Clinical trial NCT05265611: Syrian Refugee Young Adults As Community Mental Health Workers-Lebanon
Official title: Youth As Community Mental Health Workers in Humanitarian Settings: a Pilot Test of the Mechanisms of Effect on Their Own Well Being
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Mental Health
Stress, Psychological
Keywords: Lebanon
Refugee
Problem Management Plus
RCT
Psychosocial intervention
Lead sponsor: University of Iowa
Sponsor class: OTHER
First posted: 2022-03-03
Enrollment: 115
Sex: ALL
Minimum age (years): 18
Maximum age (years): 24
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: In this pilot study, we aim to evaluate the feasibility, acceptability and fidelity of Syrian refugee young adults as community mental health workers (Y-CMHW), and the impact of this work on outcomes of wellbeing, coping and stress. In addition, we aim to assess the mechanisms leading to any changes in these outcomes.

Detailed description: Involving youth and young adults (YYA) in work that impacts their communities has positive outcomes for youth wellbeing; and for their communities. But, YYA are often marginalized, particularly in humanitarian settings. YYA wellbeing is linked to seven key protective factors: positive emotions, hope, relationships, meaning, accomplishments, autonomy, and engagement. Understanding protective factors as potential mechanisms for intervention-related change in wellbeing is a priority for research in humanitarian settings.

Humanitarian crises increase mental health disorders; and 'normal' distress and psychological reactions affect a large percentage of the population. Yet, human resources for health are often insufficient to meet needs. Understanding the capacities of YYA to support communities in the context of disasters has been noted as a research imperative. Globally, task-sharing interventions train non-professional lay community members to provide mental health care. As one example, Problem Management Plus (PM+) trains community mental health workers (CMHW) and is effective in humanitarian settings for common mental disorders and other problems that emerge in response to crises.

The investigators propose to engage Syrian refugee young adults (YA) - aged 18-24 years, as YA CMHW, to implement PM+ with at-risk adults (18+ years) in their communities. The Syrian refugee crises, one of the worst humanitarian crises in recent history, provides a relevant setting to implement this project. Lebanon hosts \~1.5 million Syrian refugees, and about 60% of Syrian refugees aged 15-24 years are not employed, and not in school. The Specific Aims are:

Aim 1: Assess the effectiveness of being a YA-CMHW on their wellbeing, coping, and stress levels; as compared to (i) an active comparator group of Syrian refugee peers providing tutoring services; and (ii) a group of Syrian refugee peers that receives no intervention.

Aim 2: Identify the mechanisms associated with changes in wellbeing, coping, and stress. The conceptual model describes links between the intervention, the mechanisms, and outcomes.

Aim 3: Evaluate the feasibility, acceptability and fidelity of Syrian refugee YA as CMHW implementing PM+ with clients.

Results will (a) elucidate critical mechanisms through which engagement of YYA to support their community enhances their own wellbeing; (b) inform research around humanitarian/refugee settings, mental health, and Y-CMHW interventions; and (c) provide a robust basis for a follow-up study via a larger RCT.

Eligibility criteria: Inclusion Criteria:

1. Syrian refugee
2. 18-24 years
3. have completed high school
4. at the time of screening, live in one of the 3 catchment areas of the field-based NGO partner (MAPs) in the Bekaa region of Lebanon
5. have been involved in NGOs or service to their community'
6. motivation to be a Community Mental Health Worker

Primary outcomes:
measure: Wellbeing
timeFrame: Year 2 month 6- Year 3 month 12
measure: Stress
timeFrame: Year 2 month 6 - Year 3 month 12
measure: Coping/Resilience
timeFrame: Year 2 month 6 - Year 3 month 12
Secondary outcomes:
measure: Mechanism-Positive emotions
timeFrame: Year 2 month 6 - Year 3 month 12
measure: Mechanism-Supportive relationships
timeFrame: Year 2 month 6 - Year 3 month 12
measure: Mechanism-Engagement
timeFrame: Year 2 month 6 - Year 3 month 12
measure: Mechanism-Accomplishments
timeFrame: Year 2 month 6 - Year 3 month 12
measure: Mechanism-Optimism/Hope
timeFrame: Year 2 month 6 - Year 3 month 12
measure: Mechanism-Meaning/Purpose in life
timeFrame: Year 2 month 6 - Year 3 month 12
measure: Mechanism-Control/Autonomy
timeFrame: Year 2 month 6 - Year 3 month 12
Other outcomes:
Locations:
city: Beirut
country: Lebanon
facility: American University of Beirut, Faculty of Health Sciences
Study officials:
affiliation: University of Iowa College of Public Health
name: Rima A Afifi, PhD
role: PRINCIPAL_INVESTIGATOR
References: