Peer-led Support Program for Refugee Families

Recruiting in Palo Alto (17 mi)

Overseen by Mary Bunn, PhD

Age: < 65

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of Illinois at Chicago

Disqualifiers: Developmental disabilities, Severe mental health, others

No Placebo Group

Trial Summary

What is the purpose of this trial?

The proposed study draws on prior research to evaluate the feasibility, acceptability and explore preliminary effectiveness of Coffee and Family Education and Support, Version (CAFES2) using a pilot randomized type 1 hybrid effectiveness-implementation design. CAFES2 is a peer-led family and social strengthening multiple family group intervention that is designed to respond to multi-level needs of refugee families. Results of the trial will contribute to the emerging evidence base on family-based mental health interventions for refugee and newcomer communities. The trial will also generate new insights regarding implementation strategies needed to promote successful delivery of services by peer providers and the unique role of human-centered design practices for adaptation of mental health and psychosocial interventions.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on family support and mental health, so it's best to ask the trial organizers for more details.

What data supports the effectiveness of the treatment CAFES2 for refugee families?

Research on similar family-based support programs for refugees, like the Family Strengthening Intervention and TAFES, shows that these programs can improve family communication, social support, and mental health outcomes. These findings suggest that peer-led support and education, as in CAFES2, may also be beneficial for refugee families. ^{1 2 3 4 5}

Is the Peer-led Support Program for Refugee Families safe for participants?

The TAFES program, a similar multi-family support and education intervention for refugees, showed no safety concerns and was well-received by participants, suggesting that such programs are generally safe for human participants. ^{1 3 6 7 8}

How is the CAFES2 treatment different from other treatments for refugee families?

CAFES2 is unique because it is a peer-led support program specifically designed for refugee families, focusing on family education and support. Unlike traditional treatments that may rely on professional clinicians, this program emphasizes the involvement of trained family peers who share similar experiences, making it more relatable and accessible for participants. ^{9 10 11 12 13}

Research Team

Mary Bunn, PhD

Principal Investigator

University of Illinois Chicago

Eligibility Criteria

This trial is for resettled refugee families with at least one school-aged child (12-17 years old) living with them. Participants should be between 18-45 years old and have arrived in the U.S. as refugees. At least one family member must show moderate emotional distress to qualify.

Inclusion Criteria

I am a caregiver or parent aged between 18 and 45.

I have one or more children aged 12 or older living with me.

Adult Caregivers/Parents: arrived to the U.S as a refugee

Exclusion Criteria

not meeting the above inclusion criteria

families or individual in the midst of a crisis (e.g. family crisis or mental health crisis)

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Adaptation

Adaptation of the CAFES model for delivery by peers using implementation science and human-centered design methods

4-6 weeks

Treatment

Participants receive a home visit and participate in six multiple family group sessions

6 weeks

6 group sessions

Follow-up

Participants are monitored for changes in mental health and social support outcomes

6 weeks

Treatment Details

Interventions

• CAFES2 (Behavioral Intervention)

Trial Overview CAFES2, a peer-led group intervention aimed at strengthening family and social dynamics among refugee families, is being tested for its feasibility, acceptability, and preliminary effectiveness using a pilot randomized hybrid design.

Participant Groups

Group I: CAFES2 family and social strengthening intervention Experimental Treatment 1 Intervention

Families randomized into CAFES2 receive a home visit and participate in six multiple family group sessions in addition to any outside services or programs they are participating in.

Group II: Enhanced Control Active Control 1 Intervention

Families randomized to the enhanced control arm will not receive the CAFES2 intervention Instead, they will continue with their usual care, and also receive healthy lifestyle materials.

Who Is Running the Clinical Trial?

