The effectiveness of Hope Groups, a mental health, parenting support, and violence prevention program for families affected by the war in Ukraine: Findings from a pre-post study
Background: Nearly one in six children lived in war zones in 2023. Evidence-based psychosocial and parenting support has potential to mitigate negative impacts for parents and children co-exposed to war and displacement, especially in relation to mental health and harsh parenting reactions. In the c...
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Elsevier
2024-01-01
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| Series: | Journal of Migration and Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666623524000400 |
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| author | Susan Hillis Sydney Tucker Nicole Baldonado Evgenia Taradaika Lyudmyla Bryn Svitlana Kharchenko Tetiana Machabelii Roisin Taylor Phil Green Philip Goldman Isang Awah Joshua Baldonado Praveen Gomez Seth Flaxman Oliver Ratmann Jamie M. Lachman Andres Villaveces Lorraine Sherr Lucie Cluver |
| author_facet | Susan Hillis Sydney Tucker Nicole Baldonado Evgenia Taradaika Lyudmyla Bryn Svitlana Kharchenko Tetiana Machabelii Roisin Taylor Phil Green Philip Goldman Isang Awah Joshua Baldonado Praveen Gomez Seth Flaxman Oliver Ratmann Jamie M. Lachman Andres Villaveces Lorraine Sherr Lucie Cluver |
| author_sort | Susan Hillis |
| collection | DOAJ |
| description | Background: Nearly one in six children lived in war zones in 2023. Evidence-based psychosocial and parenting support has potential to mitigate negative impacts for parents and children co-exposed to war and displacement, especially in relation to mental health and harsh parenting reactions. In the current war in Ukraine, local mental health experts co-created and evaluated, with global experts, the effectiveness of psychosocial and parenting support groups, called ‘Hope Groups’ on improvements in mental health, positive parenting, and violence against children. This paper aimed to assess the effectiveness of psychosocial and parenting support groups, called 'Hope Groups,' on improvements in caregiver mental health, positive parenting, and prevention of violence against children, for families affected by the war in Ukraine, using a pre/post study design. Methods: Participants (n = 577) included Ukrainian caregivers, 66% (381) of whom were parents and co-residing caregivers of children ages 0–17, while the remaining 34% were non-resident informal caregivers. Internally displaced, externally displaced, and those living at-home in war-torn regions were invited to groups by trained Ukrainian peer facilitators. Using a pre-post design, we compared individual level frequency measures at three time-points – baseline, midline, and endline, to assess changes in 4 mental health, and 9 parenting and child health outcomes. We analyzed these outcomes using paired t-tests to compare outcomes at baseline-to-midline (after 4-sessions) and baseline-to-endline (after 10-sessions), which estimated the mean changes in days per week and associated percent change, during the respective periods; we quantified uncertainties using bias-corrected and accelerated (BCa) bootstrapping with 95% uncertainty ranges for baseline-midline and baseline-endline estimates. We used this same approach for stratified analyses to assess potential effect modification by displacement status and facilitator type. We further used linear models to adjust for age and sex. Findings: Compared to baseline, every mental health, parenting, and child health outcome improved significantly at midline and endline. Mental health ratings showed endline reductions in depressive symptoms of 56.8% (95% CI: -59.0,-54.3; -1.8 days/week), and increases in hopefulness, coping with grief, and self-care, ranging from 62.0% (95% CI: 53.6,71.3; 2.2 days/week) to 77.0% (95% CI: 66.3,88.3; 2.2 days/week). Significant improvements in parenting and child health outcomes included monitoring children, reinforcing positive behavior, supporting child development, protecting child, nonviolent discipline, and child verbalizing emotions. By endline, emotional violence, physical violence, and child despondency had dropped by 57.7% (95% CI: -63.0%,-51.9; -1.3 days/week), 64.0% (95% CI: -79.0,-39.5; -0.22 days/week), and 51.9% (95% CI: -45.1,-57.9; -1.2 days/week), respectively. Outcomes stratified by displacement status remained significant across all groups, as did those according to facilitator type (lay versus professional). Interpretation: This study demonstrates preliminary evidence, using a brief survey and pre-post design as is appropriate for acute and early protracted emergency settings, of the feasibility and effectiveness of Hope Groups for war-affected Ukrainian caregivers, on improved mental health, positive parenting, and reduced violence against children. |
| format | Article |
| id | doaj-art-686a7a04e5bb472b955fdeb55d9fa713 |
| institution | OA Journals |
| issn | 2666-6235 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
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| series | Journal of Migration and Health |
| spelling | doaj-art-686a7a04e5bb472b955fdeb55d9fa7132025-08-20T02:31:13ZengElsevierJournal of Migration and Health2666-62352024-01-011010025110.1016/j.jmh.2024.100251The effectiveness of Hope Groups, a mental health, parenting support, and violence prevention program for families affected by the war in Ukraine: Findings from a pre-post studySusan Hillis0Sydney Tucker1Nicole Baldonado2Evgenia Taradaika3Lyudmyla Bryn4Svitlana Kharchenko5Tetiana Machabelii6Roisin Taylor7Phil Green8Philip Goldman9Isang Awah10Joshua Baldonado11Praveen Gomez12Seth Flaxman13Oliver Ratmann14Jamie M. Lachman15Andres Villaveces16Lorraine Sherr17Lucie Cluver18Global Reference Group on Children Affected by Crisis, University of Oxford, Oxford, United Kingdom; Department of Mathematics, Imperial College London, United Kingdom; Corresponding author at: Global Reference Group on Children Affected by Crisis, University of Oxford, Oxford, United Kingdom.Centre for Evidence-Based Social Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom; Department of Mathematics, Imperial College London, United KingdomWorld Without Orphans, UkraineWorld Without Orphans, UkraineChildren's Mission, UkraineUkraine Without Orphans, UkraineNehemiah, UkraineCentre for Evidence-Based