American University of Beirut, Beirut, Lebanon.
Glob Health Sci Pract. 2022 Feb 28;10(1). doi: 10.9745/GHSP-D-21-00079.
Implementing and evaluating interventions in humanitarian settings in low- and middle-income countries presents unique challenges that are little addressed in the implementation literature. We document the process of developing, implementing, and evaluating the Amenah pilot intervention that aimed to mitigate the drivers of early marriage in a Syrian refugee community in Lebanon. Adolescent girls' vulnerability to early marriage increases following displacement due to poverty, insecurity, and school disruptions. We delineate how, as a local research team, we triangulated evidence from the international literature and formative community research to make informed decisions during the intervention's design and implementation phases. The pilot was delivered to 203 Syrian refugee schoolgirls aged 11-14 years during the 2017-2018 academic year. It consisted of 16 structured, interactive sessions with girls and a set of facilitated meetings with the girls' mothers, both of which were implemented by trained female community workers from the Syrian refugee community. Process evaluation results showed that sociodemographic factors predicted attendance among mothers, but relationships with peers in the intervention were the only significant predictor of attendance among girls. The primary outcomes of the pilot were attitudinal measures related to education and marriage. Attitudes toward education were highly positive at baseline and did not change over the course of the intervention. There were no significant changes in girls' ideal age at marriage. Among girls aged 13 and older at endline, the mean self-reported expected age at marriage increased slightly from 20.2 to 20.8 years (<.05). Our results also suggest that girls may adjust their expected age at marriage downward as they become older and if they drop out of school. We reflect in the discussion on some of the challenges encountered and lessons learned for the benefit of researchers intending to conduct community-based interventions in displacement settings.
在中低收入国家的人道主义环境中实施和评估干预措施带来了独特的挑战，而这些挑战在实施文献中很少得到解决。我们记录了开发、实施和评估 Amenah 试点干预措施的过程，该措施旨在减轻黎巴嫩叙利亚难民社区中早婚的驱动因素。由于贫困、不安全和学校中断，青少年女孩在流离失所后面临更早结婚的风险增加。我们阐述了作为一个当地研究团队，我们如何将国际文献和形成性社区研究的证据相结合，在干预设计和实施阶段做出明智的决策。该试点在 2017-2018 学年期间向 203 名 11-14 岁的叙利亚难民女学生提供服务。它包括 16 次与女孩的结构化互动课程和一系列与女孩母亲的促进会议，这些都是由来自叙利亚难民社区的受过培训的女性社区工作者实施的。过程评估结果表明，社会人口因素预测了母亲的出勤率，但与干预中的同龄人关系是女孩出勤率的唯一显著预测因素。该试点的主要结果是与教育和婚姻相关的态度衡量标准。在干预开始时，女孩对教育的态度非常积极，而且在整个干预过程中没有变化。女孩理想结婚年龄没有显著变化。在期末年龄为 13 岁及以上的女孩中，自我报告的预期结婚年龄平均略有从 20.2 岁增加到 20.8 岁（<.05）。我们的结果还表明，女孩可能会根据自己的年龄和是否辍学，向下调整自己的预期结婚年龄。我们在讨论中反思了一些遇到的挑战和吸取的教训，以便为打算在流离失所环境中进行基于社区的干预措施的研究人员提供参考。
