Addressing Mental Health Disparities in Refugee Children: A Community-based Participatory Research (CBPR) Collaboration
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Psychiatric, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 5 - Any |
| Updated: | 1/6/2019 |
| Start Date: | August 2016 |
| End Date: | February 2019 |
Addressing Mental Health Disparities in Refugee Children: A CBPR Collaboration
This study will use CBPR mixed methods (qualitative and quantitative data collection) to
conduct needs assessments and design and evaluate a core family-based intervention. Project
activities will emphasize capacity building in two refugee communities resettled in Greater
Boston—the Somali Bantu and the Bhutanese—actively engaging refugee community members,
community advisory boards, services providers, and other stakeholders. Specific Aims are to:
(1) deepen partnerships with the Somali Bantu and Bhutanese communities through
co-leadership, capacity-building, and knowledge sharing; (2) collect and apply qualitative
data to (a) prepare a needs assessment of mental health in children and adolescents, barriers
to care, and services preferences with each target refugee group; (b) develop mental
health/psychosocial assessments for refugee caregivers and children; (c) adapt the core
components of a family-based strengthening intervention for use with refugees; and (3)
conduct an 80-family pilot study to examine acceptability and sustainability of the
intervention. Key outcomes will be reduced mental health symptoms among children and
adolescents and improvement in caregiver-child relationships.
conduct needs assessments and design and evaluate a core family-based intervention. Project
activities will emphasize capacity building in two refugee communities resettled in Greater
Boston—the Somali Bantu and the Bhutanese—actively engaging refugee community members,
community advisory boards, services providers, and other stakeholders. Specific Aims are to:
(1) deepen partnerships with the Somali Bantu and Bhutanese communities through
co-leadership, capacity-building, and knowledge sharing; (2) collect and apply qualitative
data to (a) prepare a needs assessment of mental health in children and adolescents, barriers
to care, and services preferences with each target refugee group; (b) develop mental
health/psychosocial assessments for refugee caregivers and children; (c) adapt the core
components of a family-based strengthening intervention for use with refugees; and (3)
conduct an 80-family pilot study to examine acceptability and sustainability of the
intervention. Key outcomes will be reduced mental health symptoms among children and
adolescents and improvement in caregiver-child relationships.
The proposed mixed methods study will apply CBPR methods in an innovative, cross-cultural
project to assess mental health problems in children and community strengths in two refugee
communities—the Somali Bantu and the Bhutanese—and to design and pilot test a family-based
intervention for refugees in their native languages (Somali Bantu Maay Maay and the Nepali
language used by Bhutanese refugees). We will use qualitative research methods developed in
preliminary research with the Somali Bantu to identify local conceptualizations of mental
health problems, resilience, attitudes about healing and help-seeking, and preferences for
mental health services among resettled Bhutanese. The CBPR team will collaborate on mental
health needs assessments for both communities, with attention paid to shared experiences and
strengths.
Findings on risk and protective factors influencing child mental health will inform
development of a preventive intervention. Community Advisory Boards (CABs) will actively
participate in the review and selection of intervention components. Based on preliminary
research with the Somali Bantu community, we anticipate that a family-based intervention
model will respond well to community requests for parenting support and psychoeducation about
trauma and effects in families. An intervention positively oriented towards existing sources
of family resilience and self-efficacy has great potential for improving access to and
engagement in mental health care and other social services, and for increasing both formal
and non-formal supports—all essential for reducing mental health disparities.
In this manner, community and university partners will collaborate to achieve four Specific
Aims:
Aim 1: Strengthen existing relationships and decision-making partnerships with the Somali
Bantu and Bhutanese refugee communities in Greater Boston through community based
participatory research in partnership with the Shanbaro Community Association and Chelsea
Collaborative in Chelsea, Massachusetts.
Aim 2: Collect and analyze qualitative data on local conceptualizations of mental health
problems and resilience in school-age children (ages 5-17) as well as help seeking and
services preferences among Somali Bantu and Bhutanese refugee families; use findings to
inform intervention targets and critical components of a family-based preventive
intervention, the Family Strengthening Intervention (FSI) for refugees.
