Lindsay Stark

Washington University in St. Louis | WUSTL , Wash U · George Warren Brown School of Social Work

Background Girls at early stages of adolescence are vulnerable to violence victimization in humanitarian contexts, but few studies examine factors that affect girls’ hope in these settings. We assessed attitudes toward traditional gender norms as an effect modifier of the relationship between violence exposure and future orientation in displaced gi...

This paper reports on the use of a "neighborhood method" to measure the nature and incidence of violence against women and girls in post-conflict Liberia. The study population comprised females in Montserrado and Nimba counties. Study participants were randomly selected for interviews using multi-stage cluster sampling. 30 clusters of households we...

Background The Government of Cambodia has committed to supporting family care for vulnerable children, including homeless populations. Collecting baseline data on the numbers and characteristics of homeless adolescents was prioritized to illuminate the scope of the issue, mobilize resources and direct the response. Methods Administrative zones acr...

Objectives The primary objective of this study was to collect baseline data on the number of children living in residential care institutions in Cambodia. The secondary objective was to describe the characteristics of the children (eg, age, sex, duration of stay, education and health). The data were intended to guide recent efforts by the Governmen...

One in five women aged 20–24 years are first married before adulthood. Using the Violence against Children Surveys from Uganda and Malawi, we decomposed the total relationship between child marriage and psychological distress into an indirect relationship via intimate partner violence (IPV) and a direct relationship (above and beyond IPV). In Ugand...

Purpose Newcomer adolescent girls from the Middle East and North Africa region face intersectional challenges and opportunities upon resettlement. This study employs PhotoVoice participatory research methodology to explore perspectives on well-being and belonging shared by six students who resettled to Chicago from Iraq and Syria. Methods Two prog...

There has been tremendous progress in building and promoting evidence-based practice around parenting programming in low- and middle-income countries. However, there remains a dearth of evidence specifically examining gender transformative programming designed to address gender-based violence in humanitarian settings. To inform this gap, we examine...

The global refugee system prioritises self-sufficiency as a prime objective, but refugees may have different views of their success. To assess how refugees across varying contexts of exit and reception conceptualise success, this study draws on in-depth interviews with 36 adult refugees from Iraq and Democratic Republic of Congo resettled in Denver...

Background: During humanitarian crises, women face both heightened vulnerabilities and a disruption to their social networks. Previous research points to the positive impact of women’s collectives in low-income settings, but less is known about the distinct forms, mechanisms, and consequences of the social support that emerges from these collective...

Introduction Sexual violence is a significant public health concern with severe physical, social and psychological consequences, which can be mitigated by health service utilisation. However, in Uganda and much of sub-Saharan Africa, these services are significantly underused, with 9 out of 10 survivors not seeking care due to a range of psychologi...

Background Little is known regarding economic impacts of intimate partner violence (IPV) in humanitarian settings, especially the labor market burden. Examining costs of IPV beyond the health burden may provide new information to help with resource allocation for addressing IPV, including within conflict zones. This paper measures the incidence and...

Background Forcibly displaced adolescents face increased risks for mental illness and distress, with adolescent girls disproportionately affected in part due to heightened gender inequity. Although the family unit has the potential to promote healthy development in adolescents, few family interventions have employed a gender transformative approach...

Background: Governmental and non-governmental organizations across medical, legal, and psychosocial sectors providing care to survivors of gender-based violence (GBV) and their families rapidly digitalized services during the COVID-19 pandemic. GBV prevention/response services working with women and children who are forcibly displaced and/or living...

The study identifies acculturative challenges and opportunities experienced by Arab-speaking MENA refugees in the United States. The research team conducted 24 semi-structured interviews with refugee parents (11 fathers and 13 mothers) in Arabic. The findings reveal two main categories: (a) acculturative challenges and (b) opportunities and hopes f...

