Family-Based Mental Health Promotion for Somali Bantu and Bhutanese Refugees: Feasibility and Acceptability Trial

Abstract

There are disparities in mental health of refugee youth compared to the general US population. We conducted a pilot feasibility and acceptability trial of the home-visiting Family Strengthening Intervention for refugees (FSI-R) using a community-based participatory research approach. The FSI-R aims to promote youth mental health and family relationships. We hypothesized that FSI-R families would have better psychosocial outcomes and family functioning post-intervention compared to care-as-usual (CAU) families. We hypothesized that FSI-R would be feasible to implement and accepted by communities. 40 Somali Bantu (n=102 children, 58.4% female; n=43 caregivers, 79.0% female) and 40 Bhutanese (n=53 children, 55.3% female; n=67 caregivers, 54.0% female) families were randomized to receive FSI-R or CAU. Refugee research assistants conducted psychosocial assessments pre- and post-intervention and home visitors delivered the preventive intervention. Multilevel modeling assessed effects of FSI-R. Feasibility was measured from retention and acceptability was measured from satisfaction surveys. The retention rate of 82.5% indicates high feasibility and high reports of satisfaction (81.5%) indicate community acceptance. Across communities, FSI-R children reported reduced traumatic stress reactions and caregivers reported fewer child depression symptoms compared to CAU families (β=−0.42; p =0.03; β=−0.34; p =0.001). Bhutanese FSI-R children reported reduced family arguing (β=−1.32; p=0.035) and showed fewer depression symptoms and conduct problems by parent report (β= −9.20; p=0.038; β=−0.92; p =0.01) compared to CAU. There were no significant differences by group on other measures. A family-based home-visiting preventive intervention can be feasible and acceptable and has promise for promoting mental health and family functioning among refugees.