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Evaluations of education technology (ed tech) interventions in humanitarian settings are scarce. We present a proof-of-concept study of Can't Wait to Learn, a digital game-based learning program that combines an experiential, active learning design with meaningful, competency-appropriate, and contextually relevant content. We assessed the feasibility of using this program to address the current education gap in Lebanon by implementing its mathematics component in basic literacy and numeracy classes (n=30) with out-of-school children (n=390) ages 10-14. We estimated changes in numeracy competency and psychosocial wellbeing and conducted focus group discussions (n=16) and key informant interviews (n=19) with children, facilitators, parents, and partner staff members to understand the lived experience, perceived impact, and implementation challenges of the program. Our findings support the feasibility of using ed tech programs to meet the needs of out-of-school children, as we saw significant improvements in numeracy, psychological symptoms, and self-esteem; positive reported experiences with the program; increased motivation among the children; and overall ease of implementation. Our suggested improvements to the game design and implementation model will support ongoing program adaptation and implementation, with the goal of increasing access to quality education for children living in humanitarian settings. Our findings will inform future studies that seek to conclusively determine the program's effectiveness.

In humanitarian settings, mental health and psychosocial support services (MHPSS) are often delivered in group-based formats. Group interventions enable providers to reach more individuals when resources and technical expertise are limited. Group-based programs also foster social support, empathy, and collective problem-solving among the participants. To remedy the current lack of tools available to assess the group facilitation competencies of individuals delivering group-based MHPSS, we made it our objective to develop such a tool. Our approach, which focused on adults, complimented a similar initiative underway for children and adolescents. We reviewed MHPSS manuals to identify key group facilitation competencies, which include developing and reviewing group ground rules, facilitating participation among all group members, fostering empathy between members, encouraging collaborative problem-solving, addressing barriers to attendance, time management, and ensuring group confidentiality. We then developed the Group Facilitation Assessment of Competencies (GroupACT) Tool. The GroupACT is a structured observational tool for assessing these competencies during standardized role-plays with actor clients, or in vivo during the delivery of group sessions with actual clients. We conclude this article with guidance for using the GroupACT to assess facilitators' competencies in providing group-based MHPSS in the health, education, protection, and other sectors in humanitarian settings.

Objective: The authors examined moderators and mediators of a school-based psychosocial intervention for children affected by political violence, according to an ecological resilience theoretical framework. Method: The authors examined data from a cluster randomized trial, involving children aged 8-13 in Central Sulawesi, Indonesia (treatment condition n = 182, waitlist control condition n = 221). Mediators (hope, coping, peer/emotional/play social support) and moderators (gender, age, family connectedness, household size, other forms of social support, exposure to political violence, and displacement) of treatment outcome on posttraumatic stress symptoms and function impairment were examined in parallel process latent growth curve models. Results: Compared with the waitlist group, those receiving treatment showed maintained hope, increased positive coping, maintained peer social support, and increased play social support. Of these putative mediators, only play social support was found to mediate treatment effects, such that increases in play social support were associated with smaller reductions in posttraumatic stress disorder (PTSD) symptoms. Furthermore, the authors identified a number of moderators: Girls showed larger treatment benefits on PTSD symptoms; girls, children in smaller households, and children receiving social support from adults outside the household showed larger treatment benefits on function impairment. Conclusions: Findings provide limited evidence for an ecological resilience theoretical framework. On the basis of these findings, the authors recommend a stronger separation between universal prevention (e.g., resilience promotion through play) and selective/indicated prevention (e.g., interventions aimed at decreasing posttraumatic stress symptoms). Play-based interventions should be careful to exclude children with psychological distress. In addition, treatment effects may be augmented by selecting girls and socially vulnerable children. (Contains 5 tables and 1 figure.)

Background: In situations of ongoing violence, childhood psychosocial and mental health problems require care. However, resources and evidence for adequate interventions are scarce for children in low- and middle-income countries. This study evaluated a school-based psychosocial intervention in conflict-affected, rural Nepal. Methods: A cluster randomized controlled trial was used to evaluate changes on a range of indicators, including psychiatric symptoms (depression, anxiety, posttraumatic stress disorder), psychological difficulties, resilience indicators (hope, prosocial behavior) and function impairment. Children (n = 325) (mean age = 12.7, SD = 1.04, range 11-14 years) with elevated psychosocial distress were allocated to a treatment or waitlist group. Results: Comparisons of crude change scores showed significant between-group differences on several outcome indicators, with moderate effect sizes (Cohen d = 0.41 to 0.58). After correcting for nested variance within schools, no evidence for treatment effects was found on any outcome variable. Additional analyses showed gender effects for treatment on prosocial behavior (mean change difference: 2.70; 95% CI, 0.97 to 4.44), psychological difficulties (-2.19; 95% CI, -3.82 to -0.56), and aggression (-4.42; 95% CI, -6.16 to -2.67). An age effect for treatment was found for hope (0.90; 95% CI, -1.54 to -0.26). Conclusions: A school-based psychosocial intervention demonstrated moderate short-term beneficial effects for improving social-behavioral and resilience indicators among subgroups of children exposed to armed conflict. The intervention reduced psychological difficulties and aggression among boys, increased prosocial behavior among girls, and increased hope for older children. The intervention did not result in reduction of psychiatric symptoms.