Peer-led Support Program for Refugee Families

Overseen By Mary Bunn, PhD

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Illinois at Chicago

Disqualifiers: Developmental disabilities, Severe mental health, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

Duration: 6 weeks

74 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a family-based program called CAFES2 (Coffee and Family Education and Support, Version 2), which aims to help refugee families strengthen their mental and social well-being. The program includes home visits and group sessions to support families facing multiple challenges. It specifically seeks refugee families from Iraq, Syria, Lebanon, Jordan, Palestine, or Yemen who have lived in Chicago for less than three years and have a member experiencing regular mental stress. Participants will either join the CAFES2 program or continue with their usual care while receiving lifestyle tips. The trial aims to determine the program's effectiveness and the best methods for delivering it to families in need. As an unphased trial, this study offers families a unique opportunity to access potentially beneficial support and contribute to valuable research.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on family support and mental health, so it's best to ask the trial organizers for more details.

What prior data suggests that the CAFES2 intervention is safe for refugee families?

Research has shown that family-based mental health programs, like CAFES2, have been tested in various settings with refugees. These studies generally find that such programs are safe and can enhance family well-being. For example, a review of similar parent support programs suggested they can boost positive parenting and overall family health.

CAFES2 aims to assist Arabic-speaking refugee families, and similar programs have been well-received. Reports from these programs do not indicate major safety issues, suggesting they are generally well-tolerated by participants. Although specific data on CAFES2 is limited, the safety record of similar programs provides some reassurance about its safety for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

The CAFES2 program is unique because it focuses on strengthening family and social support for refugee families through a peer-led approach. Unlike most existing treatments that might focus on individual therapy or medication, CAFES2 involves home visits and multiple family group sessions. This method aims to build a supportive community environment, which can be crucial for the mental health and well-being of refugees. Researchers are excited about this trial because it explores how social connections and community support can significantly impact recovery and integration, potentially offering a more holistic approach than traditional treatments.

What evidence suggests that the CAFES2 intervention is effective for refugee families?

Studies have shown that mental health programs involving the whole family can be helpful for refugees. In this trial, families may be randomized to receive the CAFES2 intervention, a peer-led program that strengthens family and social connections. Early results suggest that similar programs improve mental health by addressing the diverse needs of refugee families. Previous programs like CAFES, which worked with families from Bosnia-Herzegovina, showed positive outcomes. These programs support families by providing help and education in a group setting. ^{6 7 8 9 10}

Who Is on the Research Team?

Mary Bunn, PhD

Principal Investigator

University of Illinois Chicago

Are You a Good Fit for This Trial?

This trial is for resettled refugee families with at least one school-aged child (12-17 years old) living with them. Participants should be between 18-45 years old and have arrived in the U.S. as refugees. At least one family member must show moderate emotional distress to qualify.

Inclusion Criteria

Adult Caregivers/Parents: arrived to the U.S as a refugee

I am a caregiver or parent aged between 18 and 45.

Youth: arrived as a refugee

Exclusion Criteria

not meeting the above inclusion criteria

families or individual in the midst of a crisis (e.g. family crisis or mental health crisis)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Adaptation

Adaptation of the CAFES model for delivery by peers using implementation science and human-centered design methods

4-6 weeks

Treatment

Participants receive a home visit and participate in six multiple family group sessions

6 weeks

6 group sessions

Follow-up

Participants are monitored for changes in mental health and social support outcomes

6 weeks

What Are the Treatments Tested in This Trial?

Interventions

• CAFES2

Trial Overview CAFES2, a peer-led group intervention aimed at strengthening family and social dynamics among refugee families, is being tested for its feasibility, acceptability, and preliminary effectiveness using a pilot randomized hybrid design.

How Is the Trial Designed?

Group I: CAFES2 family and social strengthening intervention Experimental Treatment 1 Intervention

Families randomized into CAFES2 receive a home visit and participate in six multiple family group sessions in addition to any outside services or programs they are participating in.

