Addressing Mental Health Disparities in Refugee Children Through Family and Community-based Prevention: A CBPR Collaboration and Hybrid Implementation Effectiveness Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Family Research
- Sponsor
- Boston College
- Enrollment
- 354
- Locations
- 2
- Primary Endpoint
- Change in family conflict via the Intergenerational Conflict Index
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
The proposed study will employ a cross-cultural Community Based Participatory Research (CBPR) approach to build from prior needs assessments and mixed-methods research to evaluate the effectiveness of the Family Strengthening Intervention for Refugees (FSI-R), a preventative family home-based visiting intervention intended to mitigate mental health disparities among refugee children and families using a hybrid implementation-effectiveness design. Results of the investigator's trial will expand the evidence-base on community-based interventions for refugees and has the potential to be replicated to reduce mental health disparities affecting diverse groups of refugee children and families.
Detailed Description
Using a CBPR approach, a family based prevention model, the Family Strengthening Intervention for Refugees (FSI-R) was adapted from a tested model used in Africa and designed for delivery by refugee community health workers with through a process involving stakeholder consultation and local refugee Community Advisory Board input. Pilot data on the FSI-R demonstrates strong feasibility and acceptability, but further data are needed on effectiveness as well as barriers and facilitators to implementation by community health workers embedded in refugee-serving social services agencies. Specific aims are to (1) examine the impact of a family-based preventive intervention on outcomes of parent-child relationships, family functioning, and child mental health using a Hybrid Type 2 Effectiveness-Implementation Design (families with children aged 7-17 in a two-arm randomized controlled trial); (2) identify barriers and facilitators to implementation of the FSI-R by community health workers by conducting a process evaluation concurrent with the delivery of the intervention; and (3) strengthen the science of community engagement to address health disparities by fortifying CBPR-based pathways of change via collaborative partnerships between refugee communities, service providers, and academic stakeholders.
Investigators
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- •not meeting the above inclusion criteria
- •families in the midst of a crisis (e.g. active suicide attempts)
Outcomes
Primary Outcomes
Change in family conflict via the Intergenerational Conflict Index
Time Frame: T1 (Baseline), T2 (approximately 24-months post-baseline), T3 (6-months follow-up from T2)
Utilizes a 5-point Likert scale (1-5) to assess intergenerational congruence across several domains of the parent-child relationship. Higher scores denote greater intergenerational congruence.
Change in conflict via the Family Conflict Scale
Time Frame: T1 (Baseline), T2 (approximately 24-months post-baseline), T3 (6-months follow-up from T2)
The Family Conflict Scale utilizes a 7-point Likert Scale (0-6) to assess family conflict within the past month. Higher scores reflect greater family conflict.
Change in communication via the Revised Parent- Adolescent Communication Form
Time Frame: T1 (Baseline), T2 (approximately 24-months post-baseline), T3 (6-months follow-up from T2)
Utilizes a 5-point Likert scale (1-5) to assess parent-child communication. Greater scores indicate higher communication between parents and their children.
Change in parenting via the Alabama Parenting Questionnaire
Time Frame: T1 (Baseline), T2 (approximately 24-months post-baseline), T3 (6-months follow-up from T2)
Likert scale (1-5) that includes 5 sub-domains. Each sub-domain results in a summed score that relates to 5 domains of parenting: involvement, positive parenting, poor monitoring/supervision, inconsistent discipline, and corporal punishment.
Secondary Outcomes
- Change in youth externalizing behaviors via the African Youth Psychosocial Assessment(T1 (Baseline), T2 (approximately 24-months post-baseline), T3 (6-months follow-up from T2))
- Change in youth depression via the Center for Epidemiologic Studies-Depression scale(T1 (Baseline), T2 (approximately 24-months post-baseline), T3 (6-months follow-up from T2))