Trial of the Youth Readiness Intervention

NCT01684488 | Completed

• 2 other identifiers: RPCGA-YRI-21003USIP-008-10F
• Study Type: interventional
• Target: 443
• Locations: 1 country
• Sites: 1

Brief Summary

The research will first examine data obtained from YRI participants to investigate effects of the group sessions on psychosocial and functioning outcomes in youth. In pursuit of this aim, this research will investigate the following hypothesis: Participation in the Youth Readiness Intervention will reduce symptoms of internalizing, externalizing, trauma-related symptoms, and improve prosocial skills and functioning among war-affected 15-24 year olds in Sierra Leone. The research also intends to examine whether youth enrolled in a psychosocial "Youth Readiness Intervention" (YRI) and a complementary education program fare better than an education-only control group, a psychosocial-only control group, and a waitlist control group. In pursuit of this second aim, this research will investigate the following hypothesis: A combined psychosocial-education program is an effective paradigm for improving psychosocial, functional, educational, and economic self-sufficiency outcomes among war-affected youth.

Conditions

Anxiety Disorder/Anxiety State; Depressive Disorder/Psychology; Social Problems/Psychology; Stress, Psychological; Violence, Non-accidental

Keywords

Depression/therapy;; Developing Countries;; Interpersonal Relations;; Life Change Events;; Psychotherapy, Group;; Resilience, Psychological;; Sierra Leone;; Survivors/psychology;; Social Adjustment;; Social Behavior;; War

Outcome Measures

Primary Outcomes (1)

• Change in scores on the Oxford Measure of Psychosocial Adjustment & World Health Organization Disability Assessment Schedule, 2.0 (WHODAS 2.0)

  Primary outcomes of interest include changes in depression, anxiety, hostility, confidence, and pro-social behaviors. These constructs will be measured by the Oxford Refugee Studies Psychosocial Adjustment Scale. An additional primary outcome, daily functioning, will be assessed by the World Health Organization Disability Assessment Schedule, 2.0 (WHODAS 2.0). Both measures are incorporated within the study's comprehensive Youth Assessment Battery.

  Administered at 4 timepoints: (1) baseline; (2) within 15 days of YRI completion; (3) 6 months post-YRI; (4) 12 months post-YRI

Secondary Outcomes (1)

• Change in scores on the Youth Assessment Battery

  Administered at 4 timepoints: (1) baseline; (2) within 15 days of YRI completion; (3) 6 months post-YRI; (4) 12 months post-YRI

Study Arms (4)

Waitlist+EducAid

ACTIVE COMPARATOR

Immediately following enrollment, participants do not immediately receive any intervention. At 3 months, they are enrolled in EducAid educational programming for the 2012-2013 academic year.

Other: EducAid educational programming

Waitlist

NO INTERVENTION

Participants do not receive any intervention throughout the trial period. Once the trial has concluded, participants are invited to enroll in EducAid educational programming for the 2013-2014 academic year.

YRI only

EXPERIMENTAL

Immediately following enrollment, participants complete the YRI. They are then placed on a waitlist for the remainder of the trial. At the end of the trial, participants are invited to enroll in EducAid educational programming for the 2013-2014 academic year.

Behavioral: YRI; Other: EducAid educational programming

YRI+EducAid

EXPERIMENTAL

Immediately following enrollment, participants complete the YRI. Participants are then immediately enrolled in EducAid educational programming for the 2012-2013 academic year.

Behavioral: YRI; Other: EducAid educational programming

Interventions

YRI BEHAVIORAL

The YRI brings together six empirically-supported practice elements shown to be efficacious across different mental health interventions, as well as methods intended to socialize youth and improve self-efficacy. Practice elements address the broad scope of problems evidenced in Sierra Leonean war-affected youth and enhance the YRI's pacing, which progresses through three phases traditionally used in trauma treatments (stabilization, integration, connection). The weekly intervention takes place over 10 sessions lasting approximately one hour and a half. Groups are divided by gender and age. Each group is paired with two interventionists of the same gender.