Caregivers play a critical role in mediating the impacts of forced displacement on children; however, humanitarian programming remains hampered by a lack of evidence-based programming. We present findings from an evaluation of a group-based curriculum delivered over the course of 12 sessions, journey of life (JoL). A waitlist-control quasi-experime...

Background A growing literature points to the critical role schools can play in promoting improved psychosocial wellbeing and resilience among first- and second-generation Arab immigrant and refugee adolescents, but few evaluations have examined the effectiveness of culturally adapted, school-based interventions. Methods We conducted a pilot evalu...

A study conducts a review of risk and protective factors for well-being and barriers to help-seeking among Arab-speaking MENA immigrants and refugees (IRs) in North America. Guided by Arksey and O’Malley’s Scoping Studies Methodological Framework, we use the Population, Concept, and Context (PCC) framework recommended by Joanna Briggs Institute (JB...

Adolescent refugees from the Middle East and North Africa (MENA) region face significant acculturation challenges and stressors in the United States. This qualitative study draws upon the integrated motivational-volitional model to understand MENA-background adolescents’ psychosocial wellbeing and suicide risk in three U.S. cities. Local service pr...

Background The COVID-19 pandemic produced alarming rates of disease and mortality globally, yet few nations were as severely impacted as Brazil. The pandemic also exposed and exacerbated persistent forms of structural violence across Brazil, which complicated gender-based violence (GBV) prevention and response efforts. While structural violence is...

Background: Exposure to protracted public violence is increasingly referenced as a risk factor for domestic violence, but limited quantitative evidence has demonstrated this association to date. This study analyzes associations in Colombia between lifetime experiences of external violence, including the Colombia civil conflict and community interp...

Background: Violence against children and youth poses public health risks regarding mental health symptoms and substance use. Less studied is the relationship between violence and mental health/substance abuse in the Latin American context. This study explored sex-stratified relationships between violence and mental health/substance use among Colo...

Background Little is known regarding economic impacts of IPV in humanitarian settings, and the limited number of costing studies tend to focus on the health burden of IPV without considering consider the labor burden. Examining the myriad costs associated with IPV expands understanding of the urgency to address IPV. Methods Our top-down costing st...

We explore how Arab adolescents enact critical consciousness to improve their lives and better their community. Eleven first- and second-generation Arab adolescents participated in a Photovoice study and were asked to reflect on and take photos that represented their well-being, daily life, and sense of belonging and community. The participants dis...

Adolescent resettled refugees across the United States have been significantly impacted by the COVID-19 pandemic, through socio-economic stressors in households, disproportionate morbidity and mortality in immigrant communities, and social isolation and loss of learning due to school closures and the shift to online learning. The Study of Adolescen...

Household violence poses a significant threat to the physical and mental health of adolescent girls. In conflict-affected communities, increased stresses to safety, security, health, and livelihoods may heighten this risk. While it is widely evidenced that the caregiver-child relationship can increase or protect against girls’ risk of violence, les...

Caregivers in humanitarian settings experience compounding stressors that may challenge their ability to provide quality parenting to children in their care. In recognition of this precarity, our analysis examines the linkage between psychosocial wellbeing and parenting behaviors among caregivers in Kiryandongo Settlement, Uganda. Using baseline da...

During the COVID-19 pandemic, women and girls across the globe faced increased reliance on the digital space to access education, social support, and health and gender-based violence (GBV) services. While research from the last three years has explored how women and girls navigated and responded to their new virtual reality, minimal evidence has be...

Services and policies need to be more thoughtfully designed to enable young refugees’ social and economic integration. This requires a better understanding of what constitutes sustainable integration and what factors promote it.

Mental health disorders and related symptoms are among the top leading causes of disability adjusted life years (DALYs) among youth (10–24 years) and adults (25–49 years) [...]

Background The United Nations Refugee Agency [UNHCR] implements a Framework for Child Protection for refugee children, based on a child protection systems-strengthening approach. Measurement of child protection system strength in humanitarian contexts is nascent, and existing methodologies do not capture the multiple components of the Framework. O...

