Insecurity, distress and mental health: experimental and randomized controlled trials of a psychosocial intervention for youth affected by the Syrian crisis / Catherine PANTER-BRICK in Journal of Child Psychology and Psychiatry, 59-5 (May 2018)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 59-5 (May 2018) . - p.523-541 Titre : Insecurity, distress and mental health: experimental and randomized controlled trials of a psychosocial intervention for youth affected by the Syrian crisis Type de document : Texte imprimé et/ou numérique Auteurs : Catherine PANTER-BRICK, Auteur ; R. DAJANI, Auteur ; M. EGGERMAN, Auteur ; S. HERMOSILLA, Auteur ; A. SANCILIO, Auteur ; Alastair AGER, Auteur Article en page(s) : p.523-541 Langues : Anglais (eng) Mots-clés : Mental health and psychosocial support  evaluation  forced displacement  implementation science  refugees  war Index. décimale : PER Périodiques Résumé : BACKGROUND: Strengthening the evidence base for humanitarian interventions that provide psychosocial support to war-affected youth is a key priority. We tested the impacts of an 8-week programme of structured activities informed by a profound stress attunement (PSA) framework (Advancing Adolescents), delivered in group-format to 12-18 year-olds in communities heavily affected by the Syrian crisis. We included both Syrian refugee and Jordanian youth. METHODS: We followed an experimental design, comparing treatment youth and wait-list controls over two programme implementation cycles, randomizing to study arm in cycle 2 (ClinicalTrials.gov ID: NCT03012451). We measured insecurity, distress, mental health difficulties, prosocial behaviour and post-traumatic stress symptoms at three time-points: baseline (n = 817 youth; 55% Syrian, 43% female), postintervention (n = 463; 54% Syrian, 47% female), and follow-up (n = 212, 58% Syrian, 43% female). Regression models assessed: prospective intervention impacts, adjusting for baseline scores, trauma exposure, age, and gender; differential impacts across levels of trauma exposure and activity-based modality; and sustained recovery 1 year later. We analysed cycle-specific and cycle-pooled data for youth exclusively engaged in Advancing Adolescents and for the intent-to-treat sample. RESULTS: We found medium to small effect sizes for all psychosocial outcomes, namely Human Insecurity (beta = -7.04 (95% CI: -10.90, -3.17), Cohen's d = -0.4), Human Distress (beta = -5.78 (-9.02, -2.54), d = -0.3), and Perceived Stress (beta = -1.92 (-3.05, -0.79), d = -0.3); and two secondary mental health outcomes (AYMH: beta = -3.35 (-4.68, -2.02), d = -0.4; SDQ: beta = -1.46 (-2.42, -0.50), d = -0.2). We found no programme impacts for prosocial behaviour or post-traumatic stress reactions. Beneficial impacts were stronger for youth with exposure to four trauma events or more. While symptoms alleviated for both intervention and control groups over time, there were sustained effects of the intervention on Human Insecurity. CONCLUSIONS: Findings strengthen the evidence base for mental health and psychosocial programming for a generation affected by conflict and forced displacement. We discuss implications for programme implementation and evaluation research. En ligne : http://dx.doi.org/10.1111/jcpp.12832 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=359 [article] Insecurity, distress and mental health: experimental and randomized controlled trials of a psychosocial intervention for youth affected by the Syrian crisis [Texte imprimé et/ou numérique] / Catherine PANTER-BRICK, Auteur ; R. DAJANI, Auteur ; M. EGGERMAN, Auteur ; S. HERMOSILLA, Auteur ; A. SANCILIO, Auteur ; Alastair AGER, Auteur . - p.523-541. