Syrian Refugee Youth as Community Mental Health Workers-Lebanon
Study Details
Study Description
Brief Summary
There are 1.8 billion young people in the world today. If engaged effectively, youth are resources and agents of change in their communities. Involving youth in work that impacts their communities has positive outcomes for youth wellbeing; and for their communities. But, youth are often marginalized, particularly in humanitarian settings. Youth wellbeing is linked to seven key protective factors: positive emotions, hope, relationships, meaning, accomplishments, autonomy, and engagement. Understanding protective factors as potential mechanisms for intervention-related change in wellbeing is a priority for research in humanitarian settings.
If youth are to be meaningfully engaged as intervention agents, their work should focus on a community need. Humanitarian crises increase mental health disorders; and 'normal' distress and psychological reactions affect a large percentage of the population. Yet, human resources for health are often insufficient to meet needs. Understanding the capacities of youth to support communities in the context of disasters has been noted as a research imperative. Globally, task-sharing interventions train non-professional lay community members to provide mental health care. As one example, Problem Management Plus (PM+) trains community mental health workers (CMHW) and is effective in humanitarian settings for common mental disorders and for mental distress and other problems that emerge in response to crises.
We propose to engage Syrian refugee youth - aged 18-24 years, as youth CMHW, to implement PM+ with at-risk adults (18+ years) in their communities. The Syrian refugee crises, one of the worst humanitarian crises in recent history, provides a relevant setting to implement this project. Lebanon hosts ~1.5 million Syrian refugees, and about 60% of Syrian refugees aged 15-24 years are not employed, and not in school. The Specific Aims are:
Aim 1: Assess the effectiveness of being a Y-CMHW on their wellbeing, coping, and stress levels; as compared to an equivalent control group (ECG) of Syrian refugee peers. We hypothesize that the Y-CMHW will have enhanced wellbeing and coping, and lower stress than their ECG counterparts Aim 2: Identify the mechanisms associated with changes in wellbeing, coping, and stress. Our conceptual model describes links between the intervention, the mechanisms, and outcomes.
Aim 3: Evaluate the feasibility, acceptability and fidelity of Syrian refugee youth as CMHW implementing PM+ with clients using RE-AIM as a framework for collecting implementation data.
A community-engaged research approach will involve community members, including youth, in all aspects of the research project. Our results will (a) elucidate critical mechanisms through which engagement of youth to support their community enhances their own wellbeing; (b) inform research around humanitarian/refugee settings, mental health, and Y-CMHW interventions; and (c) provide a robust basis for a follow-up study via a larger RCT. Though we assess the impact of Y- CMHW in the Syrian refugee context, the premise of this intervention and its findings are equally relevant to natural emergency situations/disasters, such as in the USA.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Youth Community Mental Health Worker
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Behavioral: low intensity psychosocial intervention
The intervention is a low-intensity mental health intervention, developed by WHO, and delivered by non-specialized CMHW. It is a transdiagnostic treatment approachthat includes four evidence-based problem solving and behavioral treatment techniques: managing stress, managing problems, get going/get doing, and social support. These strategies are implemented over five weekly sessions, of 90 minutes each.
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| Active Comparator: Equivalent Control Group
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Behavioral: Tutoring
The ECG will be engaged in tutoring students in elementary and middle school
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Outcome Measures
Primary Outcome Measures
- Wellbeing [Year 1 month 11 - Year 2 month 12]
Self report through survey
- Stress [Year 1 month 9 - Year 3 month 6]
Seld report through survey and Hair Cortisol
- Coping/Resilience [Year 1 month 11 - Year 2 month 12]
Self report through survey
Secondary Outcome Measures
- Mechanism-Positive emotions [Year 1 month 11 - Year 2 month 12]
Self report through survey
- Mechanism-Supportive relationships [Year 1 month 11 - Year 2 month 12]
Self report through survey
- Mechanism-Engagement [Year 1 month 11 - Year 2 month 12]
Self report through survey
- Mechanism-Accomplishments [Year 1 month 11 - Year 2 month 12]
Self report through survey
- Mechanism-Optimism/Hope [Year 1 month 11 - Year 2 month 12]
Self report through survey
- Mechanism-Meaning/Purpose in life [Year 1 month 11 - Year 2 month 12]
Self report through survey
- Mechanism-Control/Autonomy [Year 1 month 11 - Year 2 month 12]
Self report through survey
Eligibility Criteria
Criteria
Inclusion Criteria:
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Syrian refugee
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18-24 years
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have at least ten years of education
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at the time of screening, live in one of the selected Informal Tented Settlements in the Bekaa region of Lebanon
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have been involved in NGOs or service to their community'
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not working at the time of enrollment
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motivation to be a Community Mental Health Worker
Exclusion Criteria:
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Rema Afifi
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 202107337