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1 Conceptual model

1 Conceptual model

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There is a growing recognition that social inequities in education, housing, employment, health care, safety, resources, money, and power contribute significantly to increasing health disparities globally, within countries, and even within specific urban environments. Thus, to promote health and well-being for all people, the World Health Organizat...

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Nebraska has one of the highest numbers of refugees per capita in the U.S. A high number of Somalis have resettled in Nebraska due to job opportunities and the low cost of living. In this paper, we report the process and the results of a cervical and breast cancer education program for Somali women conducted through a collaboration among public hea...

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... Developed by Jessica Goodkind and colleagues, the Refugee Well-Being Project intervention (RWP; Goodkind, 2005;Goodkind et al., 2020;Goodkind et al., 2011) provides a sustainable and replicable collaborative model among refugees, community organizations, and universities. Using this model, refugee families and undergraduate student advocates worked together in pairs toward a fivefold goal, spanning 6 months. ...
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As migration and displacement continue to increase around the world, guidelines are needed clarifying how school counselors can use their power and privilege in working with refugee students and their families across K-12 education, more so in relation to the COVID-19 pandemic. We introduce the Refugee Well-Being Project intervention to school counselors and school counselor interns, focusing on the social determinants of health impacting the overall well-being of refugee students.
... Single interventions that emerged constituted of: providing health information [64,65], cultural brokering through ambassadors [66][67][68][69][70][71][72], bilingual advocacy and interpretation [73,74], and a community garden project addressing a sense of community and adoption of a healthy dietary pattern [75]. Complex interventions, on the other hand, concerned community-academic partnerships [76][77][78][79][80][81], community-based nursing initiatives [82][83][84], home-based health services [83], programs on prevention, and healthcare services for the uninsured [85]. ...
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Background: Strengthening community-based healthcare is a valuable strategy to reduce health inequalities and improve the integration of migrants and refugees into local communities in the European Union. However, little is known about how to effectively develop and run community-based healthcare models for migrants and refugees. Aiming at identifying the most-promising best practices, we performed a scoping review of the international academic literature into effective community-based healthcare models and interventions for migrants and refugees as part of the Mig-HealthCare project. Methods: A systematic search in PubMed, EMBASE, and Scopus databases was conducted in March 2018 following the PRISMA methodology. Data extraction from eligible publications included information on general study characteristics, a brief description of the intervention/model, and reported outcomes in terms of effectiveness and challenges. Subsequently, we critically assessed the available evidence per type of healthcare service according to specific criteria to establish a shortlist of the most promising best practices. Results: In total, 118 academic publications were critically reviewed and categorized in the thematic areas of mental health (n = 53), general health services (n = 36), noncommunicable diseases (n = 13), primary healthcare (n = 9), and women's maternal and child health (n = 7). Conclusion: A set of 15 of the most-promising best practices and tools in community-based healthcare for migrants and refugees were identified that include several intervention approaches per thematic category. The elements of good communication, the linguistic barriers and the cultural differences, played crucial roles in the effective application of the interventions. The close collaboration of the various stakeholders, the local communities, the migrant/refugee communities, and the partnerships is a key element in the successful implementation of primary healthcare provision.
... The RWP intervention was first developed and implemented in 2000-2001 by academic and community partners in Michigan (Goodkind, Hang, & Yang, 2004), and adapted and implemented six additional years by academic and community partners in New Mexico (Goodkind, Githinji, & Isakson, 2011) before collaboratively developing an RCT design and acquiring funding from the National Institutes of Health in 2013. Initial pilot testing of the RWP demonstrated feasibility, appropriateness, acceptability, and preliminary evidence that the intervention decreased Hmong, African, and Iraqi participants' psychological distress and increased protective factors (Goodkind, 2005(Goodkind, , 2006Goodkind et al., 2014). ...
... Findings also indicated that students engaged in mutual learning with their refugee partners (Goodkind, 2006) and that the RWP fostered transformative learning experiences through which refugees' and students' critical awareness was increased, which provided an impetus to work toward social change at multiple levels . For a more detailed description of the RWP intervention, see Goodkind (2005) and Goodkind, Githinji, and Isakson (2011). ...