Group II: Enhanced Control Active Control 1 Intervention

Families randomized to the enhanced control arm will not receive the CAFES2 intervention Instead, they will continue with their usual care, and also receive healthy lifestyle materials.

Who Is Running the Clinical Trial?

University of Illinois at Chicago

Lead Sponsor

Trials

653

Recruited

1,574,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Published Research Related to This Trial

A peer-led parenting intervention called 'Living with Teenagers' was found to be feasible and effective, with a 71% completion rate among 41 participants, primarily from minority ethnic backgrounds and many being lone parents.

The intervention led to significant improvements in parental concern about adolescent behavior and increased parenting satisfaction, indicating its potential to support parents in socially disadvantaged communities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

'Living with Teenagers': feasibility study of a peer-led parenting intervention for socially disadvantaged families with adolescent children. Michelson, D., Ben-Zion, I., James, AI., et al.[2016]

A randomized controlled trial (RCT) involving 93 adult refugees tested a community-based intervention aimed at reducing mental health disparities and improving access to trauma-focused treatment, highlighting the importance of addressing social determinants of health.

The study identified significant challenges in conducting community-based RCTs, such as intervention diffusion and participant engagement, while also developing innovative solutions that could benefit future community-academic partnerships in similar research efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Challenges and Innovations in a Community-Based Participatory Randomized Controlled Trial. Goodkind, JR., Amer, S., Christian, C., et al.[2020]

The Family Empowerment (FAME) program, designed for asylum seeker families in the Netherlands, was well-received by participants, with many valuing the opportunity to connect with other families, although only a small number completed all assessments.

While FAME showed potential for reducing anxiety and depression among parents, it had limited effects on overall family functioning, suggesting that the program's goals may not have fully met the specific needs of some families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family Empowerment (FAME): A feasibility trial of preventive multifamily groups for asylum seeker families in the Netherlands. van Es, CM., Boelen, PA., Zwaanswijk, M., et al.[2022]

A culturally congruent support intervention for Somali and Sudanese refugees, involving peer and professional facilitators, was successfully designed and piloted with 58 participants over 12 weeks, focusing on enhancing social networks.

Participants reported significant benefits, including increased social integration, reduced feelings of loneliness, and improved coping strategies, highlighting the importance of culturally tailored support in helping refugees adapt to new environments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supporting African refugees in Canada: insights from a support intervention. Stewart, M., Simich, L., Shizha, E., et al.[2021]

The TAFES intervention, involving family home visits and multi-family support groups, was implemented with 86 newly resettled Kosovar refugees, showing high engagement with 69% of families participating in the groups.

Post-intervention assessments indicated that participants experienced increased social support and improved knowledge and attitudes towards trauma mental health, suggesting that TAFES may be a beneficial intervention for refugee families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The TAFES multi-family group intervention for Kosovar refugees: a feasibility study. Weine, SM., Raina, D., Zhubi, M., et al.[2018]

The Pika Pamoja cooking curriculum was successfully implemented with 10 refugee family dyads, showing high retention rates and fidelity in the program's execution, indicating it is feasible and well-accepted by participants.

Participants reported positive feedback on the program, which included improvements in cooking skills, self-efficacy, and family engagement in healthy eating, suggesting potential benefits for food security among refugee families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and Acceptability of Implementing a Culturally Adapted Cooking Curriculum for Burundian and Congolese Refugee Families. McElrone, M., Colby, S., Fouts, HN., et al.[2021]

A qualitative study involving 40 participants (25 parents and 15 adolescents) from Horn of Africa refugee communities in Melbourne revealed significant differences in dietary beliefs and health perceptions between parents and their adolescent children.

Parents employed various feeding practices to maintain traditional diets for their children, highlighting the need for health programs to consider the effects of acculturation on dietary habits and family dynamics among refugee populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intergenerational differences in acculturation experiences, food beliefs and perceived health risks among refugees from the Horn of Africa in Melbourne, Australia. Wilson, A., Renzaho, A.[2023]

The study identified five key elements of a peer-led home visiting support program for Aboriginal parents, emphasizing the importance of culturally appropriate strategies and community engagement in enhancing program effectiveness.

