内的结果。将进行分析以探索基线风险和保护因素,并通过回归分析评估它们对健康与幸福状况的影响。为了解儿童的结果如何随时间变化,将采用多水平回归分析。将进行结构方程建模,以探索基线因素、中介因素与结果之间的相关性,从而评估随时间的轨迹。

伦理与传播

本研究项目已获得悉尼儿童医院网络人类研究伦理委员会的批准。在进行临床咨询的11个管理机构中的5个已批准了后续的特定地点批准。为确保本研究与该队列的需求相关且敏感,我们的研究团队包括一名曾在澳大利亚移民拘留中心待过的寻求庇护者。研究结果将在会议上展示,并发表在同行评审的被Medline索引的期刊上。

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