Investigating Outcomes of a Family Strengthening Intervention for Resettled Somali Bantu and Bhutanese Refugees: An Explanatory Sequential Mixed Methods Study

Abstract

Pre- and post-migration stressors can put resettled refugee children at risk of poor mental health outcomes. The Family Strengthening Intervention for Refugees (FSI-R) is a peer-delivered preventative home visiting program for resettled refugees that aims to draw upon families’ strengths to foster improved family communication, positive parenting, and caregiver-child relationships, with the ultimate goal of reducing children’s risk of mental health problems. Using an explanatory sequential mixed methods design, this study draws upon qualitative interviews with caregivers (n = 19) and children (n = 17) who participated in a pilot study of the FSI-R intervention in New England, as well as interventionists (n = 4), to unpack quantitative findings on mental health and family functioning from a randomized pilot study (n = 80 families). Most patterns observed in the quantitative data as published in the pilot trial were triangulated by qualitative data. Bhutanese caregivers and children noted that children were less shy or scared to speak up after participating in the FSI-R. Somali Bantu families spoke less about child mental health and underscored feasibility challenges like language barriers between caregivers and children. Interventionists suggested that families with higher levels of education were more open to implementing behavior change. In both groups, families appreciated the intervention and found it to be feasible and acceptable, but also desired additional help in addressing broader family and community needs such as jobs and literacy programs.

Impact of the Relational, Built, Community, and Policy/Political Environments on Immigrant Child Health: A Narrative Review

“…Acknowledging the impact of family relationships on children's physical and mental health, several publications examined interventions to support family well-being. The Family Strengthening Intervention for Refugees (FSI-R) demonstrated improved family power dynamics and child mental health [33,34], and a culturally based intervention with the Filipino community demonstrated promising engagement by families [35]. Additional proposed sources of support are faith communities and nonparental adult mentors [36].…”

Promoting positive development among refugee adolescents

“…In the Family Strengthening Intervention (FSI-R), which has been evaluated with a randomized control trial (RCT) in the United States, refugee caregivers work with a prevention service home visitor to strengthen the caregiver-child relationships through communication, problem-solving, and positive caregiving skills to improve family functioning and promote the mental health of school-aged children and adolescents (Betancourt, Berent, et al, 2020). Of the 10 FSI-R modules, sessions on navigating the US school systems are particularly appreciated (Neville et al, 2022). Explanations about report cards, or the role of curriculum nights and caregiver-teacher meetings and conferences help families considerably.…”

Perceptions of Resettled Refugee Congolese Women: Maintaining Cultural Traditions during Resettlement

“…While refugees do receive assistance for initial resettlement (such as employment services, applying for social security cards, and connecting with social and language services), this support is only provided by the government’s Reception and Placement Program for the first three months after arrival and are dependent on other non-governmental organizations for long-term assistance [ 34 ]. Despite the high prevalence of refugees having experienced traumatic experiences during their pre-immigration and acculturation stress during resettlement, these support services do not extend to assisting the mental health of refugees [ 35 ], despite United States resettlement potentially causing additional stressors and living difficulties [ 36 ].…”