Clinical, Neuro and Developmental Psychology, VU University, Amsterdam, The Netherlands.
School of Psychology, University of New South Wales, Sydney, Australia.
Eur J Psychotraumatol. 2021 Nov 29;12(1):1901408. doi: 10.1080/20008198.2021.1901408. eCollection 2021.
Most refugees are less than 18 years and at heightened risk of common mental disorders (CMDs) relative to other youth. Limited evidence exists for psychosocial programsfor youth in low-resource settings. Early Adolescent Skills for Emotions (EASE) was developed by the World Health Organization to address this gap.
This study tested the safety, feasibility, and trial procedures of the EASE intervention among Syrian refugee youth in preparation for a definitive randomized controlled trial (RCT).
A feasibility RCT was conducted in Amman, Jordan with Syrian children aged 10-14 years who reported psychological distress. Following community screening, youth and their caregivers were randomized to receive either the EASE intervention or enhanced treatment as usual (ETAU). EASE comprised seven group sessions teaching children coping skills, and caregivers received three group sessions to augment the youth sessions. Assessments were conducted at baseline and 1 week following the last EASE session (8 weeks following baseline). Following the trial, a qualitative process evaluation with staff and beneficiaries took place. Primary outcomes were safety and feasibility indicators, and distress was measured by the Paediatric Symptom Checklist.
In November 2018, 179 children were screened; 61 (33%) met criteria for distress (34.1%), two were excluded for suicidal risk, and 59 were randomized (EASE = 33, ETAU = 26). Of those who received EASE, 26 children (79%) completed the intervention. Group attendance was high and no adverse events were reported in either arm. Psychological distress did not show signs of abating in either group over time.
This feasibility trial demonstrated the safety and acceptability of the intervention. Important lessons were learnt regarding entry criteria into the study and engagement of caregivers in the intervention. A fully powered randomized controlled trial will be conducted to evaluate the efficacy of EASE.
大多数难民年龄在 18 岁以下，与其他年轻人相比，他们更容易出现常见精神障碍（CMD）。在资源匮乏的环境中，针对青年的心理社会方案的相关证据有限。为此，世界卫生组织开发了青少年情绪技能早期干预（EASE）项目，以解决这一空白。
本研究旨在为一项确定性随机对照试验（RCT）做准备，测试 EASE 干预措施在叙利亚难民青年中的安全性、可行性和试验程序。
在约旦安曼进行了一项可行性 RCT，入组对象为报告有心理困扰的 10-14 岁叙利亚儿童及其照护者。在社区筛查后，将青少年及其照护者随机分配至接受 EASE 干预或增强的常规治疗（ETAU）。EASE 包含 7 个小组课程，教授儿童应对技能，同时为增强青少年小组课程的效果，照护者也将参加 3 个小组课程。基线和最后一次 EASE 课程结束后 1 周（基线后 8 周）进行评估。试验结束后，工作人员和受益人开展了定性过程评估。主要结局指标为安全性和可行性指标，采用儿科症状清单（PSC）评估困扰程度。
2018 年 11 月，对 179 名儿童进行了筛查；61 名（33%）符合困扰标准（34.1%），2 名因自杀风险被排除，59 名被随机分组（EASE 组 33 名，ETAU 组 26 名）。EASE 组中，26 名儿童（79%）完成了干预。组内出席率高，两组均未报告不良事件。随着时间的推移，两组的心理困扰均未见缓解迹象。
这项可行性试验证明了干预措施的安全性和可接受性。在研究纳入标准和照护者参与干预方面，本研究获得了重要经验。将开展一项全面的 RCT，以评估 EASE 的疗效。
