Hyojin Im

Building Social Capital Through a Peer-Led Community Health Workshop: A Pilot with the Bhutanese Refugee Community.

Despite the high health and mental health care needs, resettled refugees often face cultural and linguistic challenges that hinder the access to appropriate and timely interventions and services. Additionally, such concepts as preventive health or mental health treatment are foreign to this population, which creates additional burdens to the refugee community that already have difficulty navigating a complex health care system in the U.S. To address multiple and complex gaps in health and mental health support for the refugee community, requested is an innovative approach that can convey culturally responsive and effective interventions for health promotion, such as peer-based health education. Few studies have been conducted on the effectiveness of peer-led community health interventions with refugee populations in the U.S. resettlement context. However, peer-led interventions have been shown to be effective when working with cultural minorities and interventions in an international context. Adopting a social capital framework, the current study conducted qualitative evaluation on the impact of a pilot peer-led community health workshop (CHW) in the Bhutanese refugee community. A hybrid thematic analysis of focus group discussion data revealed the improvement in health promotion outcomes and health practice, as well as perceived emotional health. The results also showed that the peer-led CHW provided a platform of community building and participation, while increasing a sense of community, sense of belonging and unity. The findings posit that a peer-led intervention model provides culturally responsive and effective tools for building social capital and promoting community health in the refugee community.

Developing self-care practices in a trauma treatment course

This article describes the development of self-care practices of social work students who were part of a larger study of students’ experiences in a graduate course on the treatment of trauma. Consensual qualitative research methods were used to analyze 17 participant journals submitted at 4 times during the course. Findings indicated that students benefited from being introduced to evidence-based practices for mediating the stress of trauma education, including journaling and mindfulness-based stress reduction. Although students reported struggling with developing effective self-care practices, they demonstrated an ability to integrate self-care into their professional practice behaviors. The authors review recommendations for research and pedagogy of self-care practices in courses on trauma treatment.

Experiences of Stress in a Trauma Treatment Course

This study explores the reactions of social work students in a course on trauma treatment and how those reactions changed over time. Consensual qualitative research methods were used to analyze 17 participant journals submitted at 4 times during the course. Findings indicate that students experienced a range of responses to traumatic material, including both positive and negative emotional, cognitive, behavioral, physical, and relational reactions. Student survivors of trauma reported reactions related to their own trauma. Although student reactions became less acute over time during the course, recommendations for the pedagogy of trauma are offered, including curriculum related to the management of vicarious and secondary trauma reactions as well as the development of evidence-based practices for self-care.

From Victim to Perpetrator of Trauma: Lived Experiences of Gang-Involved Urban Refugee Youth in Kenya

ABSTRACT Somali children and youth in displacement are exposed to prolonged trauma and chronic violence. In spite of a striking link among trauma, gang activities, victimization, and perpetration of violence, however, few studies have been conducted with Somali refugee youth in low-resource urban settings. This qualitative study demonstrates how prolonged trauma shapes ecological conditions of refugee life that induce vulnerable youth to forge support systems through gang membership and violence. The accession of the challenges, from loss of family, to discrimination and police brutality, and to chronic impoverishment, forces the high-risk refugee youth to replicate the various forms of violence to which they have been exposed to survive. Undergoing such chronic and cumulated trauma, these youth continue to normalize and become further desensitized to violence. The systems perspective of this study expands understanding of the intersection of trauma and gang membership and implies the need for an expanded approach to trauma and understanding of the complexities of gang involvement, beyond posttraumatic stress disorder treatment and clinical intervention.

Cultural translation of refugee trauma: Cultural idioms of distress among Somali refugees in displacement

Westernized approaches to mental health care often place limited emphasis on refugees’ own experiences and cultural explanations of symptoms and distress. In order to effectively assess community mental health needs and develop interventions grounded in local needs, mental health programs need to be informed by an understanding of cultural features of mental health, including cultural idioms of distress (CIDs). The current study aims to explore CIDs among Somali refugees displaced in Kenya to understand mental health needs in cultural context and serve the community in a culturally responsive and sensitive manner. This research was conducted as a two-phase qualitative study. First, key informant interviews with Somali mental health stakeholders generated a list of 7 common Somali CIDs: buufis, buqsanaan, welwel, murug, qaracan, jinn, and waali. Typologies of each CID were further explored through four focus group interviews with Somali community members. The findings from a template analysis revealed Somali lay beliefs on how trauma and daily stressors are experienced and discussed in the form of CIDs and how each term is utilized and understood in attributing symptoms to associated causes. This study highlights the need to incorporate colloquial terms in mental health assessment and to adopt a culturally relevant framework to encourage wider utilization of services and religious/spiritual support systems.

Mental health risks and stressors faced by urban refugees: Perceived impacts of war and community adversities among Somali refugees in Nairobi

Background: There is a gap in understanding of refugee mental health risks unique to urban areas of low-income countries. Material: A qualitative rapid appraisal using focus group interviews with community stakeholders explored main stressors pervasive by Somali refugees in Nairobi, Kenya. Discussion: This study identified the intersection of war trauma and daily stressors that affect both functional and structural challenges and risk of mental health issues among Somali urban refugees. Conclusion: Findings underscore the importance of understanding mental health in the broader context of community adversities, suggesting development of contextually informed interventions responsive to complex needs of urban refugees.

Exploring mental health screening feasibility and training of refugee health coordinators

Forty-four refugee health coordinators responded to a subset of questions from a 28-item, national survey exploring the mental health training of refugee health coordinators and the feasibility of refugee mental health screening. Most participants reported that it would be possible to administer a brief mental health screen; however, only half had received any mental health training. A minority of participants identified symptoms of posttraumatic stress disorder or major depression as their top concerns related to refugee mental health. The majority requested training on the mental health needs of arriving refugees. Training participation was associated with screening and positive referral outcomes.

Qualitative exploration of critical health literacy among Afghan and Congolese refugees resettled in the USA

Objectives: Previous research that revealed a high prevalence of low health literacy among immigrants and refugees tended to over emphasise functional health literacy as a risk factor for low health status and poor disease management. Despite a significant knowledge gap, little has been investigated regarding critical health literacy (CHL) in refugee populations whose culture deeply interweaves individual and contextual capacity to promote health. Design: This study adopted a qualitative approach to explore CHL that is built through community health workshops (CHWs) with Afghan and Congolese refugee communities in US resettlement. Setting: As part of a community-based participatory research project, the study was conducted with Afghan and Congolese refugees resettled in the USA. Method: A series of open-ended questions for focus group interviews were embedded in each workshop session explore health literacy skills and capacity over time. This study adopted a hybrid thematic design whereby the conceptual framework of CHL was applied to emergent themes from the data. Results: Thematic analysis revealed four major CHL thematic domains, as experienced and demonstrated by Afghan and Congolese refugee participants: (1) critical appraisal, (2) self-efficacy and confidence, (3) empowerment, and (4) collective problem solving. Conclusion: Study findings underline the importance of health education validating existing cultural knowledge and practices in a group setting so as to facilitate the building and enhancement of social support systems and community action for health promotion.