A child's adjustment to wartime stress is reliant not only on individual responses and qualities, but very significantly on the availability of support that they may receive from their parent or caregivers and quality of relationships. Strengthening parental support has the potential to be valuable. A pilot two‐arm randomised controlled trial investigated the feasibility of delivering and evaluating the “Caring for Children Through Conflict and Displacement” intervention with caregivers in the West Bank. Feasibility to recruit and train non‐specialist staff on‐the‐ground to screen families for eligibility, collect outcome data, deliver the intervention and to recruit and retain families in the study were examined. Research staff and intervention facilitators were successfully appointed in the field, screened participants and delivered the intervention to 120 caregivers, collecting outcome measures pre‐and post‐delivery. All families completed the outcome measures, with very little missing data. This indicated that the intervention can be delivered feasibly and evaluated with families in this humanitarian context. Preliminary outcome data showed promise that the intervention may have the potential to both improve family functioning and reduce children's problem behaviour. Implications of family‐focused initiatives, particularly within a conflict/post‐conflict context for the prevention of several negative health and social outcomes directions, are discussed.

As Palestinians living under occupation in the West Bank experience a variety of traumatic events, research identifying protective factors of children's mental health is essential. This study examined caregiver resilience and parenting styles as protective factors of the mental health of Palestinian children living in the West Bank. We hypothesized that: (a) higher caregiver resilience would be significantly associated with better mental health in children (caregiver reported), (b) authoritative parenting would be significantly associated with better mental health in children, and (c) both permissive and authoritarian parenting would be significantly associated with poorer mental health in children. Participants were 303 caregivers of primary schoolchildren in the city of Nablus, Palestine. Caregivers completed measures of demographics, exposure to violence, parenting styles, and mental health of their children. Results revealed that higher caregiver resilience was significantly associated with caregiver reports of better mental health in children. Both permissive and authoritarian parenting styles were significantly associated with reports of poorer mental health in children. The association between authoritative parenting style and children's mental health was nonsignificant. Implications of these findings include adopting a multilevel approach to designing interventions through integrating the family in future preventative interventions for children. This entails designing interventions to enhance resilience of caregivers and organizing psychoeducational programs to promote effective parenting practices. Public Significance StatementThis study suggests that caregiver resilience and parenting styles impact children's mental health. It highlights the importance of integrating the family in future preventative interventions such as enhancing the resilience of caregivers and organizing psychoeducational programs to promote effective parenting practices in order to support children's mental health.

Substance use remains a robust predictor of HIV infection, as well as a serious impediment to progress across the HIV care continuum for people living with HIV. As such, the careful design and implementation of interventions uniquely tailored to target substance use and HIV care behaviors remain paramount. A necessary step in these efforts is to understand the extent to which HIV care interventions have been efficacious in helping people who use substances progress across the HIV care continuum. Using PubMed and ProQuest databases, we performed a systematic review of randomized trials of HIV care continuum interventions among people who use substances published between 2011 and 2021, the treatment-as-prevention era. Existing systematic reviews and studies in which less than half of those sampled reported substance use were excluded. We identified ten studies (total N=5410; range: 210-1308), nine of which intentionally targeted substance-using populations. Four of these studies involved use of at least one of several substances, including alcohol, opioids, stimulants, and/or marijuana, among others; three involved injection drug use only; one involved methamphetamine use only; and one involved alcohol use only. One study targeted a population with incidental substance use, which involved use of alcohol, injection drug use, and non-injection drug use. Viral suppression was targeted in 8/10 studies, followed by uptake/initiation of antiretroviral therapy (ART; 6/10), ART adherence (6/10), retention to care (4/10), and linkage to care (3/10). For each outcome, intervention effects were found in roughly half of the studies in which a given outcome was assessed. Mediated (2/10) and moderated (2/10) effects were minimally examined. The diversity of substances used in and across studies, as well as other characteristics that varied across studies, prevented broad deductions or conclusions about the amenability of specific substances to intervention. Moreover, study quality was mixed due to varying attrition and assessment measures (self-report vs biological/clinical). More coordinated, comprehensive, and targeted efforts are needed to disentangle intervention effects on HIV care continuum outcomes among populations using diverse substances.