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Bosqui T, Mayya A, Farah S, Shaito Z, Jordans MJD, Pedersen G, Betancourt TS, Carr A, Donnelly M, Brown FL. Parenting and family interventions in lower and middle-income countries for child and adolescent mental health: A systematic review. Compr Psychiatry 2024; 132:152483. [PMID: 38631272 DOI: 10.1016/j.comppsych.2024.152483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 08/31/2023] [Accepted: 04/02/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Given the protective effect of nurturing caregivers and families for child and adolescent mental health, there is a need to review and synthesize research evidence regarding the effectiveness of parenting and family interventions in low and middle-income countries, including humanitarian settings. To advance practice, further understanding of the active ingredients of such interventions and implementation factors that lead to effectiveness are essential. METHOD This systematic review, an update from a previous review, included studies on any parenting or family intervention for children and adolescents aged 0-24, living in a low- or middle-income country, that quantitatively measured child or adolescent mental health outcomes. We searched Global Health, PubMed, PsychINFO, PILOTS and the Cochrane Library databases on the 9th July 2020, and updated on the 12th August 2022. Risk of bias was assessed using an adapted version of the NIH Quality Assessment Tool. We extracted data on: effectiveness outcomes, practice elements included in effective interventions, and implementation challenges and successes. MAIN FINDINGS We found a total of 80 studies (n = 18,193 participants) representing 64 different family or parenting interventions, 43 of which had evidence of effect for a child or adolescent mental health outcome. Only 3 studies found no effect on child, adolescent or caregiver outcomes. The most common practice elements delivered in effective interventions included caregiver psychoeducation, communication skills, and differential reinforcement. Key implementation strategies and lessons learned included non-specialist delivery, the engagement of fathers, and integrated or multi-sector care to holistically address family needs. PRELIMINARY CONCLUSIONS Despite a high level of heterogeneity, preliminary findings from the review are promising and support the use of parenting and family interventions to address the wider social ecology of children in low resource and humanitarian contexts. There are remaining gaps in understanding mechanisms of change and the empirical testing of different implementation models. Our findings have implications for better informing task sharing from specialist to non-specialist delivery, and from individual-focused to wider systemic interventions.
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Affiliation(s)
- Tania Bosqui
- Department of Psychology, American University of Beirut, Beirut, Lebanon; Trinity Centre for Global Health, Trinity College Dublin, Republic of Ireland.
| | - Anas Mayya
- Department of Psychology, American University of Beirut, Beirut, Lebanon.
| | - Sally Farah
- Department of Psychology, American University of Beirut, Beirut, Lebanon.
| | - Zahraa Shaito
- Department of Psychology, American University of Beirut, Beirut, Lebanon.
| | - Mark J D Jordans
- War Child Alliance, Amsterdam, The Netherlands; Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands.
| | - Gloria Pedersen
- Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, the George Washington University School of Medicine and Health Sciences, Washington D.C., United States
| | | | - Alan Carr
- University College Dublin, Dublin, Republic of Ireland.
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
| | - Felicity L Brown
- War Child Alliance, Amsterdam, The Netherlands; Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands.
