Improving psychosocial well-being and parenting practices among refugees in Uganda: Results of the journey of life effectiveness trial.

Journal: Global mental health (Cambridge, England)

Volume: 11

Issue: 

Year of Publication: 

Affiliated Institutions:  Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA. National Coalition of Independent Scholars, Battleboro, Vermont, USA. Department of Population and Family Health, Columbia University, New York, NY, USA. Transcultural Psychosocial Organization (TPO) Uganda, Kampala, Uganda. Department of Psychiatry, Columbia University, New York, NY, USA. Regional Psychosocial Support Initiative (REPSSI), Randburg, South Africa.

Abstract summary 

Caregivers play a critical role in mediating the impacts of forced displacement on children; however, humanitarian programming remains hampered by a lack of evidence-based programming. We present findings from an evaluation of a group-based curriculum delivered over the course of 12 sessions, journey of life (JoL). A waitlist-control quasi-experimental design was implemented in the Kiryandongo refugee settlement (intervention n = 631, control n = 676). Caregiver mental distress, measured using the Kessler-6, was the primary outcome. Secondary outcomes included (a) functioning, (b) social support and (c) caregiving attitudes and behaviors. Propensity score matching (PSM) and Cohen's d estimates were used to examine the intervention effects. According to our primary PSM analysis, JoL led to significant improvements in mental distress (coef.: 2.33;  < 0.001), social support (coef.: 1.45;  < 0.001), functioning (coef.: 2.64;  < 0.001), parental warmth/affection (coef.: 2.48;  < 0.001), parental undifferentiated rejection (coef.: 0.49;  < 0.001) and attitudes around violence against children (VAC) (coef.: 1.98;  < 0.001). Evidence from Cohen's analysis underscored the value of the intervention's effect on parental warmth/affection (0.74), mental distress (0.70) and VAC attitudes (0.68). This trial adds to the evidence on holistic parenting programming to improve the mental health and parenting outcomes among refugee caregivers.

Authors & Co-authors:  Stark Lindsay L Meinhart Melissa M Hermosilla Sabrina S Kajungu Rehema R Cohen Flora F Agaba Gary S GS Obalim Grace G Knox Justin J Onyango Mangen Patrick P

Study Outcome 

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Statistics
Citations :  Blackmore R, Boyle JA, Fazel M, Ranasinha S, Gray KM, Fitzgerald G, Misso M and Gibson-Helm M (2020) The prevalence of mental illness in refugees and asylum seekers: A systematic review and meta-analysis. PLOS Medicine 17(9), e1003337. 10.1371/journal.pmed.1003337.
Authors :  9
Identifiers
Doi : e42
SSN : 2054-4251
Study Population
Male,Female
Mesh Terms
Other Terms
Uganda;caregiver mental health;caregiver support;child wellbeing;parenting practices;refugees
Study Design
Study Approach
Country of Study
Publication Country
England