While family functioning interventions show promise for improving adolescent girls’ well-being in humanitarian contexts, few programs employ a gender-transformative approach to maximize benefits for adolescent girls. This paper presents findings from a mixed-methods pilot evaluation of a whole-family, gender-transformative intervention conducted wi...

Adolescents resettled to the US from conflict-affected countries in the Middle East and North Africa region face a range of acculturative challenges, including language barriers, that may affect their wellbeing. This qualitative study aims to understand the variety of approaches US schools use to support the education of Arabic-speaking students. U...

Humanitarian crises inherently exacerbate strains on social support and risks of gender-based violence (GBV), especially for women and girls. However, little is known in regard to the linkage between social support and GBV in humanitarian settings. This systematic review sheds light on this scientific gap by synthesizing evidence examining the role...

A growing body of literature has documented an increased risk of gender-based violence (GBV) within the context of COVID-19 and service providers’ reduced capacity to address this vulnerability. Less examined are the system-level impacts of the pandemic on the GBV sector in lowand middle-income countries. Drawing on the perspectives of 18 service p...

Public health scholars and practitioners have increasingly distanced themselves from the term “culture,” which has been used to essentialize and blame marginalized “others.” However, leading health theories inevitably entail the study of culture; omitting the term may sever vital connections to useful social theory. Instead, we propose the Intersec...

Purpose There is a paucity of research examining the contextual factors that shape the violence experienced by those engaged in transactional sex, particularly among adolescent boys and young men. Recognizing the acute vulnerability among youth engaged in transactional sex, this analysis examined the associations between lifetime transactional sex...

Background Migrant and refugee women have faced a myriad of challenges during COVID-19, which are often exacerbated by the interaction between this population’s diverse identities and established systems in the local context. This qualitative study uses the lens of intersectionality to understand migrant and refugee women’s experiences of gender-ba...

Audio Computer-Assisted Self-Interview (ACASI) has become increasingly popular for collecting data on sensitive topics among populations with lower levels of literacy. However, the development of an ACASI tool is an involved process that can be further complicated when working in humanitarian contexts during the COVID-19 pandemic. This study descri...

Individuals from conflict-affected countries, such as Iraq, face formidable challenges when they resettle in the United States. Drawing from intersectionality theory, we explore the lived experiences of adolescent boys and girls from Iraq who have resettled in Texas and Virginia. In this qualitative study, we focus on the school as an institution t...

Purpose The ways family members engage and communicate with each other has significant impacts on well-being and coping strategies in the face of adversity, but there is a dearth of studies examining family functioning programming in humanitarian settings, particularly programs that incorporate a gender lens and engage multiple family members and g...

Background Intimate partner violence (IPV) is the most pervasive form of gender-based violence, often first experienced in adolescence. While the prevalence of IPV is known to be exacerbated in humanitarian settings, little is known in regard to the economic burden of IPV between conflict-affected and non–conflicted-affected groups of women and gir...

Purpose: This systematic review investigates the methodological and ethical implications of using remote data collection tools to measure sexual/reproductive health (SRH) and gender-based violence (GBV) outcomes among women and girls in humanitarian and fragile settings. Methods: We included empirical studies of all design types that collected any...

Background Household violence is one of the most prevalent forms of gender-based violence faced by adolescent girls in humanitarian settings. A growing evidence base demonstrates the extent to which multiple forms of familial violence, including intimate partner violence, violence against children, and sibling violence overlap in the same household...

Background A growing body of research has begun examining the relationship between a child's age at first exposure to violence and outcomes of mental wellbeing, though no studies have assessed these relationships in the sub-Saharan African (SSA) region. Objective Given known gender and sex differences in violence exposure and mental health symptom...

A growing number of researchers studying intimate partner violence (IPV) employ aggregate measures of relevant attitudes to serve as proxy measures for norms around IPV. However, there is a lack of consistency in how these measures are constructed and how their validity is confirmed. The first aim of this study is to demonstrate and validate innova...

