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Wong MD, Quartz KH, Saunders M, Meza BP, Childress S, Seeman TE, Dudovitz RN. Turning Vicious Cycles Into Virtuous Ones: the Potential for Schools to Improve the Life Course. Pediatrics 2022; 149:186909. [PMID: 35503311 PMCID: PMC9113000 DOI: 10.1542/peds.2021-053509m] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 11/24/2022] Open
Abstract
Adolescence is a critical transition period that sets the stage for adulthood and future health outcomes. Marked by key developmental milestones in brain maturation, increasing independence from parents, and greater connections to peers, adolescence is also a time of heightened risk for behavioral health problems, including substance use, violence, delinquency, and mental health issues. High school completion is a significant life course event and a powerful social determinant of health and health disparities. Jessor's Theory of Problem Behavior suggests that adolescent health behaviors and mental health problems are closely tied to poor educational outcomes and peer network formation in a reinforcing feedback loop, or vicious cycle, often leading to school failure, school disengagement, and drop-out. Schools are a novel platform through which vicious cycles can be disrupted and replaced with virtuous ones, simultaneously improving education and health. This article describes the potential for schools to transform health trajectories through interventions creating positive and supportive school climates. In addition, new models such as the Whole School Whole Community Whole Child Model promote whole child well-being, including cognitive, social, emotional, psychological, and physical development. Full-service community schools can serve as a hub coordinating and integrating all available resources to better respond to the needs of children and families. Present in every neighborhood, schools are a way to reach every school-age child and improve their health trajectories, providing an important platform for life course intervention research.
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Affiliation(s)
- Mitchell D. Wong
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California,Address correspondence to Mitchell D. Wong, MD, Division of General Internal Medicine and Health Services Research, 1100 Glendon Ave, Suite 850, Los Angeles, CA 90024. E-mail:
| | - Karen Hunter Quartz
- University of California, Los Angeles School of Education and Information Studies, Los Angeles, California
| | - Marisa Saunders
- University of California, Los Angeles School of Education and Information Studies, Los Angeles, California
| | - Ben P.L. Meza
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | | | - Teresa E. Seeman
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - Rebecca N. Dudovitz
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
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The role of different school organizational models in the psychological adaptation of refugee adolescents. EUROPEAN JOURNAL OF PSYCHOLOGY OF EDUCATION 2021. [DOI: 10.1007/s10212-021-00582-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AbstractGiven the high number of refugee children and adolescents around the globe, it is critical to determine conditions that foster their adaptation in the receiving country. This study investigated the psychological adaptation of recently arrived adolescent refugees in Germany. We focused on whether psychological adaptation reflects the organizational approach taken by the school that refugee adolescents initially attended. School is an important context for the development and acculturation of young refugees. As in other European countries, the schooling of refugee adolescents in Germany is organized in different models: separate instruction in newcomer classes, direct immersion in regular classes, and mixed approaches. To answer our research questions, we used self-reported data from 700 refugee adolescents (12-, 14-, and 17-year-olds) in a representative survey of refugees in Germany. As indicators of their psychological adaptation, we analyzed their sense of school belonging, their emotional and behavioral problems, and their life satisfaction. Comparing them to non-refugee peers, the refugee adolescents showed similar levels of psychological adaptation, and an even higher level in the case of school belonging. Multiple regression analyses provide limited support for the assumed advantage of the mixed school organizational model: While students who initially attended a mixed approach reported higher levels of school belonging than those in other models, no differences emerged on the other indicators. We discuss the implications of our findings for the schooling of newly arrived refugees.
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Brady JA, Lee CS, Cardeli E, Winer J, Burke PJ. Refugee and Immigrant Core Stressors Toolkit to Care for Newly Arrived Children in a School Nursing Setting. J Sch Nurs 2021; 37:523-531. [PMID: 34632832 DOI: 10.1177/10598405211045688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Christina S Lee
- Associate Professor, 207391Boston University School of Social Work.
