Stress, Psychological Clinical Trial
Official title:
A Feasibility Trial of the Youth Readiness Intervention: A Group Psychosocial Intervention for War-affected Youth in Sierra Leone
The research will first examine data obtained from YRI participants to investigate effects of
the group sessions on psychosocial and functioning outcomes in youth.
In pursuit of this aim, this research will investigate the following hypothesis:
Participation in the Youth Readiness Intervention will reduce symptoms of internalizing,
externalizing, trauma-related symptoms, and improve prosocial skills and functioning among
war-affected 15-24 year olds in Sierra Leone.
The research also intends to examine whether youth enrolled in a psychosocial "Youth
Readiness Intervention" (YRI) and a complementary education program fare better than an
education-only control group, a psychosocial-only control group, and a waitlist control
group.
In pursuit of this second aim, this research will investigate the following hypothesis: A
combined psychosocial-education program is an effective paradigm for improving psychosocial,
functional, educational, and economic self-sufficiency outcomes among war-affected youth.
In Sierra Leone, a dangerous gap remains between long-term psychosocial needs and adequate
services. As youth affected by the war begin to enter adulthood, they face new challenges
including unemployment, interrupted education, the need to support families, marginalization
and stigma, as well as the remaining psychological effects of exposure to war. Healthy social
integration is critical to the long-term wellbeing of this generation, but the evidence base
on effective interventions to improve skills and self-efficacy is severely limited. Despite
the high burden of mental health problems among war-affected youth in Sub-Saharan Africa, few
empirically-supported behavioral treatments (ESBTs) or evidence-based interventions have been
implemented in this region. This study stands to make an important contribution to knowledge
on effective and culturally-sensitive mental health services that can be implemented in
settings fraught by multiple hardships, including war, poverty, low educational attainment,
and other hardships.
This randomized study of 416 school-intending youth age 15-24 will use a parallel design to
examine the potential benefits of enrolling in a psychosocial intervention--the YRI--prior to
enrolling in an educational program. Assessments will be performed pre-/post-intervention and
at 6-month and 12-month follow-ups. These long-term evaluations will examine whether benefits
are sustained, accrue, or depreciate over time. Data will improve understanding of how a
psychosocial-education intervention translates to economic outcomes like employment, as
compared to an education-only intervention.
The YRI is an evidence-based group intervention developed in 2010 to address key emotional,
behavioral, and functioning difficulties identified by the PI's prior longitudinal study of
war-affected youth. It is designed to reduce symptoms of internalizing, externalizing,
trauma-related symptoms, and improve prosocial skills and functioning among war-affected
15-24 year olds. The YRI has three overarching goals: (1) To improve interpersonal and
community relationships through work with youth and community members; (2) To help vulnerable
youth develop skills in emotional regulation, problem-solving, and interpersonal interactions
necessary to be successful members of their communities; (3) To promote the healthy
integration of difficult memories for youth who experience difficulties due to traumatic
exposure. Primary mental health outcomes include decreased anxiety, hostility, and
depression, and increased pro-social attitudes, as measured by the Oxford Refugee Studies
Psychosocial Adjustment Scale and the African Youth Psychosocial Assessment.
EducAid is a charitable trust established in 1994. Devoted to promoting education among
underprivileged and war-affected young people in Sierra Leone through holistic and academic
learning, EducAid provides free year-round education to over 1,500 youth, along with food,
medicine, and shelter when needed. EducAid has a keen interest in exploring how psychosocial
interventions can promote academic, social, and emotional well-being in students. EducAid's
education model aims to improve academic knowledge, self-efficacy, and attitudes toward
school. Additionally, it aims to nurture hope for the future and a sense of normalcy through
interactions with teachers, mentors, and peers. Following participation in the education
component, participants' employment and economic activity will be assessed using standardized
instruments for cross-cultural work, including the World Bank Living Standards Surveys.
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