Improving adolescent mental health and protection in humanitarian settings: longitudinal findings from a multi-arm randomized controlled trial of child-friendly spaces among South Sudanese refugees in Uganda / Janna METZLER in Journal of Child Psychology and Psychiatry, 64-6 (June 2023)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 64-6 (June 2023) . - p.907-917 Titre : Improving adolescent mental health and protection in humanitarian settings: longitudinal findings from a multi-arm randomized controlled trial of child-friendly spaces among South Sudanese refugees in Uganda Type de document : texte imprimé Auteurs : Janna METZLER, Auteur ; Terry SAW, Auteur ; Denis NONO, Auteur ; Agatha KADONDI, Auteur ; Yuan ZHANG, Auteur ; Cheng-Shiun LEU, Auteur ; Aimyleen GABRIEL, Auteur ; Kevin SAVAGE, Auteur ; Cassie LANDERS, Auteur Article en page(s) : p.907-917 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Background The effects of conflict and displacement on adolescent mental health and protection are profound and can have lasting consequences. We aimed to investigate the effectiveness of two group-based psychosocial interventions on mental health and protection of South Sudanese refugee adolescents. Methods A randomized controlled trial was done in four villages within the Omugo extension of Rhino Camp refugee settlement in the West Nile region of Uganda. Male and female adolescents (aged 9-14 years) were randomly assigned to attend 12 weeks of either a Standard psychosocial intervention delivered in a child-friendly space (CFS) or a more structured sequential delivery of psychosocial sessions guided by a newly developed Toolkit for Child-Friendly Spaces in Humanitarian Settings. The primary outcomes were psychological distress and resilience 12 months after baseline assessment. The trial is registered with ClinicalTrials.gov, NCT03897894. Results Between May 28, 2019, and February 20, 2020, 1,280 eligible adolescents were recruited. With 70.2% retention at follow-up, 214 assigned to the Standard, 211 assigned to the Toolkit, and 370 assigned to the waitlist control were included in the intention-to-treat and as-treated analysis. Both the Toolkit and Standard approaches were more effective in reducing psychological distress and perceived protection risks reported by adolescents compared to no intervention. Differential intervention impacts are indicated in subgroup analyses. Conclusions The trial found that both psychosocial interventions when implemented in a CFS are well suited as a first-line mental health and violence prevention intervention for adolescent populations exposed to conflict and forced displacement. Where feasible, CFS should be implemented as a primary response strategy soon after displacement to improve psychological health and reduce the risk environment for adolescents. En ligne : http://dx.doi.org/https://doi.org/10.1111/jcpp.13746 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=504 [article] Improving adolescent mental health and protection in humanitarian settings: longitudinal findings from a multi-arm randomized controlled trial of child-friendly spaces among South Sudanese refugees in Uganda [texte imprimé] / Janna METZLER, Auteur ; Terry SAW, Auteur ; Denis NONO, Auteur ; Agatha KADONDI, Auteur ; Yuan ZHANG, Auteur ; Cheng-Shiun LEU, Auteur ; Aimyleen GABRIEL, Auteur ; Kevin SAVAGE, Auteur ; Cassie LANDERS, Auteur . - p.907-917. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 64-6 (June 2023) . - p.907-917 Index. décimale : PER Périodiques Résumé : Background The effects of conflict and displacement on adolescent mental health and protection are profound and can have lasting consequences. We aimed to investigate the effectiveness of two group-based psychosocial interventions on mental health and protection of South Sudanese refugee adolescents. Methods A randomized controlled trial was done in four villages within the Omugo extension of Rhino Camp refugee settlement in the West Nile region of Uganda. Male and female adolescents (aged 9-14 years) were randomly assigned to attend 12 weeks of either a Standard psychosocial intervention delivered in a child-friendly space (CFS) or a more structured sequential delivery of psychosocial sessions guided by a newly developed Toolkit for Child-Friendly Spaces in Humanitarian Settings. The primary outcomes were psychological distress and resilience 12 months after baseline assessment. The trial is registered with ClinicalTrials.gov, NCT03897894. Results Between May 28, 2019, and February 20, 2020, 1,280 eligible adolescents were recruited. With 70.2% retention at follow-up, 214 assigned to the Standard, 211 assigned to the Toolkit, and 370 assigned to the waitlist control were included in the intention-to-treat and as-treated analysis. Both the Toolkit and Standard approaches were more effective in reducing psychological distress and perceived protection risks reported by adolescents compared to no intervention. Differential intervention impacts are indicated in subgroup analyses. Conclusions The trial found that both psychosocial interventions when implemented in a CFS are well suited as a first-line mental health and violence prevention intervention for adolescent populations exposed to conflict and forced displacement. Where feasible, CFS should be implemented as a primary response strategy soon after displacement to improve psychological health and reduce the risk environment for adolescents. En ligne : http://dx.doi.org/https://doi.org/10.1111/jcpp.13746 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=504

Short- and longer-term impacts of Child Friendly Space Interventions in Rwamwanja Refugee Settlement, Uganda / Janna 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 Auteurs : Janna METZLER, Auteur ; Karin DIACONU, Auteur ; Sabrina HERMOSILLA, Auteur ; Robert KAIJUKA, Auteur ; George EBULU, Auteur ; Kevin 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] / Janna METZLER, Auteur ; Karin DIACONU, Auteur ; Sabrina HERMOSILLA, Auteur ; Robert KAIJUKA, Auteur ; George EBULU, Auteur ; Kevin 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

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