Syrian Refugee Young Adults as Community Mental Health Workers-Lebanon

NCT ID: NCT05265611

Last Updated: 2025-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

115 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-11

Study Completion Date

2025-03-25

Brief Summary

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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

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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.

Conditions

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Mental Health Stress, Psychological

Keywords

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Lebanon Refugee Problem Management Plus RCT Psychosocial intervention

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Young Adult Community Mental Health Worker

Syrian refugee young adults will be trained to implement Problem Management Plus (PM+): a WHO evidence-based low intensity mental health intervention to Syrian refugee adults in their community. They will complete 4 surveys to measure outcomes and mechanisms.

Group Type EXPERIMENTAL

low intensity psychosocial intervention - Problem Management Plus (PM+)

Intervention Type BEHAVIORAL

Syrian refugee young adults will be trained to implement Problem Management Plus (PM+). PM+ is a low-intensity mental health intervention, developed by WHO, and delivered by non-specialized CMHW. It is a transdiagnostic treatment approach that includes four evidence-based problem solving and behavioral treatment techniques: managing stress, managing problems, get going/get doing, and social support. These strategies are implemented over five weekly sessions, of 90 minutes each.

Young Adult Tutors

Syrian refugee young adults will be trained to tutor elementary school students in their community.They will complete 4 surveys to measure outcomes and mechanisms.

Group Type ACTIVE_COMPARATOR

Tutoring

Intervention Type BEHAVIORAL

Young adults will be trained to tutor students in elementary school.

Young Adut Control Group

Syrian refugee young adults in the control group will only complete the surveys. They will complete 4 surveys to measure outcomes and mechanisms.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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low intensity psychosocial intervention - Problem Management Plus (PM+)

Syrian refugee young adults will be trained to implement Problem Management Plus (PM+). PM+ is a low-intensity mental health intervention, developed by WHO, and delivered by non-specialized CMHW. It is a transdiagnostic treatment approach that includes four evidence-based problem solving and behavioral treatment techniques: managing stress, managing problems, get going/get doing, and social support. These strategies are implemented over five weekly sessions, of 90 minutes each.

Intervention Type BEHAVIORAL

Tutoring

Young adults will be trained to tutor students in elementary school.

Intervention Type BEHAVIORAL

Eligibility Criteria

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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
Minimum Eligible Age

18 Years

Maximum Eligible Age

24 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Rema Afifi

OTHER

Sponsor Role lead

Responsible Party

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Rema Afifi

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Rima A Afifi, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Iowa College of Public Health

Locations

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American University of Beirut, Faculty of Health Sciences

Beirut, , Lebanon

Site Status

Countries

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Lebanon

References

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Nakkash R, Ghandour L, Brown G, Panter-Brick C, Bomar H, Tleis M, Al Masri H, Fares M, Al Halabi F, Najjar Y, Louis B, Hodroj M, Chamoun Y, Zarzour M, Afifi RA. Syrian refugee young adults as community mental health workers implementing problem management plus: Protocol for a pilot randomized controlled trial to measure the mechanisms of effect on their own wellbeing, stress and coping. Contemp Clin Trials Commun. 2024 Jun 28;40:101325. doi: 10.1016/j.conctc.2024.101325. eCollection 2024 Aug.

Reference Type RESULT
PMID: 39045391 (View on PubMed)

Ghandour L, Brown G, Tleis M, Al Masri H, Fares M, Al Halabi F, Najjar Y, Louis B, Afifi RA, Nakkash R. Structural and political determinants of health among Syrian refugee young adults in the Bekaa, Lebanon: a prospective cohort study of the impact of security raids on perceived discrimination and well-being. BMJ Open. 2024 Dec 5;14(12):e087777. doi: 10.1136/bmjopen-2024-087777.

Reference Type RESULT
PMID: 39638591 (View on PubMed)

Nakkash R, Fares M, Tleis M, Mugharbil A, Antaby M, Al Masri H, Ghandour L, Al Halabi F, Najjar Y, Louis B, Afifi RA. (2024). Power Sharing in Community-Engaged Research with Syrian Refugees in Lebanon: Using community engagement to shape Intervention Fit to Context. Social Science and Medicine, Mental Health; 6(4): 100358, https://doi.org/10.1016/j.ssmmh.2024.100358.

Reference Type RESULT

Other Identifiers

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202107337

Identifier Type: -

Identifier Source: org_study_id