Introduction: Evidence-based programs are needed to engage men and boys that encourage the transformation of concepts of masculinity that uphold patterns of intimate partner violence (IPV). This study explores the constructs of masculinity and male gender norms surrounding sexual attitudes and IPV among men and boys living in Rakai, Uganda. Methods...

Intimate partner violence (IPV) poses a significant threat as young as adolescence, globally. Girls and women in sub-Saharan Africa (SSA) often face even greater risk of IPV. The risk of IPV in this region often materializes during adolescence, before girls have even entered into a formal union or marriage. This study presents findings from a study...

IntroductionThere is substantial evidence linking stressful life events (SLEs) in childhood to poor mental health later in life, but few studies explore how various types of SLEs differentially impact mental health. The purpose of this study is to assess associations between SLEs and psychosocial outcomes in a diverse adolescent population in the U...

Background The impacts of infectious disease outbreaks, epidemics, and pandemics are not gender neutral. Instead, infectious diseases and gender-based violence (GBV) mutually reinforce each other. Women and girls in humanitarian settings are disproportionately impacted as crises exacerbate gender inequality, violence, and community transmission. A...

Background Understanding how gender norms affect health is an important entry point into designing programs and policies to change norms and improve gender equality and health. However, it is rare for global health datasets to include questions on gender norms, especially questions that go beyond measuring gender-related attitudes, thus limiting ge...

Youth violence poses a substantive public health burden in Latin America, particularly among adolescent boys and young men. Understanding predictors of youth violence perpetration among boys and young men is critical to more effectively target and tailor prevention programs, especially in Colombia, which has endured decades-long internal armed conf...

Background Adolescent girls face myriad threats to their well-being and safety as a result of gender-inequitable attitudes and norms, and these risks are often exacerbated during humanitarian emergencies. While humanitarian actors have begun to address caregivers’ behaviors and gender attitudes as an approach to support and meet the needs of adoles...

Background A growing literature has drawn attention to the central role that schools play in supporting the adjustment of resettled refugee youth and promoting their mental health and psychosocial wellbeing. In particular, the recent proliferation of school-based social and emotional learning (SEL) initiatives presents an opportunity to strengthen...

Although programmes and policies targeting violence against women and girls (VAWG) have increased in the past decade, there is a paucity of evidence on the effectiveness of these interventions. To expand this evidence base, researchers increasingly employ remote data collection (RDC)—including online surveys, mobile applications and telephone inter...

Young refugees resettled to the U.S. from the Middle East and North Africa (MENA) region face significant acculturative stressors, including language barriers, unfamiliar norms and practices, new institutional environments, and discrimination. While schools may ease newcomer adjustment and inclusion, they also risk exacerbating acculturative stress...

Purpose Nearly 20% of U.S. adolescents have considered suicide. Yet, gaps remain in understanding correlates of resilience and suicide risk, especially among populations born outside the United States who may face unique migration- and acculturation-related stressors. This study adds to the literature by exploring correlates of suicide ideation amo...

Background Humanitarian practitioners have recently expanded their focus from the provision of assistance only to working to ensure refugees and internally displaced peoples (IDPs) can develop sustained ‘self-reliance’. However, few tools measure self-reliance, and even fewer capture non-financial dimensions of self-reliance or measure the construc...

Intimate partner violence (IPV) is a pervasive form of gender-based violence that exacerbates in humanitarian settings. This systematic review examined the myriad IPV impacts and the quality of existing evidence of IPV in humanitarian settings. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) procedures, a t...

Gender attitudes play a powerful role in influencing girls' involvement in formal education, which is associated with positive outcomes pertaining to girls' protection and well-being. A quantitative survey was conducted with 866 girls (ages 10-14) and 774 matched primary caregivers from 14 sites in South Kivu, Democratic Republic of the Congo. Data...

