Digital Mental Health Innovations to Support Scaling Out a Family Strengthening Intervention for Afghan Refugee Families

Project Summary

To respond to the high volume and heightened service needs of resettling Afghan populations in the U.S., our team proposes to adapt a digital tool to facilitate home visitor’s delivery of FSI-R in Afghan refugee communities at scale across the U.S. With support from Boston College Internal Funding – Schiller Institute Grants for Exploratory Collaborative Scholarship (SIGECS) our team is creating a digital application of our Family Strengthening Intervention for Refugees (FSI-R) for the Afghan community in New England.

The SIGECS project team comprises faculties and collaborators to apply human-centered design to co-develop and pilot digital tool for refugee home-visitors delivering an evidence-based intervention to promote Afghan refugee families’ mental health and family functioning. Our project team aims to develop digital tools to support the rapid scaling and quality improvement of Family Strengthening Intervention for Refugees (FSI-R) related to mental health and family functioning for newly resettling Afghan populations in the U.S. The FSI-R consists of ten modules designed to build communication and family relationships, illuminate and engage in problem-solving regarding concerns about children, and help families plan for a future together.

Approach

To respond to the mental health needs of newly resettling Afghan families, a cultural adaptation process of our FSI-R was done in collaboration with the US Government Office of Refugee Resettlement. The creation of the digital tools will build off of our previous work with our ATIG project to create an application for Somali Bantu and Bhutanese refugees of the FSI-R.

Our diverse faculty team will offer technical support to application developers who will then run “Community Co-Design Teams” (CCDTs) to collaboratively yield culturally-relevant imagery and intervention content. We will design, protype, and test the culturally sensitive graphic elements in easy-to-use User Interface (UI)/User Experience (UX) design through our co-design methodology through group discussion and story-telling. The project will leverage and build upon the previous work with the Somali Bantu and Bhutanese communities to broaden our partnerships and respond nimbly to Afghan resettlement.

Prior NIMH-funded R01 Study

For 15 years, Dr. Theresa Betancourt has worked with refugees in the New England Area through Cross-cultural application of community-based participatory research (CBPR) methods. Using a CBPR approach, a family based prevention model, the Family Strengthening Intervention for Refugees (FSI-R) was adapted from a tested model used in Africa and designed for delivery by refugee community health workers with through a process involving stakeholder consultation and local refugee Community Advisory Board input. Pilot data on the FSI-R demonstrated that a family home-visiting interventionadministered by refugees for refugees using a CBPR approach is feasible and acceptable. The retention rate of 82.50% is comparable to retention rates of other refugee interventions. From 2019-2022, we ran a Hybrid Type 2Effectiveness-Implementation Design (families with children aged 7-17 in a two-arm randomized controlled trial); (2) identify barriers and facilitators to implementation of the FSI-R by community health workers by conducting a process evaluation concurrent with the delivery of the intervention; and (3) strengthen the science of community engagement to address health disparities by fortifying CBPR-based pathways of change via collaborative partnerships between refugee communities, service providers, and academic stakeholders. We are currently analyzing this data.

For more information on this prior study, please contact our Post Doctoral Fellow, Dr. Euijin Jung.