Also known as: Youth Readiness Intervention

YRI only; YRI+EducAid

EducAid educational programming OTHER

EducAid is a charitable trust that provides free year-round education to over 1,500 youth, along with food, medicine, and shelter when needed. EducAid's education model aims to improve academic knowledge, self-efficacy, and attitudes toward school. Additionally, it aims to nurture hope for the future and a sense of normalcy through interactions with teachers, mentors, and peers.

Waitlist+EducAid; YRI only; YRI+EducAid

Eligibility Criteria

• Age: 15 Years - 24 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Participants must be between 15-24 years of age;
• Participants must prefer to have the opportunity to join an educational program but not currently be enrolled in school;
• A participant's total score on the Oxford scale must equal or exceed 30 AND
• Participants must display at least one non-zero score on the functioning questions.

You may not qualify if:

• Participant does not plan to reside in the Freetown urban area for the duration of the study (9 months from start date);
• Participant fails to meet age requirements;
• Participant is currently enrolled in school;
• Participant is not in favor of joining an educational program;
• Participant fails to meet Oxford psychosocial or functioning thresholds;
• Participant is judged by clinical staff as:
• Needing mental health treatment beyond the scope of the YRI
• Otherwise not suitable for a group treatment setting
• Participant displays the following:
• Cognitive delays
• Active suicidality
• Psychosis
• Risk of harm to themselves or others
• Participants at risk of harm to themselves or others, as well as those requiring treatment beyond the scope of the YRI, will be referred to local mental health or social work treatment facilities as appropriate.

Sponsors & Collaborators

• Boston College: lead
• Caritas Freetown: collaborator
• International Rescue Committee: collaborator
• Harvard Medical School (HMS and HSDM): collaborator
• Yale University: collaborator
• The City College of New York: collaborator

Study Sites (1)

CARITAS Freetown

Freetown, Sierra Leone

Location

Related Publications (14)

• Betancourt TS, Borisova II, de la Soudiere M, Williamson J. Sierra Leone's child soldiers: war exposures and mental health problems by gender. J Adolesc Health. 2011 Jul;49(1):21-8. doi: 10.1016/j.jadohealth.2010.09.021. Epub 2010 Dec 24.

  PMID: 21700152 BACKGROUND

• Betancourt TS. Attending to the mental health of war-affected children: the need for longitudinal and developmental research perspectives. J Am Acad Child Adolesc Psychiatry. 2011 Apr;50(4):323-5. doi: 10.1016/j.jaac.2011.01.008. No abstract available.

  PMID: 21421171 BACKGROUND

• Betancourt TS, Borisova II, Williams TP, Brennan RT, Whitfield TH, de la Soudiere M, Williamson J, Gilman SE. Sierra Leone's former child soldiers: a follow-up study of psychosocial adjustment and community reintegration. Child Dev. 2010 Jul-Aug;81(4):1077-95. doi: 10.1111/j.1467-8624.2010.01455.x.

  PMID: 20636683 BACKGROUND

• Betancourt TS, Brennan RT, Rubin-Smith J, Fitzmaurice GM, Gilman SE. Sierra Leone's former child soldiers: a longitudinal study of risk, protective factors, and mental health. J Am Acad Child Adolesc Psychiatry. 2010 Jun;49(6):606-15. doi: 10.1016/j.jaac.2010.03.008. Epub 2010 May 1.

  PMID: 20494270 BACKGROUND

• Betancourt TS, Agnew-Blais J, Gilman SE, Williams DR, Ellis BH. Past horrors, present struggles: the role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone. Soc Sci Med. 2010 Jan;70(1):17-26. doi: 10.1016/j.socscimed.2009.09.038. Epub 2009 Oct 28.

