Ghandour Lilian, Brown Grant, Tleis Malak, Al Masri Hanan, Fares Marwa, Al Halabi Fadi, Najjar Yamen, Louis Bayan, Afifi Rima A, Nakkash Rima
American University of Beirut, Beirut, Lebanon.
Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa, USA
BMJ Open. 2024 Dec 5;14(12):e087777. doi: 10.1136/bmjopen-2024-087777.
In this work, which forms part of a larger study of a longitudinal intervention focused on empowering Community Mental Health Workers in a humanitarian context, we examine changes in and correlates of well-being of refugees as a result of discriminatory practices by the State, with comparisons motivated by a mechanistic model of well-being.
This cohort study examines well-being at a single follow-up time as predicted by baseline characteristics in response to a changing social conditions including security raids on our participants; the parent interventional randomised trial focuses on a population of youth in a refugee context, but the present work precedes the main intervention period.
Refugee populations are among the most vulnerable globally, and the total refugee population is growing dramatically. As of 2022, more than 12 million Syrians have been forcibly displaced with 6.5 million of them classified as refugees. In Lebanon specifically, tension between refugees and the host government has recently risen most evident through security raids, threatening the well-being of already displaced persons.
The study recruited Syrian refugee young adults (18-24 years) who have completed at least high school; additional inclusion criteria included: living in the catchment areas within the Bekaa at the time of screening, having been involved in non-governmental organisations (NGOs) or service to their community and having expressed motivation to serve their community. Applicants who fit the inclusion criteria were further screened by a psychiatrist to ensure that they were not experiencing acute distress at the time of recruitment (February 2023-March 2023). Recruitment occurred through posters on social media platforms of Multi-Aid Programmes. Ninety-two young adults were randomly assigned to one of the three randomised controlled trial arms.
None at the time of the study.
Primary outcomes were measures of well-being at baseline and follow-up.
We find that the ability of NGOs to work with refugee populations may be threatened in important ways by government security raids, with possibly the most vulnerable subjects participating at baseline being less likely to respond during the raids. Moreover, we discuss the paradoxical short-term effects of the isolation induced by the raids, where daily experience of stigmatising events actually decreased during this period.
These results highlight the challenging environment in which refugees in Lebanon live in, and raise important questions about long-term solutions to the crisis.
NCT05265611; LBCTR2023015206.
本研究是一项更大规模纵向干预研究的一部分，该纵向干预研究聚焦于在人道主义背景下增强社区心理健康工作者的能力。我们考察了因国家歧视性做法导致的难民幸福感变化及其相关因素，并依据幸福感的机制模型进行了比较。
这项队列研究在单一随访时间点考察幸福感，该幸福感由基线特征预测，以应对不断变化的社会状况，包括对我们参与者的安全突袭；母体干预随机试验聚焦于难民背景下的青年人群，但本研究在主要干预期之前进行。
难民群体是全球最脆弱的群体之一，全球难民总数正在急剧增长。截至2022年，超过1200万叙利亚人被迫流离失所，其中650万人被归类为难民。特别是在黎巴嫩，难民与东道国政府之间的紧张关系最近有所加剧，最明显的表现是安全突袭，这威胁到了已经流离失所者的幸福感。
该研究招募了至少完成高中学业的叙利亚难民青年（18 - 24岁）；其他纳入标准包括：筛查时居住在贝卡地区的集水区内，曾参与非政府组织（NGO）或为其社区提供服务，并表达了为社区服务的意愿。符合纳入标准的申请者由一名精神科医生进一步筛查，以确保他们在招募时（2023年2月 - 2023年3月）没有经历急性痛苦。通过多援助项目在社交媒体平台上张贴海报进行招募。92名青年被随机分配到三个随机对照试验组之一。
研究期间无干预措施。
主要结局是基线和随访时的幸福感测量。
我们发现，政府的安全突袭可能会在重要方面威胁到非政府组织为难民群体开展工作的能力，可能在基线时参与度最高的最脆弱受试者在突袭期间做出回应的可能性较小。此外，我们讨论了突袭导致的隔离所产生的自相矛盾的短期影响，在此期间，遭受污名化事件的日常经历实际上有所减少。
这些结果凸显了黎巴嫩难民所处的具有挑战性的环境，并提出了有关该危机长期解决方案的重要问题。
NCT05265611；LBCTR2023015206。
