Social Emotional Wellness
Conditions
Keywords
Refugee Children
Brief summary
The overall goal of this overall goal is to pilot an adaptation of an established Social-Emotional Learning Program with novel wellness and COVID-19 safety components that are trauma-informed and culturally-specific in a resettled refugee community. In this pilot, EMPOWER (Emotions Program Outside the clinic and Wellness Education for Refugees), the study team will assess implementation outcomes (adoption, acceptability, and feasibility) of EMPOWER with refugee children and families during the COVID-19 pandemic through longitudinal evaluations and measurements of feasibility, acceptability, and attrition. The study team will also evaluate the impact of EMPOWER by assessing (a) children's social-emotional learning competence and (b) children's and family's COVID-19 knowledge.
Detailed description
The major question that guides this research is: can an adaptation of an established Social-Emotional Learning (SEL) curriculum effectively improve Social-Emotional wellness for refugee children and their families? The hypothesis is that participation in this program will (a) improve children's SEL competence and (b) lessen stress and improve quality of life for refugee families. The overall objective of this study is to establish and evaluate the preliminary efficacy and implementation of an adapted social-emotional learning (SEL) and Wellness Program for refugees: EMPOWER (Emotions Program Outside the clinic with Wellness Education for Refugees). To achieve the two aims of this study, the study team will conduct a wait-list controlled pilot to establish and evaluate the preliminary efficacy of participation in EMPOWER by assessing (a) children's SEL competence and (b) measures of mental health, stress, quality of life and wellness before and after participation in the program (Aim 1). Then, the study team will assess the implementation of EMPOWER with refugee children by using mixed methods to perform a summative evaluation of implementation outcomes-including fidelity, sustainability, and reach-in the Afghan refugee community (Aim 2).
Interventions
BEHAVIORALEMPOWER
EMPOWER is an adapted social emotional learning (SEL) and wellness education initiative delivered to a community of refugee families that was developed through a pre-pilot in the New Haven Afghan refugee community in 2020. Unlike traditional school-based SEL curricula, EMPOWER partners with community organizations to provide translated and trauma-informed wellness education to family units. The program combines in-person (socially distant) and remote delivery of culturally-informed physical, emotional, and medical wellness tools adapted from evidenced-based behavioral medicine, refugee trauma and recovery, and community health research.
Sponsors
Academic Pediatric Association
National Center for Advancing Translational Sciences (NCATS)
Yale University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
5 Years to 15 Years
Healthy volunteers
Yes
Inclusion criteria
* at least 1 year of schooling in the United States * must speak: Pashto, Dari or English * connected with the community organization: Elena's Light
Exclusion criteria
* inability to meet any of the requirements of the inclusion criteria
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Social Emotional Competence | Baseline to 4 Weeks | Subscale from Trait Meta Mood Scale: Attention to Feelings Score, Maximum 35 (7 questions on a 1-5 Likert scale, with 35 being the highest score and 7 being the lowest score) |
| Change in COVID-19 Knowledge | Baseline to 4 Weeks | Number Correct out of 5 (yes/no) COVID-19 Knowledge Questions. Score range 0-5, with 0 being the lowest score (incorrect for all questions), and 5 being the highest score (correct for all questions). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Quality of Life | Baseline to 4 Weeks | Scored subscales of: emotional, social, and school functioning. Ten total questions, each scored on a 0-4 Likert scale. Scores transformed to a 0-100 scale, with higher scores indicating a higher quality of life score. |
| Parent Afghan Symptom Checklist | Only asked of parents. To save time and build trust, this exploratory measure was not asked on follow-up because of participant burden for questions. | The Afhgan symptom checklist is a culturally-informed measure to evaluate distress and functioning in individuals from Afghanistan. We administered 21 of 22 questions to parents. Each question was scored on a scale of 1 to 5 (so minimum score (least distress) could be 21, and maximum score (most distressed) could be 105. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Intervention - Child The Child respondents for the intervention group.