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 59-5 (May 2018) . - p.523-541 Mots-clés : Mental health and psychosocial support  evaluation  forced displacement  implementation science  refugees  war Index. décimale : PER Périodiques Résumé : BACKGROUND: Strengthening the evidence base for humanitarian interventions that provide psychosocial support to war-affected youth is a key priority. We tested the impacts of an 8-week programme of structured activities informed by a profound stress attunement (PSA) framework (Advancing Adolescents), delivered in group-format to 12-18 year-olds in communities heavily affected by the Syrian crisis. We included both Syrian refugee and Jordanian youth. METHODS: We followed an experimental design, comparing treatment youth and wait-list controls over two programme implementation cycles, randomizing to study arm in cycle 2 (ClinicalTrials.gov ID: NCT03012451). We measured insecurity, distress, mental health difficulties, prosocial behaviour and post-traumatic stress symptoms at three time-points: baseline (n = 817 youth; 55% Syrian, 43% female), postintervention (n = 463; 54% Syrian, 47% female), and follow-up (n = 212, 58% Syrian, 43% female). Regression models assessed: prospective intervention impacts, adjusting for baseline scores, trauma exposure, age, and gender; differential impacts across levels of trauma exposure and activity-based modality; and sustained recovery 1 year later. We analysed cycle-specific and cycle-pooled data for youth exclusively engaged in Advancing Adolescents and for the intent-to-treat sample. RESULTS: We found medium to small effect sizes for all psychosocial outcomes, namely Human Insecurity (beta = -7.04 (95% CI: -10.90, -3.17), Cohen's d = -0.4), Human Distress (beta = -5.78 (-9.02, -2.54), d = -0.3), and Perceived Stress (beta = -1.92 (-3.05, -0.79), d = -0.3); and two secondary mental health outcomes (AYMH: beta = -3.35 (-4.68, -2.02), d = -0.4; SDQ: beta = -1.46 (-2.42, -0.50), d = -0.2). We found no programme impacts for prosocial behaviour or post-traumatic stress reactions. Beneficial impacts were stronger for youth with exposure to four trauma events or more. While symptoms alleviated for both intervention and control groups over time, there were sustained effects of the intervention on Human Insecurity. CONCLUSIONS: Findings strengthen the evidence base for mental health and psychosocial programming for a generation affected by conflict and forced displacement. We discuss implications for programme implementation and evaluation research. En ligne : http://dx.doi.org/10.1111/jcpp.12832 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=359

Short- and longer-term impacts of Child Friendly Space Interventions in Rwamwanja Refugee Settlement, Uganda / J. METZLER in Journal of Child Psychology and Psychiatry, 60-11 (November 2019)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 60-11 (November 2019) . - p.1152-1163 Titre : Short- and longer-term impacts of Child Friendly Space Interventions in Rwamwanja Refugee Settlement, Uganda Type de document : Texte imprimé et/ou numérique Auteurs : J. METZLER, Auteur ; K. DIACONU, Auteur ; S. HERMOSILLA, Auteur ; R. KAIJUKA, Auteur ; G. EBULU, Auteur ; K. SAVAGE, Auteur ; Alastair AGER, Auteur Article en page(s) : p.1152-1163 Langues : Anglais (eng) Mots-clés : Humanitarian crisis  impact  longitudinal  protection  psychosocial support  refugees Index. décimale : PER Périodiques Résumé : BACKGROUND: The establishment of Child Friendly Spaces (CFSs) has become a widespread intervention targeting protection and support for displaced children in humanitarian contexts. There is a lack of evidence of impact of these interventions with respect to both short-term outcomes and longer-term developmental trajectories. METHODS: We collected data from caregivers of Congolese refugee children residing in Rwamwanja Refugee Settlement at three timepoints. To assess short-term impact of CFSs, we compared indicators assessed shortly after refugees' arrival (baseline, T1) and endline (T2, three to six months after CFS implementation) amongst 430 CFS attenders and 161 nonattenders. Follow-up assessments after the end of CFS programming were conducted 18 months post-baseline (T3) with caregivers of 249 previous CFS attenders and 77 CFS nonattenders. RESULTS: In the short-term, attendance at CFSs was associated with better maintenance of psychosocial well-being (PSWB; beta = 2.093, p < .001, Cohen's d = .347) and greater increases in developmental assets (beta = 2.517, p < .001, Cohen's d = .231), with significantly stronger impacts for girls. CFS interventions meeting higher programing quality criteria were associated with greater impact on both PSWB and development assets (beta = 2.603 vs. beta = 1.793 and beta = 2.942 vs. beta = 2.337 for attenders at higher and lower-quality CFSs c.f. nonattenders, respectively). Amongst boys, benefits of program attendance were only indicated for those attending higher-quality CFS (beta = 2.084, p = .006 for PSWB). At follow-up, however, there were no discernable impacts of prior CFS attendance on any measures. Age and school attendance were the only characteristics that predicted an outcome - developmental assets - at follow-up. CONCLUSIONS: Attendance at CFSs - particularly involving higher-quality programming - supported children's well-being and development. However, sustained impact beyond active CFS programming was not demonstrated. Intervention goals and strategies in humanitarian contexts need to address the challenge of connecting children to other resources to facilitate developmental progress in conditions of protracted displacement. En ligne : http://dx.doi.org/10.1111/jcpp.13069 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=408 [article] Short- and longer-term impacts of Child Friendly Space Interventions in Rwamwanja Refugee Settlement, Uganda [Texte imprimé et/ou numérique] / J. METZLER, Auteur ; K. DIACONU, Auteur ; S. HERMOSILLA, Auteur ; R. KAIJUKA, Auteur ; G. EBULU, Auteur ; K. SAVAGE, Auteur ; Alastair AGER, Auteur . - p.1152-1163. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 60-11 (November 2019) . - p.1152-1163 Mots-clés : Humanitarian crisis  impact  longitudinal  protection  psychosocial support  refugees Index. décimale : PER Périodiques Résumé : BACKGROUND: The establishment of Child Friendly Spaces (CFSs) has become a widespread intervention targeting protection and support for displaced children in humanitarian contexts. There is a lack of evidence of impact of these interventions with respect to both short-term outcomes and longer-term developmental trajectories. METHODS: We collected data from caregivers of Congolese refugee children residing in Rwamwanja Refugee Settlement at three timepoints. To assess short-term impact of CFSs, we compared indicators assessed shortly after refugees' arrival (baseline, T1) and endline (T2, three to six months after CFS implementation) amongst 430 CFS attenders and 161 nonattenders. Follow-up assessments after the end of CFS programming were conducted 18 months post-baseline (T3) with caregivers of 249 previous CFS attenders and 77 CFS nonattenders. RESULTS: In the short-term, attendance at CFSs was associated with better maintenance of psychosocial well-being (PSWB; beta = 2.093, p < .001, Cohen's d = .347) and greater increases in developmental assets (beta = 2.517, p < .001, Cohen's d = .231), with significantly stronger impacts for girls. CFS interventions meeting higher programing quality criteria were associated with greater impact on both PSWB and development assets (beta = 2.603 vs. beta = 1.793 and beta = 2.942 vs. beta = 2.337 for attenders at higher and lower-quality CFSs c.f. nonattenders, respectively). Amongst boys, benefits of program attendance were only indicated for those attending higher-quality CFS (beta = 2.084, p = .006 for PSWB). At follow-up, however, there were no discernable impacts of prior CFS attendance on any measures. Age and school attendance were the only characteristics that predicted an outcome - developmental assets - at follow-up. CONCLUSIONS: Attendance at CFSs - particularly involving higher-quality programming - supported children's well-being and development. However, sustained impact beyond active CFS programming was not demonstrated. Intervention goals and strategies in humanitarian contexts need to address the challenge of connecting children to other resources to facilitate developmental progress in conditions of protracted displacement. En ligne : http://dx.doi.org/10.1111/jcpp.13069 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=408

---

1 (1 - 2 / 2)