Aim 3: Use qualitative findings to prepare (a) a needs assessment of mental health in
school-age children, community strengths, barriers to care, and services preferences with
each target refugee group; (b) a preliminary battery of mental health/psychosocial measures
for use in mental health assessment of children and caregivers; and (c) a draft set of
intervention, recruitment, and training materials.
Aim 4: Use CBPR approaches to recruit and enroll 80 families in a feasibility study, with
half randomized to care as usual and half to the FSI delivered by trained community
interventionists; conduct longitudinal assessments at baseline, post-intervention, and 6
months. Hypothesis 4.1: Participation in the refugee FSI will be associated with improved
communication and connectedness within families, increased mental health services access, and
increased knowledge among caregivers and children on the consequences of trauma in refugee
families. Hypothesis 4.2: Participation in the refugee FSI will be associated with increased
application of healthy parenting skills, parental self-efficacy, parental supervision of
children, improved functioning and reduced symptoms of internalizing and externalizing in
school-age refugee children.
project to assess mental health problems in children and community strengths in two refugee
communities—the Somali Bantu and the Bhutanese—and to design and pilot test a family-based
intervention for refugees in their native languages (Somali Bantu Maay Maay and the Nepali
language used by Bhutanese refugees). We will use qualitative research methods developed in
preliminary research with the Somali Bantu to identify local conceptualizations of mental
health problems, resilience, attitudes about healing and help-seeking, and preferences for
mental health services among resettled Bhutanese. The CBPR team will collaborate on mental
health needs assessments for both communities, with attention paid to shared experiences and
strengths.
Findings on risk and protective factors influencing child mental health will inform
development of a preventive intervention. Community Advisory Boards (CABs) will actively
participate in the review and selection of intervention components. Based on preliminary
research with the Somali Bantu community, we anticipate that a family-based intervention
model will respond well to community requests for parenting support and psychoeducation about
trauma and effects in families. An intervention positively oriented towards existing sources
of family resilience and self-efficacy has great potential for improving access to and
engagement in mental health care and other social services, and for increasing both formal
and non-formal supports—all essential for reducing mental health disparities.
In this manner, community and university partners will collaborate to achieve four Specific
Aims:
Aim 1: Strengthen existing relationships and decision-making partnerships with the Somali
Bantu and Bhutanese refugee communities in Greater Boston through community based
participatory research in partnership with the Shanbaro Community Association and Chelsea
Collaborative in Chelsea, Massachusetts.
Aim 2: Collect and analyze qualitative data on local conceptualizations of mental health
problems and resilience in school-age children (ages 5-17) as well as help seeking and
services preferences among Somali Bantu and Bhutanese refugee families; use findings to
inform intervention targets and critical components of a family-based preventive
intervention, the Family Strengthening Intervention (FSI) for refugees.
Aim 3: Use qualitative findings to prepare (a) a needs assessment of mental health in
school-age children, community strengths, barriers to care, and services preferences with
each target refugee group; (b) a preliminary battery of mental health/psychosocial measures
for use in mental health assessment of children and caregivers; and (c) a draft set of
intervention, recruitment, and training materials.
Aim 4: Use CBPR approaches to recruit and enroll 80 families in a feasibility study, with
half randomized to care as usual and half to the FSI delivered by trained community
interventionists; conduct longitudinal assessments at baseline, post-intervention, and 6
months. Hypothesis 4.1: Participation in the refugee FSI will be associated with improved
communication and connectedness within families, increased mental health services access, and
increased knowledge among caregivers and children on the consequences of trauma in refugee
families. Hypothesis 4.2: Participation in the refugee FSI will be associated with increased
application of healthy parenting skills, parental self-efficacy, parental supervision of
children, improved functioning and reduced symptoms of internalizing and externalizing in
school-age refugee children.
Inclusion Criteria:
- Refugee families must have a school-aged child (aged 5-17), and caregivers must be at
least 18 years of age and live in the same household as the child.
Exclusion Criteria:
- Untreated mental illness or active family crisis
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