Effects of an exercise and sport intervention among refugees living in a Greek refugee camp on mental health, physical fitness and cardiovascular risk markers: study protocol for the SALEEM pragmatic randomized controlled trial

Abstract

Background Due to ongoing political and social conflicts, the number of international refugees has been increasing. Refugees are exposed to severe mental and physical strain, as well as traumatic experiences during their flight. Therefore, the risk of psychiatric disorders is markedly increased among international refugees. International organizations have criticized the lack of early interventions as a key problem, because untreated mental disorders are often difficult to cure at a later stage. Today, exercise and sport have been successfully employed to treat a wide range of psychiatric disorders. With patients with post-traumatic stress disorders (PTSD), very limited empirical evidence exists, and studies carried out with international refugees are nearly non-existent. Methods We intend to implement a pragmatic randomized controlled trial (RCT) with an exercise and sport intervention group (n = 68, 50% women) and a wait-list control group (n = 68, 50% women) in the Koutsochero refugee camp, located close to the city of Larissa (Greece). During the RCT, exercise and sport will be offered five times per week (60 min/session) for 10 weeks. Participants will be asked to participate in at least two sessions per week. The programme is developed according to the participants’ needs and preferences and they will be able to choose between a range of activities. PTSD symptoms will serve as primary outcome, and several secondary outcomes will be assessed. Qualitative data collection methods will be used to gain a more in-depth appraisal of the participants’ perception of the intervention programme. In the second year of study, the programme will be opened to all camp residents. A strategy will be developed how the programme can be continued after the end of the funding period, and how the programme can be scaled up beyond the borders of the Koutsochero camp. Discussion By moving towards the primary prevention of chronic physical conditions and psychiatric disorders, a relevant contribution can be done to enhance the quality and quantity of life of refugee camp residents in Greece. Our findings may also strengthen the evidence for exercise as medicine as a holistic care option in refugee camps, by helping camp residents to adopt and maintain a physically active lifestyle. Trial registration The study was registered prospectively on the 8 February 2021 with ISRCTN https://www.isrctn.com/ISRCTN16291983

Psychological well-being, mental distress, metabolic syndrome, and associated factors among people living in a refugee camp in Greece: a cross-sectional study

“…This analysis is part of a larger randomized controlled trial that examines the effects of a sport and exercise intervention on mental health, cardiovascular risk markers, and physical fitness among people living in a refugee camp in Greece (ISRCTN16291983). The sample and the procedures of the present study were based on the sampling and the procedures described in the registration of the project (20). In this paper, we present cross-sectional data from the baseline data assessment.…”

“…Additional households were drawn in case of non-appearance in order for the parent project to have a sufficient number of participants. A minimum sample size of 136 participants was estimated based on a power analysis to detect an intervention effect on PTSD symptoms (20).…”

Assessing the mental health needs of Yazidi adolescents and young adults in an Iraqi Kurdi IDP Camp: a focus group study

“…Artistic activities, especially those which involve active participation, for example participatory photography, may provide tools to address the holistic wellbeing of adolescent refugees in camps [ 41 ]. Both art therapy and sport have proven to be an effective tool to reduce mental distress and improve the mental health of refugees in protracted situations, particularly for those suffering from post-traumatic stress disorder and depression, conditions that can lead to suicidal ideation and attempts [ 42 , 43 ].…”

Effects of a co-designed exercise and sport intervention on cardiorespiratory fitness and metabolic syndrome components among individuals living in a refugee camp in Greece: A randomized controlled trial

“…The present paper provides insight into the immediate post-intervention effects on CRF and MetS components following a 10-week intervention period. The sampling and procedure of this study aligned with those outlined in the registered project ( Gerber et al, 2021 ). Ethical approval was granted by the Research Ethics Committee of the University of Thessaly, ref.…”

“…Arabic, Farsi, and French represented most camp resident's linguistic backgrounds. A minimum sample size of 136 participants, with an expected dropout rate of 25 %, was estimated to detect an intervention effect on PTSD symptoms, the primary outcome of the parent study ( Gerber et al, 2021 ). Since the power analysis accounted for a rather small effect size ( ƒ = 0.15), the calculated sample size was considered sufficient for the present study, expecting a moderate effect ( ƒ = 0.25) for CRF ( Batacan et al, 2017 ; Milanović et al, 2015 ).…”