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Understanding processes that support the well‐being of the unprecedented numbers of forcibly displaced people throughout the world is essential. Growing evidence documents post‐migration stressors related to marginalization as key social determinants of refugee mental health. The goal of this RCT was to rigorously test a social justice approach to reducing high rates of distress among refugees in the United States. The 6‐month multilevel, strengths‐based Refugee Well‐being Project (RWP) intervention brought together university students enrolled in a 2‐semester course and recently resettled refugees to engage in mutual learning and collaborative efforts to mobilize community resources and improve community and systems responsiveness to refugees. Data collected from 290 Afghan, Great Lakes African, Iraqi, and Syrian refugees at four time points over 12 months were used to test the effectiveness of RWP to reduce distress (depression and anxiety symptoms) and increase protective factors (English proficiency, social support, connection to home and American cultures). Intention‐to‐treat analyses using multilevel modeling revealed significant intervention effects for all hypothesized outcomes. Results provide evidence to support social justice approaches to improving refugee mental health. Findings have implications for refugees worldwide, and for other immigrant and marginalized populations who experience inequities in resources and disproportionate exposure to trauma/stress. Highlights • Multilevel strengths‐based intervention decreases refugee distress and improves protective factors. • Holistic focus on psychological, material, social, educational, and cultural needs is effective. • High recruitment/retention rates support importance of non‐stigmatizing universal interventions. • RWP intervention reaches refugees unlikely to access formal mental health services. • RWP circumvents typical barriers to services (stigma, trust, linguistic/cultural appropriateness).
... Therapeutic factors in group work that are applicable to working with refugee trauma include corrective emotional experiences, altruism, universality (Yalom, 2005), and love (Bemak & Epp, 1996). The merits of social support and group counseling with refugees have been acknowledged (e.g., Bemak & Chung, 2014;Stansfield, 2006), and the sharing of stories and social engagement have been found to be highly effective interventions for addressing refugee stressors and trauma (Ehntholt, Smith, & Yule, 2005;Goodkind, Githinji, & Isakson, 2011). Thus, group counseling is highlighted in Phase II and extends to psychoeducational group sessions in Phase I and cultural empowerment groups in Phase III. ...
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This article presents the Multiphase Model of Psychotherapy, Counseling, Social Justice, and Human Rights as a culturally responsive intervention model for working with refugee trauma. The model specifically addresses unique challenges in working with refugees with trauma, taking into account premigration displacement and postmigration adjustment and adaptation brought about by the increased number of global refugees with high rates of posttraumatic stress and psychopathology due to war and conflict. © 2017 by the American Counseling Association. All rights reserved.
... The former focuses on the pragmatic and therapeutic elements of cultural exchange (Goodkind 2006) to foster cohesiveness and support within the RWP cohorts themselves, and to serve as fora for the reinforcement and/or generation of new familial roles in response to resettlement stressors. Advocacy provided support in education, as well as health care, finding safe housing, and assisting with immigration and residency logistics (Goodkind et al. 2011). Goodkind (2005) found that both mutual learning and advocacy applied together were successful in mitigating some of the deleterious effects of displacement and resettlement over the course of the 1-year study and can be applied with other refugee groups. ...
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Social and geographic displacement is a global phenomenon that precipitates novel stressors and disruptions that intersect with long-standing familial and social roles. Among the displaced are war-torn Iraqi refugee families, who must address these new obstacles in unconventional ways. This study explores how such disruptions have influenced associations between gender and apparent self-worth experienced by Iraqi refugee families upon relocation to the USA. Further, the psychosocial mechanisms requisite of any novel approach to a new social construct are explored and reveal that production in the family is at the core of instability and shifting power dynamics during resettlement, preventing family members from “seeing the life” in the USA that they had envisioned prior to immigration. Over 200 semi-structured qualitative interviews with Iraqi participants and mental health providers were conducted over the course of the study, which demonstrate a plasticity among social roles in the family and community that transcends the notion of a simple role reversal, and illustrate the complex positionalities that families under stress must approximate during such physical and social displacement.
... Of note, the intervention was initially developed by academic and community partners over 4 years in Michigan (Goodkind, Hang, & Yang, 2004) and adapted and implemented 6 additional years by academic and community partners in New Mexico (Goodkind, Githinji, & Isakson, 2011) before collaboratively developing an RCT design and acquiring funding from the National Institutes of Health in 2013. The initial pilot testing of the RWP demonstrated feasibility, appropriateness, acceptability, and preliminary evidence that the intervention decreased Hmong, African, and Iraqi participants' psychological distress and increased protective factors (Goodkind, 2005(Goodkind, , 2006Goodkind et al., 2014). ...
