Refugee Well-Being Project: Efficacy of a Community-Based Intervention to Address Social Determinants of Mental Health.

Conflict, violence, and instability have led to unprecedented numbers of forcibly displaced people throughout the world. Thus, understanding the factors and processes that support the well-being of these populations is essential. Growing evidence documents postmigration stressors related to marginalization and exclusion as key social determinants of refugee mental health. This paper presents results from a randomized controlled trial (RCT) of the Refugee Wellbeing Project (RWP) a community-based, multilevel intervention. The goal of the waitlist RCT of the RWP was to rigorously test an ecological social justice approach to reducing high rates of psychological distress among African and Middle Eastern refugee adults resettled in the United States. The 6-month RWP intervention brought together university students enrolled in a 2-semester course and recently resettled refugee families to engage in mutual learning, cultural exchange, and collaborative efforts to mobilize community resources related to health, housing, employment, education, and legal issues and to improve community and systems responsiveness to refugees. A mixed methods strategy with data collected from 290 refugee participants at four time points over a period of 14 months was used to test the effectiveness of the RWP to reduce emotional distress and increase protective factors (English proficiency, social support, connection to home and American cultures). Multi-level modeling of quantitative data revealed significant intervention effects for all hypothesized outcomes, which provides important evidence to support social justice approaches to improving refugee mental health. These findings have implications not only for the growing numbers of refugees worldwide, but also because the RWP model has the potential to alleviate high rates of psychological distress among other immigrant and marginalized populations who experience inequities in resources and disproportionate exposure to trauma and stress. [ABSTRACT FROM AUTHOR]