The intervention arm will receive the EMPOWER curriculum between the pre- and post-evaluations.
EMPOWER: EMPOWER is an adapted social emotional learning (SEL) and wellness education initiative delivered to a community of refugee families that was developed through a pre-pilot in the New Haven Afghan refugee community in 2020. Unlike traditional school-based SEL curricula, EMPOWER partners with community organizations to provide translated and trauma-informed wellness education to family units. The program combines in-person (socially distant) and remote delivery of culturally-informed physical, emotional, and medical wellness tools adapted from evidenced-based behavioral medicine, refugee trauma and recovery, and community health research. | 13 |
| Intervention - Parent The Parent respondents for the intervention group.
The intervention arm will receive the EMPOWER curriculum between the pre- and post-evaluations.
EMPOWER: EMPOWER is an adapted social emotional learning (SEL) and wellness education initiative delivered to a community of refugee families that was developed through a pre-pilot in the New Haven Afghan refugee community in 2020. Unlike traditional school-based SEL curricula, EMPOWER partners with community organizations to provide translated and trauma-informed wellness education to family units. The program combines in-person (socially distant) and remote delivery of culturally-informed physical, emotional, and medical wellness tools adapted from evidenced-based behavioral medicine, refugee trauma and recovery, and community health research. | 3 |
| Waitlist - Child The Child respondents for the intervention group.
The waitlist control arm will receive the EMPOWER curriculum after the evaluations. They will receive a second set of evaluations at the same time as the post evaluations of the control arm.
EMPOWER: EMPOWER is an adapted social emotional learning (SEL) and wellness education initiative delivered to a community of refugee families that was developed through a pre-pilot in the New Haven Afghan refugee community in 2020. Unlike traditional school-based SEL curricula, EMPOWER partners with community organizations to provide translated and trauma-informed wellness education to family units. The program combines in-person (socially distant) and remote delivery of culturally-informed physical, emotional, and medical wellness tools adapted from evidenced-based behavioral medicine, refugee trauma and recovery, and community health research. | 6 |
| Waitlist - Parents The Parent respondents for the intervention group.
The waitlist control arm will receive the EMPOWER curriculum after the evaluations. They will receive a second set of evaluations at the same time as the post evaluations of the control arm.
EMPOWER: EMPOWER is an adapted social emotional learning (SEL) and wellness education initiative delivered to a community of refugee families that was developed through a pre-pilot in the New Haven Afghan refugee community in 2020. Unlike traditional school-based SEL curricula, EMPOWER partners with community organizations to provide translated and trauma-informed wellness education to family units. The program combines in-person (socially distant) and remote delivery of culturally-informed physical, emotional, and medical wellness tools adapted from evidenced-based behavioral medicine, refugee trauma and recovery, and community health research. | 3 |
| Total | 25 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 |
|---|---|---|---|---|---|
| Overall Study | Excluded families participated in EMPOWER previously | 4 | 2 | 0 | 0 |
Baseline characteristics
| Characteristic | Waitlist - Child | Total | Intervention - Parent | Intervention - Child | Waitlist - Parents |
|---|---|---|---|---|---|
| Age, Continuous | 14.33 years STANDARD_DEVIATION 3.51 | 28.0 years STANDARD_DEVIATION 2 | 37.67 years STANDARD_DEVIATION 2.33 | 9.69 years STANDARD_DEVIATION 0.76 | 7.50 years STANDARD_DEVIATION 0.85 |
| Covid Knowledge Score | 3.0 units on a scale STANDARD_DEVIATION 1 | 3.58 units on a scale STANDARD_DEVIATION 0.26 | 4.33 units on a scale STANDARD_DEVIATION 0.33 | 3.60 units on a scale STANDARD_DEVIATION 0.22 | 3.33 units on a scale STANDARD_DEVIATION 1.2 |
