Department of Pediatrics, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA.
Department of Psychological Sciences, University of Connecticut, 1 University Pl, Stamford, CT 06901, USA.
Health Educ Res. 2024 Mar 20;39(2):119-130. doi: 10.1093/her/cyad034.
Many refugee children experience trauma in early childhood. Effective, tailored interventions are needed to improve refugee children's access to preventive mental health. We interviewed refugee-serving stakeholders and parents participating in an evidence-based preventive mental health and wellness intervention adapted for Afghan refugee children and families who may have experienced trauma. Interview guide development was informed by two implementation science frameworks: the Consolidated Framework for Implementation Research and the Model for Adaptation Design and Impact. A three-person team coded transcripts via rapid qualitative analysis, and the study team reached consensus on themes. Six refugee-serving facilitators and five refugee parents discussed key determinants of successful implementation. Themes included: (i) modeling cultural humility to promote communication about emotions; (ii) needed linguistic support and referral networks to avoid miscommunications and missed communications; (iii) bridging connections between children, families and schools; (iv) different takeaways, or differing goals and expectations between facilitators and participants; and (v) timely, specific cultural considerations to overcome participation barriers. Overall, we found key determinants of successful implementation of a preventive mental health and wellness intervention for refugee children and families included adaptations to enhance cultural humility and sensitivity to cultural context while strengthening communication among facilitators, children and families.
许多难民儿童在童年早期经历过创伤。需要有效的、量身定制的干预措施来改善难民儿童获得预防性心理健康服务的机会。我们采访了为难民服务的利益相关者和参与为可能经历过创伤的阿富汗难民儿童和家庭改编的基于证据的预防性心理健康和健康干预措施的家长。访谈指南的制定是基于两个实施科学框架：实施研究综合框架和适应设计与影响模型。一个三人小组通过快速定性分析对抄本进行编码，研究小组就主题达成共识。六名难民服务协调员和五名难民家长讨论了成功实施的关键决定因素。主题包括：（i）树立文化谦逊的榜样，以促进关于情绪的沟通；（ii）需要语言支持和转介网络，以避免误解和沟通不畅；（iii）在儿童、家庭和学校之间建立联系；（iv）协调员和参与者之间的不同收获，或不同的目标和期望；以及（v）及时、具体的文化考虑因素，以克服参与障碍。总的来说，我们发现，为难民儿童和家庭实施预防性心理健康和健康干预措施的关键决定因素包括对文化谦逊和文化背景敏感性的适应，同时加强协调员、儿童和家庭之间的沟通。
