Improving adolescent mental health and protection in humanitarian settings: longitudinal findings from a multi-arm randomized controlled trial of child-friendly spaces among South Sudanese refugees in Uganda.

Journal: Journal of child psychology and psychiatry, and allied disciplines

Volume: 64

Issue: 6

Year of Publication: 2023

Affiliated Institutions:  Columbia University Mailman School of Public Health, New York, NY, USA. AfriChild Center for the Study of the African Child, Makerere University, New York, NY, USA. World Vision Uganda, Kampala, Uganda. World Vision UK, Milton Keynes, UK. World Vision International, Geneva, Switzerland.

Abstract summary 

The effects of conflict and displacement on adolescent mental health and protection are profound and can have lasting consequences. We aimed to investigate the effectiveness of two group-based psychosocial interventions on mental health and protection of South Sudanese refugee adolescents.A randomized controlled trial was done in four villages within the Omugo extension of Rhino Camp refugee settlement in the West Nile region of Uganda. Male and female adolescents (aged 9-14 years) were randomly assigned to attend 12 weeks of either a Standard psychosocial intervention delivered in a child-friendly space (CFS) or a more structured sequential delivery of psychosocial sessions guided by a newly developed Toolkit for Child-Friendly Spaces in Humanitarian Settings. The primary outcomes were psychological distress and resilience 12 months after baseline assessment. The trial is registered with ClinicalTrials.gov, NCT03897894.Between May 28, 2019, and February 20, 2020, 1,280 eligible adolescents were recruited. With 70.2% retention at follow-up, 214 assigned to the Standard, 211 assigned to the Toolkit, and 370 assigned to the waitlist control were included in the intention-to-treat and as-treated analysis. Both the Toolkit and Standard approaches were more effective in reducing psychological distress and perceived protection risks reported by adolescents compared to no intervention. Differential intervention impacts are indicated in subgroup analyses.The trial found that both psychosocial interventions when implemented in a CFS are well suited as a first-line mental health and violence prevention intervention for adolescent populations exposed to conflict and forced displacement. Where feasible, CFS should be implemented as a primary response strategy soon after displacement to improve psychological health and reduce the risk environment for adolescents.

Authors & Co-authors:  Metzler Janna J Saw Terry T Nono Denis D Kadondi Agatha A Zhang Yuan Y Leu Cheng-Shiun CS Gabriel Aimyleen A Savage Kevin K Landers Cassie C

Study Outcome 

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Statistics
Citations :  Amone-P'Olak, K. (2005). Psychological impact of war and sexual abuse on adolescent girls in Northern Uganda. Intervention, 3, 33-45.
Authors :  9
Identifiers
Doi : 10.1111/jcpp.13746
SSN : 1469-7610
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Humanitarian;adolescents;conflict;mental health;protection;psychosocial;refugee
Study Design
Randomized Control Trial,Case Control Trial,Longitudinal Study,Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
England