| | - Emma Cardeli
- Research Associate, Boston Children's Hospital Trauma and Community Resilience Center, Instructor in Psychology, Harvard Medical School, Department of Psychiatry, Boston Children's Hospital, Boston, MA
| | - Jeffrey Winer
- Attending Psychologist, 1862Boston Children's Hospital Trauma and Community Resilience Center, Instructor in Psychology, Harvard Medical School
| | - Pamela J Burke
- Clinical Professor (Retired), 50919Northeastern University, School of Nursing. .,Faculty, LEAH Program (Leadership Education in Adolescent Health), Boston Children's Hospital, Division of Adolescent & Young Adult Medicine, Lecturer in Pediatrics, Part Time, Harvard Medical School,
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Baker JR, Silove D, Horswood D, Al-Shammari A, Mohsin M, Rees S, Eapen V. Psychological distress, resettlement stress, and lower school engagement among Arabic-speaking refugee parents in Sydney, Australia: A cross-sectional cohort study. PLoS Med 2021; 18:e1003512. [PMID: 34252076 PMCID: PMC8312975 DOI: 10.1371/journal.pmed.1003512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 07/26/2021] [Accepted: 06/17/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Schools play a key role in supporting the well-being and resettlement of refugee children, and parental engagement with the school may be a critical factor in the process. Many resettlement countries have policies in place to support refugee parents' engagement with their children's school. However, the impact of these programs lacks systematic evaluation. This study first aimed to validate self-report measures of parental school engagement developed specifically for the refugee context, and second, to identify parent characteristics associated with school engagement, so as to help tailor support to families most in need. METHODS AND FINDINGS The report utilises 2016 baseline data of a cohort study of 233 Arabic-speaking parents (77% response rate) of 10- to 12-year-old schoolchildren from refugee backgrounds across 5 schools in Sydney, Australia. Most participants were born in Iraq (81%) or Syria (11%), and only 25% spoke English well to very well. Participants' mean age was 40 years old, and 83% were female. Confirmatory factor analyses were run on provisional item sets identified from a literature review and separate qualitative study. The findings informed the development of 4 self-report tools assessing parent engagement with the school and school community, school belonging, and quality of the relationship with the schools' bilingual cultural broker. Cronbach alpha and Pearson correlations with an established Teacher-Home Communication subscale demonstrated adequate reliability (α = 0.67 to 0.80) and construct and convergent validity of the measures (p < 0.01), respectively. Parent characteristics were entered into respective least absolute shrinkage and selection operator (LASSO) regression analyses. The degree of parents' psychological distress (as measured by the Kessler10 self-report instrument) and postmigration living difficulties (PLMDs) were each associated with lower school engagement and belonging, whereas less time lived in Australia, lower education levels, and an unemployed status were associated with higher ratings in relationship quality with the schools' cultural broker. Study limitations include the cross-sectional design and the modest amount of variance (8% to 22%) accounted for by the regression models. CONCLUSIONS The study offers preliminary refugee-specific measures of parental school engagement. It is expected they will provide a resource for evaluating efforts to support the integration of refugee families into schools. The findings support the need for initiatives that identify and support parents with school-attending children from refugee backgrounds who are experiencing psychological distress or resettlement stressors. At the school level, the findings suggest that cultural brokers may be effective in targeting newly arrived families.
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Affiliation(s)
- Jess R. Baker
- School of Psychiatry, University of New South Wales, Sydney, Australia
- * E-mail:
| | - Derrick Silove
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Deserae Horswood
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Afaf Al-Shammari
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Mohammed Mohsin
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Susan Rees
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, Sydney, Australia
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Iqbal H, West J, Haith-Cooper M, McEachan RRC. A systematic review to identify research priority setting in Black and minority ethnic health and evaluate their processes. PLoS One 2021; 16:e0251685. [PMID: 34048459 PMCID: PMC8162667 DOI: 10.1371/journal.pone.0251685] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 05/01/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Black, Asian and minority ethnic communities suffer from disproportionately poorer health than the general population. This issue has been recently exemplified by the large numbers of infection rates and deaths caused by covid-19 in BAME populations. Future research has the potential to improve health outcomes for these groups. High quality research priority setting is crucial to effectively consider the needs of the most vulnerable groups of the population. OBJECTIVE The purpose of this systematic review is to identify existing research priority studies conducted for BAME health and to determine the extent to which they followed good practice principles for research priority setting. METHOD Included studies were identified by searching Medline, Cinnahl, PsychINFO, Psychology and Behavioral Sciences Collection, as well as searches in grey literature. Search terms included "research priority setting", "research prioritisation", "research agenda", "Black and minority ethnic", "ethnic group". Studies were included if they identified or elicited research priorities for BAME health and if they outlined a process of conducting a research prioritisation exercise. A checklist of Nine Common Themes of Good Practice in research priority setting was used as a methodological framework to evaluate the research priority processes of each study. RESULTS Out of 1514 citations initially obtained, 17 studies were included in the final synthesis. Topic areas for their research prioritisation exercise included suicide prevention, knee surgery, mental health, preterm birth, and child obesity. Public and patient involvement was included in eleven studies. Methods of research prioritisation included workshops, Delphi techniques, surveys, focus groups and interviews. The quality of empirical evidence was diverse. None of the exercises followed all good practice principles as outlined in the checklist. Areas that were lacking in particular were: the lack of a comprehensive approach to guide the process; limited use of criteria to guide discussion around priorities; unequal or no representation from ethnic minorities, and poor evaluation of their own processes. CONCLUSIONS Research priority setting practices were found to mostly not follow good practice guidelines which aim to ensure rigour in priority setting activities and support the inclusion of BAME communities in establishing the research agenda. Research is unlikely to deliver useful findings that can support relevant research and positive change for BAME communities unless they fulfil areas of good practice such as inclusivity of key stakeholders' input, planning for implementation of identified priorities, criteria for deciding on priorities, and evaluation of their processes in research priority setting.