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Backhaus S, Blackwell A, Gardner F. The effectiveness of parenting interventions in reducing violence against children in humanitarian settings in low- and middle-income countries: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2024:106850. [PMID: 38880688 DOI: 10.1016/j.chiabu.2024.106850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/23/2024] [Accepted: 05/07/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Violence against children is a global phenomenon, yet children living in humanitarian settings are at elevated risk of experiencing violent parenting. Parenting interventions are a recommended prevention strategy. OBJECTIVE To conduct a systematic review and meta-analysis on the effectiveness of parenting interventions in preventing violence against children and related parent and child outcomes. PARTICIPANTS AND SETTING Primary caregivers in humanitarian settings in low- and middle-income countries (LMICs). METHODS A highly sensitive multi-language systematic search in electronic and grey-literature database. Studies were appraised for risk of bias, summary effects by certainty of effect, and effect estimates pooled using robust variance estimation. RESULTS Twenty-three randomized trials were meta-analyzed finding a small effect on physical and psychological violence (n = 14, k = 21, d = -0.36, 95 % CI [-0.69, -0.04]), positive parenting (n = 16, k = 43, d = 0.48, 95 % CI [0.29, 0.67]), negative parenting (n = 17, k = 37, d = -0.42, 95 % CI [-0.67, -0.16]), parental poor mental health (n = 9, k = 15, d = -0.34, 95 % CI [-0.66, -0.02]), and internalizing behaviors (n = 11, k = 29, d = -0.38, 95 % CI [-0.70, -0.05]); a non-significant effect on externalizing child behaviors (n = 9, k = 17, d = -0.12, 95 % CI [-0.50, 0.27]). Too few studies reported intimate partner violence, sexual violence, and parenting stress outcomes. CONCLUSIONS Our findings suggest that parenting interventions in humanitarian settings in LMICs may be an effective strategy to reduce physical and psychological violence, and numerous related parent and child outcomes. However, findings need to be interpreted in light of the limited number of available studies and imprecise statistical significance for selected outcomes.
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Affiliation(s)
- Sophia Backhaus
- Centre for Evidence-based Intervention, Department of Social Policy and Intervention, University of Oxford, UK; Research Institute Child Development and Education, University of Amsterdam, the Netherlands.
| | - Alexandra Blackwell
- Centre for Evidence-based Intervention, Department of Social Policy and Intervention, University of Oxford, UK
| | - Frances Gardner
- Centre for Evidence-based Intervention, Department of Social Policy and Intervention, University of Oxford, UK
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Nguyen AJ, Murray SM, Rahaman KS, Lasater ME, Barua S, Lee C, Schojan M, Tonon B, Clouin L, Le Roch K. Psychosocial impacts of Baby Friendly Spaces for Rohingya refugee mothers in Bangladesh: A pragmatic cluster-randomized controlled trial. Glob Ment Health (Camb) 2024; 11:e64. [PMID: 38827334 PMCID: PMC11140488 DOI: 10.1017/gmh.2024.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/05/2024] [Accepted: 04/29/2024] [Indexed: 06/04/2024] Open
Abstract
Background This study evaluated the effectiveness of Baby Friendly Spaces (BFS), a psychosocial support program for Rohingya refugee mothers of malnourished young children in Bangladesh. Because BFS was already being implemented, we examined the benefit of enhancing implementation supports. Methods In matched pairs, 10 sites were randomized to provide BFS treatment as usual (BFS-TAU) or to receive enhanced implementation support (BFS-IE). 600 mothers were enrolled and reported on maternal distress, functional impairment, subjective well-being and coping at baseline and 8-week follow-up. Data were analyzed using multilevel linear regression models to account for clustering; sensitivity analyses adjusted for the small number of clusters. Results Significant within-group improvements in BFSIE were observed for distres (-.48, p = .014), functional impairment (-.30, p = .002) and subjective well-being (.92, p = .011); improvements in BFS-TAU were smaller and not statistically significant. Between-group comparisons favored BFS-IE for distress (β = -.30, p = .058) and well-being (β = .58, p = .038). Sensitivity adjustments produced p-values above .05 for all between-group comparisons. Discussion Feasible adjustments to implementation can improve program delivery to increase impact on maternal distress and well-being. Although results should be interpreted with caution, study design limitations are common in pragmatic, field-based research.