| Parent Afghan Symptom Checklist Score | — | 39.33 units on a scale | 35.33 units on a scale | — | 43 units on a scale |
| Pediatric Quality of Life Score | 82.5 units on a scale STANDARD_DEVIATION 4.87 | 73.47 units on a scale STANDARD_DEVIATION 3.75 | — | 70 units on a scale STANDARD_DEVIATION 4.57 | — |
| Primary Language Dari | 1 Participants | 8 Participants | 2 Participants | 4 Participants | 1 Participants |
| Primary Language Pashto | 5 Participants | 17 Participants | 1 Participants | 9 Participants | 2 Participants |
| Race/Ethnicity, Customized Afghan (Asian) | 6 Participants | 25 Participants | 3 Participants | 13 Participants | 3 Participants |
| Region of Enrollment United States | 6 Participants | 25 Participants | 3 Participants | 13 Participants | 3 Participants |
| Sex: Female, Male Female | 2 Participants | 14 Participants | 2 Participants | 7 Participants | 3 Participants |
| Sex: Female, Male Male | 4 Participants | 11 Participants | 1 Participants | 6 Participants | 0 Participants |
| Trait Meta Mood Scale | 25 units on a scale STANDARD_DEVIATION 2 | 25.57 units on a scale STANDARD_DEVIATION 1.23 | — | 25.67 units on a scale STANDARD_DEVIATION 1.43 | — |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 13 | 0 / 3 | 0 / 6 | 0 / 3 |
| other Total, other adverse events | 0 / 13 | 0 / 3 | 0 / 6 | 0 / 3 |
| serious Total, serious adverse events | 0 / 13 | 0 / 3 | 0 / 6 | 0 / 3 |
Outcome results
Primary
Change in COVID-19 Knowledge
Number Correct out of 5 (yes/no) COVID-19 Knowledge Questions. Score range 0-5, with 0 being the lowest score (incorrect for all questions), and 5 being the highest score (correct for all questions).
Time frame: Baseline to 4 Weeks
Population: Young children unable to answer questions were excluded
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Intervention - Child | Change in COVID-19 Knowledge | 4.50 score on a scale |
| Intervention Parent | Change in COVID-19 Knowledge | 4.33 score on a scale |
| Waitlist - Child | Change in COVID-19 Knowledge | 4.00 score on a scale |
| Waitlist - Parent | Change in COVID-19 Knowledge | 5 score on a scale |
Primary
Change in Social Emotional Competence
Subscale from Trait Meta Mood Scale: Attention to Feelings Score, Maximum 35 (7 questions on a 1-5 Likert scale, with 35 being the highest score and 7 being the lowest score)
Time frame: Baseline to 4 Weeks
Population: Children were excluded if they or their parents were unsure how to answer. The question was only asked of and/or about child participants (not parents)
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Intervention - Child | Change in Social Emotional Competence | 25.33 units on a scale |
| Waitlist - Child | Change in Social Emotional Competence | 20.00 units on a scale |
Secondary
Change in Quality of Life
Scored subscales of: emotional, social, and school functioning. Ten total questions, each scored on a 0-4 Likert scale. Scores transformed to a 0-100 scale, with higher scores indicating a higher quality of life score.
Time frame: Baseline to 4 Weeks
Population: Questions were only asked to or about children, not parents
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Intervention - Child | Change in Quality of Life | 70 score on a scale |
| Waitlist - Child | Change in Quality of Life | 82.5 score on a scale |
Secondary
Parent Afghan Symptom Checklist
The Afhgan symptom checklist is a culturally-informed measure to evaluate distress and functioning in individuals from Afghanistan. We administered 21 of 22 questions to parents. Each question was scored on a scale of 1 to 5 (so minimum score (least distress) could be 21, and maximum score (most distressed) could be 105.
Time frame: Only asked of parents. To save time and build trust, this exploratory measure was not asked on follow-up because of participant burden for questions.
Population: Only asked of parents. To save time and build trust, this exploratory measure was not asked on follow-up because of participant burden for questions.