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Affiliation(s)
- Halima Iqbal
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, United Kingdom
- * E-mail:
| | - Jane West
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, United Kingdom
| | | | - Rosemary R. C. McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, United Kingdom
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Long KM, Vasi S, Westbury S, Shergill S, Guilbert-Savary C, Whitelaw A, Cheng IH, Russell G. Improving access to refugee-focused health services for people from refugee-like backgrounds in south-eastern Melbourne through the education sector. Aust J Prim Health 2021; 27:93-101. [PMID: 33715761 DOI: 10.1071/py20233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/18/2021] [Indexed: 11/23/2022]
Abstract
People from refugee-like backgrounds living in Australia face substantial health challenges that benefit from access to health and social services. Many people from refugee-like backgrounds have frequent contact with education sector staff, who have the potential to act as conduits to health and social services. The aim of this project was to improve access to refugee-focused health services for people from refugee-like backgrounds in south-eastern Melbourne by codesigning and delivering a 1-day education forum to education sector staff. Evaluation of the forum used mixed-methods analysis of data from pre-post and follow-up surveys (n =11; administered before, immediately after and 1 month after the forum respectively), post-forum interviews (n =4) and one school's referral records. The forum improved attendees' refugee-focused health service referral knowledge, confidence and behaviour. This was supported by the qualitative findings of high staff motivation, high forum satisfaction and evidence of outcome sustainability. Education staff are an important complement to an integrated model of health care for recently resettled people from refugee-like backgrounds. These results show that a straightforward local intervention can improve the ability of education staff to act as conduits to health services, increasing access to health services for people from refugee-like backgrounds.
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Affiliation(s)
- Katrina M Long
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Level 3, Building G, Monash University Peninsula Campus, 47-49 Mooroduc Highway, Frankston, Vic. 3199, Australia; and Corresponding author
| | - Shiva Vasi
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Level 3, P Block, Monash Medical Centre, 246 Clayton Road, Clayton, Vic. 3168, Australia
| | - Susannah Westbury
- Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
| | - Sandy Shergill
- Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
| | - Chloé Guilbert-Savary
- Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
| | - Ashley Whitelaw
- Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
| | - I-Hao Cheng
- Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
| | - Grant Russell
- Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
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Cardeli E, Phan J, Mulder L, Benson M, Adhikari R, Ellis BH. Bhutanese Refugee Youth: The Importance of Assessing and Addressing Psychosocial Needs in a School Setting. THE JOURNAL OF SCHOOL HEALTH 2020; 90:731-742. [PMID: 32715496 DOI: 10.1111/josh.12935] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 12/10/2019] [Accepted: 01/23/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Traumatic exposure combined with significant stressors in resettlement place Bhutanese refugees at risk for mental health problems. Despite this, refugee youth often are reluctant to seek mental health services. Psychosocial support services, such as school-based groups, offer one solution to this barrier to care. We had 2 aims in this study: (1) to describe the psychosocial needs of resettled Bhutanese refugee students; and (2) to evaluate the impact of skills-based groups on these students' sense of school belonging and mental health. METHODS Bhutanese refugee students in middle school (N = 34) participated in the 12-week group curriculum (a component of Trauma Systems Therapy for Refugees) and the associated preevaluation/postevaluation. RESULTS Baseline descriptive analyses indicated high levels of mental health symptoms; approximately, 49% of students met partial or full criteria for posttraumatic stress disorder. In addition, sense of school belonging was significantly inversely associated with depressive and posttraumatic stress symptoms at baseline. Paired sample t tests indicate that students' avoidance symptoms significantly decreased postintervention. CONCLUSIONS Findings suggest that skills-based groups may be an effective way to engage students in supportive services and address psychosocial needs. Results further highlight the potential protective role of school belonging in reducing refugee students' vulnerability to psychological distress.