Social Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, United KingdomVIVA International, IndiaMaestral International, United StatesCentre for Evidence-Based Social Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, United KingdomWorld Without Orphans, UkraineWorld Without Orphans, UkraineDepartment of Computer Science, University of Oxford, Oxford, United KingdomDepartment of Mathematics, Imperial College London, United KingdomCentre for Evidence-Based Social Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom; Parenting for Lifelong Health, United Kingdom; Centre of Social Science Research, University of Cape Town, Cape Town, South AfricaDivision of Violence Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United StatesUniversity College London, United KingdomCentre for Evidence-Based Social Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom; Department of Psychiatry, University of Cape Town, Cape Town, South AfricaBackground: Nearly one in six children lived in war zones in 2023. Evidence-based psychosocial and parenting support has potential to mitigate negative impacts for parents and children co-exposed to war and displacement, especially in relation to mental health and harsh parenting reactions. In the current war in Ukraine, local mental health experts co-created and evaluated, with global experts, the effectiveness of psychosocial and parenting support groups, called ‘Hope Groups’ on improvements in mental health, positive parenting, and violence against children. This paper aimed to assess the effectiveness of psychosocial and parenting support groups, called 'Hope Groups,' on improvements in caregiver mental health, positive parenting, and prevention of violence against children, for families affected by the war in Ukraine, using a pre/post study design. Methods: Participants (n = 577) included Ukrainian caregivers, 66% (381) of whom were parents and co-residing caregivers of children ages 0–17, while the remaining 34% were non-resident informal caregivers. Internally displaced, externally displaced, and those living at-home in war-torn regions were invited to groups by trained Ukrainian peer facilitators. Using a pre-post design, we compared individual level frequency measures at three time-points – baseline, midline, and endline, to assess changes in 4 mental health, and 9 parenting and child health outcomes. We analyzed these outcomes using paired t-tests to compare outcomes at baseline-to-midline (after 4-sessions) and baseline-to-endline (after 10-sessions), which estimated the mean changes in days per week and associated percent change, during the respective periods; we quantified uncertainties using bias-corrected and accelerated (BCa) bootstrapping with 95% uncertainty ranges for baseline-midline and baseline-endline estimates. We used this same approach for stratified analyses to assess potential effect modification by displacement status and facilitator type. We further used linear models to adjust for age and sex. Findings: Compared to baseline, every mental health, parenting, and child health outcome improved significantly at midline and endline. Mental health ratings showed endline reductions in depressive symptoms of 56.8% (95% CI: -59.0,-54.3; -1.8 days/week), and increases in hopefulness, coping with grief, and self-care, ranging from 62.0% (95% CI: 53.6,71.3; 2.2 days/week) to 77.0% (95% CI: 66.3,88.3; 2.2 days/week). Significant improvements in parenting and child health outcomes included monitoring children, reinforcing positive behavior, supporting child development, protecting child, nonviolent discipline, and child verbalizing emotions. By endline, emotional violence, physical violence, and child despondency had dropped by 57.7% (95% CI: -63.0%,-51.9; -1.3 days/week), 64.0% (95% CI: -79.0,-39.5; -0.22 days/week), and 51.9% (95% CI: -45.1,-57.9; -1.2 days/week), respectively. Outcomes stratified by displacement status remained significant across all groups, as did those according to facilitator type (lay versus professional). Interpretation: This study demonstrates preliminary evidence, using a brief survey and pre-post design as is appropriate for acute and early protracted emergency settings, of the feasibility and effectiveness of Hope Groups for war-affected Ukrainian caregivers, on improved mental health, positive parenting, and reduced violence against children.http://www.sciencedirect.com/science/article/pii/S2666623524000400WarArmed conflictRefugeesInternally displacedChildrenAbuse |
| spellingShingle | Susan Hillis Sydney Tucker Nicole Baldonado Evgenia Taradaika Lyudmyla Bryn Svitlana Kharchenko Tetiana Machabelii Roisin Taylor Phil Green Philip Goldman Isang Awah Joshua Baldonado Praveen Gomez Seth Flaxman Oliver Ratmann Jamie M. Lachman Andres Villaveces Lorraine Sherr Lucie Cluver The effectiveness of Hope Groups, a mental health, parenting support, and violence prevention program for families affected by the war in Ukraine: Findings from a pre-post study Journal of Migration and Health War Armed conflict Refugees Internally displaced Children Abuse |
| title | The effectiveness of Hope Groups, a mental health, parenting support, and violence prevention program for families affected by the war in Ukraine: Findings from a pre-post study |
| title_full | The effectiveness of Hope Groups, a mental health, parenting support, and violence prevention program for families affected by the war in Ukraine: Findings from a pre-post study |
| title_fullStr | The effectiveness of Hope Groups, a mental health, parenting support, and violence prevention program for families affected by the war in Ukraine: Findings from a pre-post study |
| title_full_unstemmed | The effectiveness of Hope Groups, a mental health, parenting support, and violence prevention program for families affected by the war in Ukraine: Findings from a pre-post study |
| title_short | The effectiveness of Hope Groups, a mental health, parenting support, and violence prevention program for families affected by the war in Ukraine: Findings from a pre-post study |
| title_sort | effectiveness of hope groups a mental health parenting support and violence prevention program for families affected by the war in ukraine findings from a pre post study |
| topic | War Armed conflict Refugees Internally displaced Children Abuse |
| url | http://www.sciencedirect.com/science/article/pii/S2666623524000400 |
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