Evidence demonstrating the economic burden of violence against women and girls can support policy and advocacy efforts for investment in violence prevention and response programming. We undertook a systematic review of evidence on the costs of violence against women and girls in low- and middle-income countries published since 2005. In addition to...

Background Child psychological distress in refugee settings is a significant public health concern, which is exacerbated by poor caregiver mental health and functioning. However, there are limited studies about effective interventions to improve caregiver mental health in support of child wellbeing. The objective of the current study is to evaluate...

Introduction: Few studies have assessed the impact of displacement, resettlement, and discrimination on well-being outcomes for adolescent refugees resettled within the U.S. Conducted in three charter schools in the intergenerational Arab enclave of the Detroit Metropolitan Area, this mixed-methods study assessed the mental health and psychosocial...

One in three women and girls will experience violence in their lifetime. In conflict and postconflict settings, the incidence of violence against women and girls (VAWG) is exacerbated, resulting in increased negative social, economic, health, and psychosocial effects. In an attempt to prevent and respond to the occurrence of VAWG in humanitarian se...

This commentary identifies and underscores the importance of key considerations for the global commitment to end violence against children. The authors draw from recent research to highlight the overlap in risk factors for violence against women and children and argue for greater coordination and collaboration in the prevention of both forms of vio...

Background A growing literature has drawn attention to the central role that schools play in supporting the adjustment of resettled refugee youth and promoting their mental health and psychosocial wellbeing. In particular, the recent proliferation of school-based social and emotional learning (SEL) initiatives presents an opportunity to strengthen...

Every year, thousands of young refugees and their families face challenges as they adjust to schools in the US. This article explores how families resettled to the US from conflict-affected, Arab-majority countries in the Middle East and North Africa region , such as Iraq and Syria, view education, and how parents support their children's education...

Adolescent girls face elevated risks of gender-based violence in humanitarian settings because of the intersectionality of age and gender, and the additional and exacerbated risk factors relevant to emergencies. Because there is no clear division of labour between the gender-based violence and child protection sectors, adolescent girls are often ne...

As the gendered dimensions of COVID-19 are increasingly recognised, efforts to situate gender-based violence (GBV) within the pandemic remain inadequate. It is critical to first acknowledge that the drivers and impacts of COVID-19 and GBV do not occur in isolation; rather, they present as a syndemic—each is made more destructive by the presence of...

Every advance in understanding the effects of exposure to political violence on children relies on the active engagement of girls and boys, whose decision to participate in research can present countless risks. Nevertheless, children’s participation in research is critical for scientific advancement. It can also confer benefits to participants, the...

This study examined outcomes associated with early sexual debut in five sub-Saharan African countries for males and females, separately. We employed Violence Against Children Surveys (VACS) from Kenya, Malawi, Nigeria, Tanzania, and Uganda, restricting samples to males and females age 18–24 years. Early sexual debut was defined as having one’s firs...

Every advance in understanding the effects of exposure to political violence on children relies on the active engagement of girls and boys, whose decision to participate in research can present countless risks. Nevertheless, children’s participation in research is critical for scientific advancement. It can also confer benefits to participants, the...

Background: Accurately identifying the magnitude of gender-based violence (GBV) in humanitarian settings is hindered by logistical and methodological complexities. The 'Neighborhood Method', an adapted household survey that uses primary and secondary reporting to assess the prevalence of GBV in humanitarian settings, reduces the length of time and...

Experiences of intimate partner violence (IPV) victimization have well-established associations with poor mental health. There is also burgeoning evidence regarding the association between IPV perpetration and mental health in a small number of countries. However, there is a paucity of data about the gendered differences for these IPV experiences w...

Today, one in six young people lives in a conflict zone. Children and adolescents may experience armed conflict as witnesses and targets, participants and protestors, and victims and survivors. Young people also make up about half of the world’s refugees and internally displaced persons. Through conflict and displacement, these girls and boys encou...