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Affiliation(s)
- Emma Cardeli
- Research Associate and Attending Psychologist, , Department of Psychiatry, Boston Children's Hospital, Boston, MA; Instructor, Harvard Medical School, Refugee Trauma and Resilience Center, 21 Autumn Street, Boston, MA 02215., USA
| | - Jenny Phan
- Graduate Student in Clinical Psychology, , Psychology Department, Loyola University Chicago, 1000 W. Sheridan Rd, Coffey Hall, Chicago, IL 60626., USA
| | - Luna Mulder
- Psychologist, , Department of Psychiatry, Boston Children's Hospital, Boston, MA; Instructor, Harvard Medical School, Refugee Trauma & Resilience Center, 21 Autumn Street, Boston, MA 02115., USA
| | - Molly Benson
- Attending Psychologist, , Department of Psychiatry, Boston Children's Hospital, Boston, MA; Assistant Professor (Part-time), Harvard Medical School, Refugee Trauma & Resilience Center, P.O. Box 1384, Concord, MA 01742., USA
| | - Radha Adhikari
- Outpatient Clinician and Community Support Program Worker, , Behavioral Health Network, 1504 Galena St, Aurora, CO 80010., USA
| | - B Heidi Ellis
- Director, , Refugee Trauma and Resilience Center, Department of Psychiatry, Boston Children's Hospital, Boston, MA; Associate Professor, Harvard Medical School21 Autumn St. Boston, MA 02215., USA
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Taylor LK, Goldberg MG, Tran MHD. Promoting Student Success: How Do We Best Support Child and Youth Survivors of Catastrophic Events? Curr Psychiatry Rep 2019; 21:82. [PMID: 31410584 DOI: 10.1007/s11920-019-1067-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW School mental health services have achieved recognition for increased access to care and intervention completion rates. While best practice recommendations include connection of school mental health programming to multi-tiered systems of support that promote early identification and intervention, many schools struggle to operationalize student screening for trauma exposure, trauma symptoms, and service identification. Relatedly, progress monitoring for trauma symptoms, and the effect of trauma on school functioning in the context of catastrophic events, can also be difficult to systematically collect. RECENT FINDINGS Research regarding the effects of catastrophic events, such as exposure to natural disasters, terrorist attacks, war, or the journey to refugee status on children and youths school functioning, indicates salient age and gender differences among student responses. In addition, school professionals have been identified as sources of social support for students and as potential brokers to school linked intervention resources for children, youth, and their families. Based on our review, we outline recommendations for school professionals, including potential changes to school policies and procedures, and delineate future research questions.
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Affiliation(s)
- Leslie K Taylor
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, 1941 East Rd, Houston, TX, 77054, USA.
| | - Melissa G Goldberg
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, 1941 East Rd, Houston, TX, 77054, USA
| | - Minh-Hao D Tran
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, 1941 East Rd, Houston, TX, 77054, USA
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Abstract
This study examined the coping strategies used by Syrian refugees in Jordan in relation to their demographics. A cross-sectional correlational study was conducted with a convenient sample of 550 Syrian refugees. Out of all the study participants, 88% reported seeking social support, 64.5% reported using avoidance, and 39.5% reported using problem solving. Participants who were male, single, and younger, and who had a higher education and a higher total income were satisfied with their income, were employed and free of chronic illnesses, and had higher problem-solving scores. Higher social support-seeking scores were associated with being female, older, and widowed; having a lower education and lower total income; being dissatisfied with their income; being nonemployed; and having chronic illnesses. A number of significant predictors were identified for each coping strategy. The results of this study could be used to formulate programs and develop services regarding the stressors encountered by Syrian refugees and their coping strategies.
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Abstract
The United States is known as a nation of immigrants and a land of promise that welcomes the needy, poor, and oppressed. Immigrants represent some of the most vulnerable in society. It is vital that nurses and other health care providers possess knowledge of social, economic, and political factors related to health care for immigrant populations. This article provides definitions of the various immigrant populations, addresses health needs within this group, and offers suggestions for nursing practice and advocacy.
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