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Randomized controlled trials (RCTs) are a long-standing and important design for conducting rigorous tests of the effectiveness of health interventions. However, many questions have been raised about the external validity of RCTs, their utility in explicating mechanisms of intervention and participants’ intervention experiences, and their feasibility and acceptability. In the current mixed-methods study, academic and community partners developed and implemented an RCT to test the effectiveness of a collaboratively developed community-based advocacy, learning, and social support intervention. The goals of the intervention were to address social determinants of health and build trust and connections with other mental health services in order to reduce mental health disparities among Afghan, Great Lakes Region African, and Iraqi refugee adults and to engage and retain refugees in trauma-focused treatment, if needed. Two cohorts completed the intervention between 2013 and 2015. Ninety-three adult refugees were randomly assigned to intervention or control group and completed four research interviews (pre-, mid-, and postintervention, and follow-up). Several challenges to conducting a community-based RCT emerged, including issues related to interviewer intervention to assist participants in the control group, diffusion of intervention resources throughout the small refugee communities, and staff and community concerns about the RCT design and what evidence is meaningful to demonstrate intervention effectiveness. These findings highlight important epistemological, methodological, and ethical challenges that should be considered when conducting community-based RCTs and interpreting results from them. In addition, several innovations were developed to address these challenges, which may be useful for other community–academic partnerships engaged in RCTs.
... This article reports on one aspect of a larger study of the Refugee Well-being Project, a community-based intervention that aims to address social determinants of health in a holistic way in an attempt to reduce the burden of mental illness experienced by refugees (Goodkind, Githinji, & Isakson, 2011). In this article, we explore one mechanism within the intervention that may contribute to addressing these social determinants: pairing undergraduate students with recently arrived refugees to engage in mutual learning and advocacy to foster transformative learning among refugee and student participants. ...
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Distribution of power and resources greatly impacts the mental health of individuals and communities. Thus, to reduce mental health disparities, it is imperative to address these social determinants of mental health through social change. Engaging in social change efforts requires people to critically engage with present conditions on personal, local, national, and global levels and to develop knowledge, capacity, and experience with envisioning and creating more equitable conditions. This critical engagement can be fostered through a process of transformative learning. In this article, we examine the Refugee Well-being Project (RWP), a program that aims to improve the mental health of refugees in the United States. From 2007 to 2009, participants in the RWP in New Mexico were refugees from the Great Lakes region of Africa. The RWP paired undergraduate students with refugees to engage in mutual learning and advocacy. Data from in-depth qualitative interviews with 72 refugees and 53 undergraduate students suggest that participation in the RWP constituted a transformative learning experience through which refugees and students came to new understandings of the relationship between social inequities and well-being. For many, this provided an impetus to work toward change at multiple levels. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
... Through this process, refugees' culture, experiences, and knowledge were valued and utilized in the promotion of their well-being. For a more detailed description of the intervention, see Goodkind, Githinji, and Isakson (2011). ...
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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. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
... Thus, it is difficult to find scholarly contributions from applied anthropologists in the field. There are some exceptions including authors working with urban health disparities issues and advocacy (Goodkind, et al. 2011), recommendations for structural and nutritional education (Trapp 2010), and special calls for interdisciplinary work in the field during complex emergencies . ...
... Yet, US resettlement agencies struggle to help new ethnic groups adapt to their lives in the US. Most of the literature on Burmese refugees and their health is coming from state and local health departments and resettlement agencies (Goodkind, et al. 2011;Gulf Coast Jewish Family and Community Services 2011;Mitschke, et al. 2011;Oleson 2009;Power, et al. 2010;Swe and Ross 2010;Trapp 2010). As these resources are very helpful for service providers in different locations across the US, it is important that any research that gets conducted with this population gets shared with the intention of a broad readership. ...
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Burmese refugees are entering the US at record speed. Resettlement agencies focus on immediate needs, and ethnic community-based organizations (ECBOs) fill any service gaps through community-driven programs. The Tampa Bay Burmese Council (TBBC) is an ECBO in Tampa, FL dedicated to the Burmese community. This research explores the reproductive beliefs of the women in the community, paying particular attention to any differences that arise due to beliefs specific to their ethnic group. Findings include the importance of menses for women's health, the preference for both male and female children, a lack of knowledge about family planning methods, a tendency to use family planning only after the ideal family composition is reached, and periods of food and activity prohibitions during pregnancy and the postpartum period. The recommendations offered will be used by the TBBC to apply for grants to fund needed community-based services.
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Minimal research has simultaneously explored the premigration, displacement, and postmigration experiences of loneliness among older adults with a refugee history. Drawing from a constructivist grounded theory study guided by an intersectionality framework, this study aimed to explore the factors influencing loneliness in these three phases among Hmong older adults with a refugee background. Interviews were conducted with 17 Hmong older adults aged 65 and older residing in Northern California. Findings revealed the influencing factors emerging from systems of oppression grounded within the social, political, and cultural context of each phase. Influencing factors of loneliness were identified as betrayal, familial loss, instability, war violence, loss of social status, isolation, diminishing filial piety, language barrier, declining health, and lack of purpose. This study highlights the need for more research, practice, and policy focused on the context of the refugee experience to gain a greater insight into their loneliness experiences.