University of Illinois at Chicago

Lead Sponsor

Trials

653

Recruited

1,574,000+

Mark I. Rosenblatt

University of Illinois at Chicago

Chief Executive Officer

MD, PhD, MBA, MHA

Jon Radosta

University of Illinois at Chicago

Chief Medical Officer since 2023

MD

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Dr. Joshua A. Gordon

National Institute of Mental Health (NIMH)

Chief Executive Officer since 2016

MD, PhD

Dr. Shelli Avenevoli

National Institute of Mental Health (NIMH)

Chief Medical Officer

PhD

Findings from Research

A randomized controlled trial (RCT) involving 93 adult refugees tested a community-based intervention aimed at reducing mental health disparities and improving access to trauma-focused treatment, highlighting the importance of addressing social determinants of health.

The study identified significant challenges in conducting community-based RCTs, such as intervention diffusion and participant engagement, while also developing innovative solutions that could benefit future community-academic partnerships in similar research efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Challenges and Innovations in a Community-Based Participatory Randomized Controlled Trial. Goodkind, JR., Amer, S., Christian, C., et al.[2020]

The Family Strengthening Intervention for Refugees (FSI-R) was piloted with 80 refugee families in Greater Boston, showing that community-based participatory research (CBPR) can enhance the acceptability and feasibility of mental health interventions.

Key factors for the success of FSI-R included flexibility in scheduling, involvement of community members as interventionists, and improvements in family communication, which collectively contributed to better family functioning and children's mental health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Understanding mechanisms of change in a family-based preventive mental health intervention for refugees by refugees in New England. DiClemente-Bosco, K., Elizabeth Neville, S., Berent, JM., et al.[2023]

The TAFES intervention, involving family home visits and multi-family support groups, was implemented with 86 newly resettled Kosovar refugees, showing high engagement with 69% of families participating in the groups.

Post-intervention assessments indicated that participants experienced increased social support and improved knowledge and attitudes towards trauma mental health, suggesting that TAFES may be a beneficial intervention for refugee families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The TAFES multi-family group intervention for Kosovar refugees: a feasibility study. Weine, SM., Raina, D., Zhubi, M., et al.[2018]

The Family Empowerment (FAME) program, designed for asylum seeker families in the Netherlands, was well-received by participants, with many valuing the opportunity to connect with other families, although only a small number completed all assessments.

While FAME showed potential for reducing anxiety and depression among parents, it had limited effects on overall family functioning, suggesting that the program's goals may not have fully met the specific needs of some families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family Empowerment (FAME): A feasibility trial of preventive multifamily groups for asylum seeker families in the Netherlands. van Es, CM., Boelen, PA., Zwaanswijk, M., et al.[2022]

A culturally congruent support intervention for Somali and Sudanese refugees, involving peer and professional facilitators, was successfully designed and piloted with 58 participants over 12 weeks, focusing on enhancing social networks.

Participants reported significant benefits, including increased social integration, reduced feelings of loneliness, and improved coping strategies, highlighting the importance of culturally tailored support in helping refugees adapt to new environments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supporting African refugees in Canada: insights from a support intervention. Stewart, M., Simich, L., Shizha, E., et al.[2021]

The Pika Pamoja cooking curriculum was successfully implemented with 10 refugee family dyads, showing high retention rates and fidelity in the program's execution, indicating it is feasible and well-accepted by participants.

Participants reported positive feedback on the program, which included improvements in cooking skills, self-efficacy, and family engagement in healthy eating, suggesting potential benefits for food security among refugee families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and Acceptability of Implementing a Culturally Adapted Cooking Curriculum for Burundian and Congolese Refugee Families. McElrone, M., Colby, S., Fouts, HN., et al.[2021]

All 30 households with children under 5 years old in the study were found to be food-insecure, with 60% of the children experiencing hunger, highlighting a critical issue among recently arrived refugee families.

Child hunger was linked to factors such as recent arrival in the UK and receiving fewer benefits, suggesting that targeted support and resources are needed to address food insecurity in this vulnerable population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Food insecurity among refugee families in East London: results of a pilot assessment. Sellen, DW., Tedstone, AE., Frize, J.[2019]

A qualitative study involving 40 participants (25 parents and 15 adolescents) from Horn of Africa refugee communities in Melbourne revealed significant differences in dietary beliefs and health perceptions between parents and their adolescent children.

