Authors: Theresa S. Betancourt, Jenna M. Berent, Jordan Freeman, Rochelle L. Frounfelker, Robert T. Brennan, Saida Abdi, Ali Maalim, Abdirahman Abdi, Tej Mishra, Bhuwan Gautam, John W. Creswell and William R. Beardslee

2020, Journal of Adolescent Health

Purpose

There are disparities in mental health of refugee youth compared with the general U.S. population. We conducted a pilot feasibility and acceptability trial of the home-visiting Family Strengthening Intervention for refugees (FSI-R) using a community-based participatory research

approach. The FSI-R aims to promote youth mental health and family relationships. We hypothesized that FSI-R families would have better psychosocial outcomes and family functioning postintervention compared with care-as-usual (CAU) families. We hypothesized that FSI-R would be feasible to implement and accepted by communities.

Methods

A total of 40 Somali Bantu (n ¼ 103 children, 58.40% female; n ¼ 43 caregivers, 79.00% female) and 40 Bhutanese (n ¼ 49 children, 55.30% female; n ¼ 62 caregivers, 54.00% female) families were randomized to receive FSI-R or CAU. Refugee research assistants conducted psychosocial assessments pre- and post-intervention, and home visitors delivered the preventive intervention. Multilevel modeling assessed the effects of FSI-R. Feasibility was measured from retention, and acceptability was measured from satisfaction surveys.

Results

The retention rate of 82.50% indicates high feasibility, and high reports of Satisfaction (81.50%) indicate community acceptance. Across communities, FSI-R children reported reduced traumatic stress reactions, and caregivers reported fewer child depression symptoms compared with CAU families (b ¼ [1].42; p ¼ .03; b ¼ [1].34; p ¼ .001). Bhutanese FSI-R children reported reduced family arguing (b ¼ [1]1.32; p ¼ .04) and showed fewer depression symptoms and conduct problems by parent report (b ¼[1]9.20; p ¼ .04; b ¼[1].92; p ¼ .01) compared with CAU. There were no significant differences by group on other measures.