Highlights• Multilevel strengths-based intervention decreases refugee distress and improves protective factors.• Holistic focus on psychological, material, social, educational, and cultural needs is effective.• High recruitment/retention rates support importance of non-stigmatizing universal interventions.• Refugee Well-being Project (RWP) intervention reaches refugees unlikely to access formal mental health services.• RWP circumvents typical barriers to services (stigma, trust, linguistic/cultural appropriateness).

Randomized controlled trials (RCTs) are a long-standing and important design for conducting rigorous tests of the effectiveness of health interventions. However, many questions have been raised about the external validity of RCTs, their utility in explicating mechanisms of intervention and participants’ intervention experiences, and their feasibility and acceptability. In the current mixed methods study, academic and community partners developed and implemented an RCT to test the effectiveness of a collaboratively developed community-based advocacy, learning, and social support intervention. The goals of the intervention were to address social determinants of health and build trust and connections with other mental health services in order to reduce mental health disparities among Afghan, Great Lakes Region African and Iraqi refugee adults and engage and retain refugees in trauma-focused treatment, if needed. Two cohorts completed the intervention between 2013-2015. Ninety-three adult refugees were randomly assigned to intervention or control group and completed four research interviews (pre-, mid-, post-intervention, and follow-up). Several challenges to conducting a community-based RCT emerged, including issues related to interviewer intervention to assist participants in the control group, diffusion of intervention resources throughout the small refugee communities, and staff and community concerns about the RCT design and what evidence is meaningful to demonstrate intervention effectiveness. These findings highlight important epistemological, methodological, and ethical challenges that should be considered when conducting community-based RCTs and interpreting results from them. In addition, several innovations were developed to address these challenges, which may be useful for other community-academic partnerships engaged in RCTs.

Although refugees who are accepted for resettlement in a third country are guaranteed certain rights and experience safety from war and persecution, they face many mental health challenges. Using qualitative methods and constructivist grounded theory, we explored culturally-specific perspectives on trauma and recovery among Burundian, Congolese and Iraqi refugees resettled in the United States. Eighteen semi-structured interviews provided extensive data on the meaning of productivity and work, the ways in which they index normalcy and self-sufficiency, and how they create security that facilitates the healing process. Our inductive analyses revealed that participants emphasized the relationship between productivity and healing when they described recovery from trauma. Participants also discussed individual and structural facilitators and barriers to work. Finally, prominent themes emerged around gendered roles and expectations and the ways these function in refugee resettlement contexts that are shaped by policies that demand rapid economic self-sufficiency. Taken together, these findings suggest that policies that promote

With forcible displacement at unprecedented levels and only expected to increase as conflict, economic inequities, and climate change escalate, it is critical to understand the ways in which social networks of migrants are disrupted and reconstituted in new contexts. This requires critical examination and expansion of existing social network conceptualization, measurement, and theory that considers transnational movement and experiences to ensure cultural and contextual validity. As part of a community-engaged intervention study designed to promote the well-being of recently resettled refugees by addressing social determinants of mental health, the social networks of refugees were measured over time. This paper describes the conceptualization, operationalization, data collection, and data analysis of refugees’ social networks; challenges and lessons learned; and implications for transdisciplinary social network theory and methodologies. Tracing the development of quantitative and qualitative instruments and participatory processes of iteratively refining them throughout implementation with four cohorts of refugees (2013–2017; N = 290) resettling in a medium-sized city in the Southwestern United States, we offer innovative ways of viewing social networks that expand conceptualization, improve measurement, and extend theory. Our findings address known challenges to social network data collection (e.g., instrument bias, participant recall bias, and interviewer capacity) and suggest how social networks data collection can be strengthened through approaches that include (1) community members as collaborative researchers, (2) transdisciplinary theoretical and methodological perspectives, and (3) team-based practices that share leadership, learning experiences, and responsibility for data analysis, interpretation, and dissemination.