Parents employed various feeding practices to maintain traditional diets for their children, highlighting the need for health programs to consider the effects of acculturation on dietary habits and family dynamics among refugee populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intergenerational differences in acculturation experiences, food beliefs and perceived health risks among refugees from the Horn of Africa in Melbourne, Australia. Wilson, A., Renzaho, A.[2023]

The study identified five key elements of a peer-led home visiting support program for Aboriginal parents, emphasizing the importance of culturally appropriate strategies and community engagement in enhancing program effectiveness.

Participants highlighted the need for ongoing support for peer support workers and interagency collaboration to ensure the sustainability and success of the program, which is crucial for developing positive family environments among Aboriginal families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aboriginal parent support: A partnership approach. Munns, A., Toye, C., Hegney, D., et al.[2021]

The 'Families Helping Families' program in Melbourne has successfully integrated trained family peer supporters into mental health services, responding to government policies and family feedback.

Preliminary results indicate that this program is positively received by families, highlighting the potential benefits of incorporating lived experience into mental health treatment and care plans, though further research is needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family peer support work in an early intervention youth mental health service. Leggatt, M., Woodhead, G.[2017]

The demonstration project successfully tested a self-help model for female single parents, leading to increased membership and improved self-awareness, confidence, and leadership skills among participants.

Key factors contributing to the project's success included initial individual contact, informal agreements, and strong community support, which helped enhance coping skills and access to resources.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supportive group action for women: a self-help strategy. Stewart, M.[2009]

Peer supporters in South Africa play a crucial role in promoting exclusive breastfeeding, but they face unique challenges such as marketing their services and negotiating entry into mothers' homes, which differs from traditional healthcare roles.

The effectiveness of peer supporters is enhanced by supportive supervision that addresses both their health-related tasks and the social challenges they encounter, such as stigma and normative feeding practices that complicate their efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Selling a service: experiences of peer supporters while promoting exclusive infant feeding in three sites in South Africa. Nkonki, LL., Daniels, KL.[2021]

References

1. United States pubmed.ncbi.nlm.nih.gov

Challenges and Innovations in a Community-Based Participatory Randomized Controlled Trial. [2020]

2. England pubmed.ncbi.nlm.nih.gov

Understanding mechanisms of change in a family-based preventive mental health intervention for refugees by refugees in New England. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

The TAFES multi-family group intervention for Kosovar refugees: a feasibility study. [2018]

4. United States pubmed.ncbi.nlm.nih.gov

Family Empowerment (FAME): A feasibility trial of preventive multifamily groups for asylum seeker families in the Netherlands. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Supporting African refugees in Canada: insights from a support intervention. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Feasibility and Acceptability of Implementing a Culturally Adapted Cooking Curriculum for Burundian and Congolese Refugee Families. [2021]

7. England pubmed.ncbi.nlm.nih.gov

Food insecurity among refugee families in East London: results of a pilot assessment. [2019]

8. England pubmed.ncbi.nlm.nih.gov

Intergenerational differences in acculturation experiences, food beliefs and perceived health risks among refugees from the Horn of Africa in Melbourne, Australia. [2023]

9. England pubmed.ncbi.nlm.nih.gov

Aboriginal parent support: A partnership approach. [2021]

10. England pubmed.ncbi.nlm.nih.gov

'Living with Teenagers': feasibility study of a peer-led parenting intervention for socially disadvantaged families with adolescent children. [2016]

11. Australia pubmed.ncbi.nlm.nih.gov

Family peer support work in an early intervention youth mental health service. [2017]

12. Canada pubmed.ncbi.nlm.nih.gov

Supportive group action for women: a self-help strategy. [2009]

13. England pubmed.ncbi.nlm.nih.gov

Selling a service: experiences of peer supporters while promoting exclusive infant feeding in three sites in South Africa. [2021]