Family-based mental health promotion for Somali Bantu and Bhutanese refugees: Feasibility and acceptability trial

Purpose: There are disparities in mental health of refugee youth compared with the general U.S.
population. We conducted a pilot feasibility and acceptability trial of the home-visiting Family
Strengthening Intervention for refugees (FSI-R) using a community-based participatory research
approach. The FSI-R aims to promote youth mental health and family relationships. We hypothesized
that FSI-R families would have better psychosocial outcomes and family functioning postintervention
compared with care-as-usual (CAU) families. We hypothesized that FSI-R would be
feasible to implement and accepted by communities.
Methods: A total of 40 Somali Bantu (n ¼ 103 children, 58.40% female; n ¼ 43 caregivers, 79.00%
female) and 40 Bhutanese (n ¼ 49 children, 55.30% female; n ¼ 62 caregivers, 54.00% female)
families were randomized to receive FSI-R or CAU. Refugee research assistants conducted psychosocial
assessments pre- and post-intervention, and home visitors delivered the preventive
intervention. Multilevel modeling assessed the effects of FSI-R. Feasibility was measured from
retention, and acceptability was measured from satisfaction surveys.
Results: The retention rate of 82.50% indicates high feasibility, and high reports of satisfaction
(81.50%) indicate community acceptance. Across communities, FSI-R children reported reduced
traumatic stress reactions, and caregivers reported fewer child depression symptoms compared
with CAU families (b ¼ .42; p ¼ .03; b ¼ .34; p ¼ .001). Bhutanese FSI-R children reported
reduced family arguing (b ¼ 1.32; p ¼ .04) and showed fewer depression symptoms and conduct
problems by parent report (b ¼ 9.20; p ¼ .04; b ¼ .92; p ¼ .01) compared with CAU. There were
no significant differences by group on other measures.