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Affiliation(s)
- Amanda J. Nguyen
- Department of Human Services, School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - Sarah M. Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Molly E. Lasater
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Suzit Barua
- Action Against Hunger, Cox’s Bazar, Bangladesh
| | - Catherine Lee
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Matthew Schojan
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Brennan-Wilson A, Marques M, Coates A, Amin A, Garry J, Tomlinson M, Nyembezi A, George A, Lohan M. Masculinities and sexual and reproductive health and rights: a global research priority setting exercise. Lancet Glob Health 2024; 12:e882-e890. [PMID: 38614636 DOI: 10.1016/s2214-109x(24)00053-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/12/2024] [Accepted: 01/25/2024] [Indexed: 04/15/2024]
Abstract
Engaging men and boys in sexual and reproductive health and rights (SRHR) and doing so in a way that challenges harmful masculinities, is both neglected and vital for improving the SRHR of both women and men. To address this gap, WHO commissioned a global research priority setting exercise on masculinities and SRHR. The exercise adapted the quantitative child health and nutrition research initiative priority setting method by combining it with qualitative methods. Influenced by feminist and decolonial perspectives, over 200 diverse stakeholders from 60 countries across all WHO regions participated. The exercise forges a collaborative research agenda emphasising four key areas: gender-transformative approaches to men's and boys' engagement in SRHR, applied research to deliver services addressing diversity in SRHR among men and women and to generate gender-equality, research designs to support participation of target audiences and reach to policy makers, and research addressing the priorities of those in low-income and middle-income countries.
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Affiliation(s)
- Aoibheann Brennan-Wilson
- School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, Belfast, UK
| | | | | | | | - John Garry
- School of History, Anthropology, Philosophy and Politics, Queen's University Belfast, Belfast, UK
| | - Mark Tomlinson
- School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, Belfast, UK; Stellenbosch University, Stellenbosch, South Africa
| | - Anam Nyembezi
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Asha George
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Maria Lohan
- School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, Belfast, UK.
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Lambert JE, Karugahe W, Baguma PK. Unpacking gender-specific risk and protective factors for mental health status among Congolese refugees in Uganda. Eur J Psychotraumatol 2024; 15:2334190. [PMID: 38590137 PMCID: PMC11005866 DOI: 10.1080/20008066.2024.2334190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/15/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Research indicates refugees from the Democratic Republic of Congo (DRC), particularly females, have a higher incidence of mental health problems compared to the global norm for conflict-affected populations.Objective: This study aimed to unpack gender differences in the mental health of Congolese refugees by examining specific risk (trauma exposure, adaptation challenges, and discrimination) and protective factors (marital status, literacy, and social resources) in relation to posttraumatic stress symptoms (PTSS) and depression. Method: Utilizing systematic random sampling, we surveyed 667 adult refugees (370 females, 297 males) in the Kyaka II refugee settlement in Western Uganda. A multi-group path analysis was conducted, initially allowing for variance between genders and subsequently comparing a constrained model, where paths were set equal across groups.Results: The unconstrained model presented an excellent fit to the data. When paths were set to be equal across groups, the decline in model fit, confirmed by a chi-square difference test, indicated differences in the model for males and females. A series of Z-tests were used to compare individual paths. Experiencing discrimination was a stronger risk factor for depression among men, whereas a history of rape was more strongly associated with depression for females. Being literate and a member of a social group in the settlement were stronger protective factors for depression among men, whereas living with a partner and a felt sense of connection to their community was more important for women. Associations between risk and protective factors and PTSS were more similar across groups, only membership in a group was significantly moderated by gender; with group membership being more impactful for males.Conclusion: The results highlight similarities and differences in predictors of distress for male and female Congolese refugees and point to potential avenues for tailoring programming to be gender sensitive.
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Affiliation(s)
| | - Wilber Karugahe
- Department of Mental Health & Community Psychology, Makerere University, Kampala, Uganda
| | - Peter K. Baguma
- Department of Educational, Social & Organizational Psychology, Makerere University, Kampala, Uganda
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Fernández Capriles I, Armijos A, Angulo A, Schojan M, Wainberg ML, Bonz AG, Tol WA, Greene MC. Improving Retention in Mental Health and Psychosocial Support Interventions: An Analysis of Completion Rates across a Multi-Site Trial with Refugee, Migrant, and Host Communities in Latin America. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:397. [PMID: 38673310 PMCID: PMC11049853 DOI: 10.3390/ijerph21040397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
Research on mental health and psychosocial support (MHPSS) interventions within refugee and migrant communities has increasingly focused on evaluating implementation, including identifying strategies to promote retention in services. This study examines the relationship between participant characteristics, study setting, and reasons for intervention noncompletion using data from the Entre Nosotras feasibility trial, a community-based MHPSS intervention targeting refugee, migrant, and host community women in Ecuador and Panama that aimed to promote psychosocial wellbeing. Among 225 enrolled women, approximately half completed the intervention, with varying completion rates and reasons for nonattendance across study sites. Participants who were older, had migrated for family reasons, had spent more time in the study community, and were living in Panamá (vs. Ecuador) were more likely to complete the intervention. The findings suggest the need to adapt MHPSS interventions to consider the duration of access to the target population and explore different delivery modalities including the role of technology and cellular devices as reliable or unreliable source for engaging with participants. Engaging younger, newly arrived women is crucial, as they showed lower completion rates. Strategies such as consulting scheduling preferences, providing on-site childcare, and integrating MHPSS interventions with other programs could enhance intervention attendance.
