title: Reducing refugee mental health disparities: a community-based intervention to address postmigration stressors with African adults.
abstract: Refugees resettled in the United States have disproportionately high rates of psychological distress. Research has demonstrated the roles of postmigration stressors, including lack of meaningful social roles, poverty, unemployment, lack of environmental mastery, discrimination, limited English proficiency, and social isolation. We report a multimethod, within-group longitudinal pilot study involving the adaptation for African refugees of a community-based advocacy and learning intervention to address postmigration stressors. We found the intervention to be feasible, acceptable, and appropriate for African refugees. Growth trajectory analysis revealed significant decreases in participants' psychological distress and increases in quality of life, and also provided preliminary evidence of intervention mechanisms of change through the detection of mediating relationships whereby increased quality of life was mediated by increases in enculturation, English proficiency, and social support. Qualitative data helped to support and explain the quantitative data. Results demonstrate the importance of addressing the sociopolitical context of resettlement to promote the mental health of refugees and suggest a culturally appropriate, and replicable model for doing so.
authors.affiliation: Department of Sociology, University of New Mexico.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Goodkind
authors.affiliation: Department of Pediatrics, University of New Mexico Health Sciences Center.
authors.forename: Julia M
authors.initials: JM
authors.lastname: Hess
authors.affiliation: Department of Psychiatry, University of New Mexico Health Sciences Center.
authors.forename: Brian
authors.initials: B
authors.lastname: Isakson
authors.affiliation: Department of Family & Community Medicine, Jefferson Medical College, Thomas Jefferson University.
authors.forename: Marianna
authors.initials: M
authors.lastname: LaNoue
authors.affiliation: Department of Anthropology, University of Virginia.
authors.forename: Ann
authors.initials: A
authors.lastname: Githinji
authors.affiliation: Department of Pediatrics, University of New Mexico Health Sciences Center.
authors.forename: Natalie
authors.initials: N
authors.lastname: Roche
authors.affiliation: Department of Psychology, Michigan State University.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Vadnais
authors.affiliation: Department of Pediatrics, University of New Mexico Health Sciences Center.
authors.forename: Danielle P
authors.initials: DP
authors.lastname: Parker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D012036:Refugees / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy*; D014481:United States; D055815:Young Adult; D001741:Black or African American