  PMID: 19875215 BACKGROUND

• Betancourt TS, Simmons S, Borisova I, Brewer SE, Iweala U, Soudiere MD. High Hopes, Grim Reality: Reintegration and the Education of Former Child Soldiers in Sierra Leone. Comp Educ Rev. 2008 Nov 1;52(4):565-587. doi: 10.1086/591298. No abstract available.

  PMID: 19337570 BACKGROUND

• Betancourt TS, Bass J, Borisova I, Neugebauer R, Speelman L, Onyango G, Bolton P. Assessing local instrument reliability and validity: a field-based example from northern Uganda. Soc Psychiatry Psychiatr Epidemiol. 2009 Aug;44(8):685-92. doi: 10.1007/s00127-008-0475-1. Epub 2009 Jan 22.

  PMID: 19165403 BACKGROUND

• Verdeli H, Clougherty K, Onyango G, Lewandowski E, Speelman L, Betancourt TS, Neugebauer R, Stein TR, Bolton P. Group Interpersonal Psychotherapy for depressed youth in IDP camps in Northern Uganda: adaptation and training. Child Adolesc Psychiatr Clin N Am. 2008 Jul;17(3):605-24, ix. doi: 10.1016/j.chc.2008.03.002.

  PMID: 18558315 BACKGROUND

• Bolton P, Bass J, Betancourt T, Speelman L, Onyango G, Clougherty KF, Neugebauer R, Murray L, Verdeli H. Interventions for depression symptoms among adolescent survivors of war and displacement in northern Uganda: a randomized controlled trial. JAMA. 2007 Aug 1;298(5):519-27. doi: 10.1001/jama.298.5.519.

  PMID: 17666672 BACKGROUND

• Betancourt TS, Speelman L, Onyango G, Bolton P. A qualitative study of mental health problems among children displaced by war in northern Uganda. Transcult Psychiatry. 2009 Jun;46(2):238-56. doi: 10.1177/1363461509105815.

  PMID: 19541749 BACKGROUND

• Betancourt TS, Khan KT. The mental health of children affected by armed conflict: protective processes and pathways to resilience. Int Rev Psychiatry. 2008 Jun;20(3):317-28. doi: 10.1080/09540260802090363.

  PMID: 18569183 BACKGROUND

• Betancourt TS. Child soldiers: reintegration, pathways to recovery, and reflections from the field. J Dev Behav Pediatr. 2008 Apr;29(2):138-41. doi: 10.1097/DBP.0b013e31816be946. No abstract available.

  PMID: 18408537 BACKGROUND

• Betancourt TS, Williams T. Building an evidence base on mental health interventions for children affected by armed conflict. Intervention (Amstelveen). 2008;6(1):39-56. doi: 10.1097/WTF.0b013e3282f761ff.

  PMID: 19997531 BACKGROUND

• Betancourt TS, McBain R, Newnham EA, Akinsulure-Smith AM, Brennan RT, Weisz JR, Hansen NB. A behavioral intervention for war-affected youth in Sierra Leone: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2014 Dec;53(12):1288-97. doi: 10.1016/j.jaac.2014.09.011. Epub 2014 Oct 2.

  PMID: 25457927 DERIVED

Related Links

• Click here for more information about this study: The Research Program on Children in Global Adversity, FXB Center, Harvard School of Public Health

MeSH Terms

Conditions

Anxiety Disorders; Depressive Disorder; Stress, Psychological; Depression; Social Adjustment; Social Behavior

Condition Hierarchy (Ancestors)

Mental Disorders; Mood Disorders; Behavioral Symptoms; Behavior

Study Officials

• Theresa S Betancourt, ScD, MA

  Boston College

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Salem Professor in Global Practice

Study Record Dates

• First Submitted: March 19, 2012
• First Posted: September 13, 2012
• Study Start: April 1, 2012
• Primary Completion: December 1, 2014
• Study Completion: December 1, 2014
• Last Updated: May 31, 2018

Record last verified: 2018-05

Locations

SI (1)