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Affiliation(s)
- Isabella Fernández Capriles
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY 10032, USA;
| | | | | | | | - Milton L. Wainberg
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA;
| | - Annie G. Bonz
- HIAS, Silver Spring, MD 20910, USA; (M.S.); (A.G.B.)
| | - Wietse A. Tol
- Global Health Section, Department of Public Health, University of Copenhagen, 1172 Copenhagen, Denmark;
- Athena Research Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - M. Claire Greene
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY 10032, USA;
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Greene MC, Wimer G, Larrea M, Mejia Jimenez I, Armijos A, Angulo A, Guevara ME, Vega C, Heard EW, Demis L, Benavides L, Corrales C, de la Cruz A, Lopez MJ, Moyano A, Murcia A, Noboa MJ, Rodriguez A, Solis J, Vergara D, Andersen LS, Cristobal M, Wainberg M, Bonz AG, Tol W. Strategies to improve the implementation and effectiveness of community-based psychosocial support interventions for displaced, migrant and host community women in Latin America. Glob Ment Health (Camb) 2024; 11:e32. [PMID: 38572247 PMCID: PMC10988141 DOI: 10.1017/gmh.2024.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/16/2023] [Accepted: 02/26/2024] [Indexed: 04/05/2024] Open
Abstract
As evidence supporting the effectiveness of mental health and psychosocial interventions grows, more research is needed to understand optimal strategies for improving their implementation in diverse contexts. We conducted a qualitative process evaluation of a multicomponent psychosocial intervention intended to promote well-being among refugee, migrant and host community women in three diverse contexts in Ecuador and Panamá. The objective of this study is to describe the relationships among implementation determinants, strategies and outcomes of this community-based psychosocial intervention. The five implementation strategies used in this study included stakeholder engagement, promoting intervention adaptability, group and community-based delivery format, task sharing and providing incentives. We identified 10 adaptations to the intervention and its implementation, most of which were made during pre-implementation. Participants (n = 77) and facilitators (n = 30) who completed qualitative interviews reported that these strategies largely improved the implementation of the intervention across key outcomes and aligned with the study's intervention and implementation theory of change models. Participants and facilitators also proposed additional strategies for improving reach, implementation and maintenance of this community-based psychosocial intervention.
