In the US, refugee children and families face dramatic disparities in the incidence and treatment of mental health disorders. Resettlement stressors (poverty, limited access to care) and acculturative challenges (differences in cultural norms, discrimination) often exacerbate risks due to war-related trauma exposure. Commonly, refugee mental health services are limited-usually with a narrow focus on clinical treatment of PTSD-and rarely respond to the holistic needs of refugee communities;few interventions are designed to be used across cultures and refugee groups, despite rapidly evolving refugee demographics in the US. The cross-cultural application of community-based participatory research (CBPR) methods can increase understanding of risk and protective factors in refugee communities and contribute to development of flexible mental health interventions to address disparities. This CBPR project builds on an existing collaborative research relationships with the Somali Bantu refugee community in Greater Boston. Preliminary research has identified numerous cultural and community strengths as well as ongoing problems of family conflict, poor parent-child communication which interact with ongoing stressors to increase risks for child emotional and behavioral problems. Family-based intervention models adapted via local input and delivered by trained members of the community hold great promise for use among these and other refugee groups in the US. 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 improvements in caregiver-child relationships, mental health services access, increased functioning, and reduced mental health symptoms in children and adolescents.

Public Health Relevance

The proposed study will employ cross-cultural CBPR methods to develop a family-based intervention grounded in needs assessments on contributors to mental health disparities among refugee children and families. The mixed methods research approach to selecting, adapting and implementing culturally-informed assessments and intervention models has the potential to contribute to feasible, acceptable and sustainable intervention models of mental health services for diverse groups of refugee children and families.

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Resource-Related Research Projects (R24)
Project #
5R24MD008057-02
Application #
8655907
Study Section
Special Emphasis Panel (ZMD1-RN (07))
Program Officer
Wasserman, Joan
Project Start
2013-05-01
Project End
2016-04-30
Budget Start
2014-05-01
Budget End
2015-04-30
Support Year
2
Fiscal Year
2014
Total Cost
$330,520
Indirect Cost
$35,972
Name
Harvard University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
149617367
City
Boston
State
MA
Country
United States
Zip Code
02115