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Affiliation(s)
- M. Claire Greene
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Gabrielle Wimer
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Maria Larrea
- Hunter College, City University of New York, New York, NY, USA
| | - Ingrid Mejia Jimenez
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | | | | | - Carolina Vega
- HIAS Ecuador, Quito, Ecuador
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Emily W. Heard
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Lina Demis
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | | | | | | | | | | | | | | | | | | | - Lena S. Andersen
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Milton Wainberg
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons/New York State Psychiatric Institute, New York, NY, USA
| | | | - Wietse Tol
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Athena Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Ceccarelli C, Prina E, Alkasaby M, Cadorin C, Gandhi Y, Cristofalo D, Abujamei Y, Muneghina O, Barbui C, Jordans MJD, Purgato M. Implementation outcomes in psychosocial intervention studies for children and adolescents living in low- and middle-income countries: A systematic review. Clin Psychol Rev 2024; 107:102371. [PMID: 38118259 DOI: 10.1016/j.cpr.2023.102371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/16/2023] [Accepted: 12/01/2023] [Indexed: 12/22/2023]
Abstract
Psychosocial interventions play a key role in addressing mental health and substance use needs for children and adolescents living in low- and middle-income countries (LMICs). While research efforts have primarily focused on their effectiveness, implementation outcomes also require examining. We conducted a systematic review of qualitative, quantitative, and mixed-methods studies (PROSPERO: CRD42022335997) to synthesize the literature on implementation outcomes for psychosocial interventions for children and adolescents in LMICs. We searched Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Web of Science, PsychINFO, and Global Health through April 2023. Data were extracted and quality appraised through the Mixed Methods Appraisal Tool (MMAT) independently by two reviewers. A total of 13,380 records were screened, and 87 studies met inclusion criteria. Feasibility was the most reported implementation outcome (69, 79%), followed by acceptability (60, 69%), and fidelity (32, 37%). Appropriateness was assessed in 11 studies (13%), implementation costs in 10 (11%), and sustainability in one (1%). None of the included studies reported on penetration or adoption. Despite a growing body of evidence for implementation research in child and adolescent global mental health, most research focused on earlier-stage implementation outcomes, assessing them in research-controlled settings. To overcome this, future efforts should focus on assessing interventions in routine care, assessing later-stage implementation outcomes through standardized tools.
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Affiliation(s)
- Caterina Ceccarelli
- Global Program Expert Group on Mental Health and Psychosocial Support, SOS Children's Villages, Milan, Italy.
| | - Eleonora Prina
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Muhammad Alkasaby
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Camilla Cadorin
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Yashi Gandhi
- Addictions and related-Research Group, Sangath, Goa, India
| | - Doriana Cristofalo
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Yasser Abujamei
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Orso Muneghina
- Global Program Expert Group on Mental Health and Psychosocial Support, SOS Children's Villages, Milan, Italy
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Mark J D Jordans
- War Child, Amsterdam, the Netherlands; University of Amsterdam, Amsterdam, the Netherlands; IoPPN, King's College London, London, UK
| | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Cochrane Global Mental Health, University of Verona, Verona, Italy
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Panter-Brick C. Pathways to resilience and pathways to flourishing: Examining the added-value of multisystem research and intervention in contexts of war and forced displacement. Dev Psychopathol 2023; 35:2214-2225. [PMID: 37766475 DOI: 10.1017/s095457942300113x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
This paper examines the added-value that multisystem approaches bring to research and intervention in contexts of war and forced displacement. I highlight what is useful and truly innovative about systems-level work, aware that providing data-related evidence is only part of the story when connecting research to policy and practice. I discuss four types of added-value: these are conceptual, instrumental, capacity-building, and connectivity impacts that, respectively, aim to change current knowledge, improve implementation, build research skills, and strengthen network connectivity. Specifically, systems-based research can help transform the key frames of humanitarian work, fostering the more integrated and distributive models of professional assistance known as resilience and network humanitarianism. I argue that systems-level approaches on resilience and flourishing in war-affected and refugee populations help to articulate new mindsets, methodologies, partnerships, and ways of working relevant for humanitarian research, policy and practice. I focus attention on interdisciplinary, interventionist, prospective, transgenerational, and network-building initiatives. My specific examples cover the family context of mental health and trauma memory in Afghanistan, as well as program evaluation with Syrian refugees in Jordan, connecting stress biology to human experience, and social networks to psychological empowerment. The paper suggests future directions to support more effective and impactful systems-level work in protracted humanitarian crises.
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Affiliation(s)
- Catherine Panter-Brick
- Department of Anthropology, Yale University, New Haven, CT, USA
- Jackson School of Global Affairs, Yale University, New Haven, CT, USA
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Pandi-Perumal SR, van de Put WACM, Maercker A, Hobfoll SE, Mohan Kumar V, Barbui C, Mahalaksmi AM, Chidambaram SB, Lundmark PO, Khai TS, Atwoli L, Poberezhets V, Rajesh Kumar R, Madoro D, Andrés Marín Agudelo H, Hoole SRH, Teixeira-Santos L, Pereira P, Saravanan KM, Vrdoljak A, Meira E Cruz M, Ramasubramanian C, Tay AK, Grønli J, Sijbrandij M, Sivasubramaniam S, Narasimhan M, Mbong EN, Jansson-Fröjmark M, Bjorvatn B, de Jong JTVM, Braakman MH, Eisenbruch M, Acuña-Castroviejo D, van der Velden K, Brown GM, Partinen M, McFarlane AC, Berk M. Harbingers of Hope: Scientists and the Pursuit of World Peace. CLINICAL PSYCHOLOGY IN EUROPE 2023; 5:e13197. [PMID: 38357426 PMCID: PMC10863676 DOI: 10.32872/cpe.13197] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
The ongoing wars in many regions-such as the conflict between Israel and Hamas-as well as the effects of war on communities, social services, and mental health are covered in this special editorial. This article emphasizes the need for international efforts to promote peace, offer humanitarian aid, and address the mental health challenges faced by individuals and communities affected by war and violence.
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Affiliation(s)
- Seithikurippu R Pandi-Perumal
- Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Division of Research and Development, Lovely Professional University, Phagwara, Punjab, India
| | - Willem A C M van de Put
- Section of International Health Policy, Institute for Tropical Medicine Antwerp, Antwerp, Belgium
- Institute of International Humanitarian Affairs (IIHA), Fordham University, Bronx, NY, USA
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | - Stevan E Hobfoll
- STAR Consultants - STress, Anxiety and Resilience, Salt Lake City, UT, USA
| | | | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Arehally Marappa Mahalaksmi
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, India
| | - Saravana Babu Chidambaram
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, India
| | - Per Olof Lundmark
- Department of Optometry, Radiography and Lightning Design, University of South-Eastern Norway, Kongsberg, Norway
- National Centre for Optics, Vision and Eye Care, Kongsberg, Norway
| | - Tual Sawn Khai
- School of Graduate Studies, Lingnan University, Hong Kong SAR, China
| | - Lukoye Atwoli
- Medical College East Africa, Brain and Mind Institute, The Aga Khan University, Nairobi, Kenya
| | - Vitalii Poberezhets
- Department of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
| | | | - Derebe Madoro
- Department of Psychiatry, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
| | | | | | - Luísa Teixeira-Santos
- Center for Health Technology and Services Research, Porto, Portugal
- Nursing School of Coimbra, Coimbra, Portugal
| | - Paulo Pereira
- Environmental Management Laboratory, Mykolas Romeris University, Vilnius, Lithuania
| | - Konda Mani Saravanan
- Department of Biotechnology, Bharath Institute of Higher Education & Research, Chennai, India
| | - Anton Vrdoljak
- Faculty of Civil Engineering, Architecture and Geodesy, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Miguel Meira E Cruz
- Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Lisbon, Portugal
| | | | - Alvin Kuowei Tay
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Janne Grønli
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Meera Narasimhan
- Department of Neuropsychiatry and Behavioral Science, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - Eta Ngole Mbong
- MOMENTUM Integrated Health Resilience (MIHR), IMA World Health, Goma, North Kivu, Democratic Republic of Congo
| | - Markus Jansson-Fröjmark
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
- Stockholm Health Care Services, Region of Stockholm, Stockholm, Sweden
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Joop T V M de Jong
- Cultural Psychiatry and Global Mental Health, Amsterdam UMC, Amsterdam, The Netherlands
- Boston University School of Medicine, Boston, MA, USA
| | - Mario H Braakman
- Transcultural Forensic Psychiatry, Tilburg Law School, Department of Criminal Law, Tilburg University, Tilburg, The Netherlands
| | - Maurice Eisenbruch
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Darío Acuña-Castroviejo
- Centro de Investigación Biomédica, Departamento de Fisiología, Facultad de Medicina, Instituto de Biotecnología, Universidad de Granada, Granada, Spain
| | - Koos van der Velden
- Public Health, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gregory M Brown
- Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Markku Partinen
- Sleep Medicine, Helsinki Sleep Clinic, Helsinki, Finland
- Department of Clinical Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland
| | - Alexander C McFarlane
- Psychiatry, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Barwon Health, Geelong, Australia
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