Participants highlighted the need for ongoing support for peer support workers and interagency collaboration to ensure the sustainability and success of the program, which is crucial for developing positive family environments among Aboriginal families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aboriginal parent support: A partnership approach. Munns, A., Toye, C., Hegney, D., et al.[2021]

The 'Families Helping Families' program in Melbourne has successfully integrated trained family peer supporters into mental health services, responding to government policies and family feedback.

Preliminary results indicate that this program is positively received by families, highlighting the potential benefits of incorporating lived experience into mental health treatment and care plans, though further research is needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family peer support work in an early intervention youth mental health service. Leggatt, M., Woodhead, G.[2017]

The demonstration project successfully tested a self-help model for female single parents, leading to increased membership and improved self-awareness, confidence, and leadership skills among participants.

Key factors contributing to the project's success included initial individual contact, informal agreements, and strong community support, which helped enhance coping skills and access to resources.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supportive group action for women: a self-help strategy. Stewart, M.[2009]

All 30 households with children under 5 years old in the study were found to be food-insecure, with 60% of the children experiencing hunger, highlighting a critical issue among recently arrived refugee families.

Child hunger was linked to factors such as recent arrival in the UK and receiving fewer benefits, suggesting that targeted support and resources are needed to address food insecurity in this vulnerable population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Food insecurity among refugee families in East London: results of a pilot assessment. Sellen, DW., Tedstone, AE., Frize, J.[2019]

Peer supporters in South Africa play a crucial role in promoting exclusive breastfeeding, but they face unique challenges such as marketing their services and negotiating entry into mothers' homes, which differs from traditional healthcare roles.

The effectiveness of peer supporters is enhanced by supportive supervision that addresses both their health-related tasks and the social challenges they encounter, such as stigma and normative feeding practices that complicate their efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Selling a service: experiences of peer supporters while promoting exclusive infant feeding in three sites in South Africa. Nkonki, LL., Daniels, KL.[2021]

The Family Strengthening Intervention for Refugees (FSI-R) was piloted with 80 refugee families in Greater Boston, showing that community-based participatory research (CBPR) can enhance the acceptability and feasibility of mental health interventions.

Key factors for the success of FSI-R included flexibility in scheduling, involvement of community members as interventionists, and improvements in family communication, which collectively contributed to better family functioning and children's mental health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Understanding mechanisms of change in a family-based preventive mental health intervention for refugees by refugees in New England. DiClemente-Bosco, K., Elizabeth Neville, S., Berent, JM., et al.[2023]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT06261463

Hybrid Type 1 Randomized Pilot Trial of a Peer-led Family ... CAFES2 is a peer-led family and social strengthening multiple family group intervention that is designed to respond to multi-level needs of refugee families.

2. trialstoday.org trialstoday.org/trial/NCT06261463

Hybrid Type 1 Randomized Pilot Trial of a Peer-led Family ... CAFES2 is a peer-led family and social strengthening multiple family group intervention that is designed to respond to multi-level needs of ...

3. reporter.nih.gov reporter.nih.gov/project-details/10525624

1K01MH128524-01A1 Using a pilot randomized type 1 hybrid implementation-effectiveness design, the research aims include: 1) Adapting the multiple family CAFES model for Syrian ...

4. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/18412823/

Evaluating a multiple-family group access intervention for ... This study investigated a nine-session multiple-family group called Coffee and Families Education and Support with refugee families from Bosnia-Herzegovina in ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S2666560322000937

Family-based mental health interventions for refugees ... This study reviewed the literature on family-based mental health interventions for refugees across migration contexts and settings.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10392776/

Family-based mental health interventions for refugees ... This study reviewed the literature on family-based mental health interventions for refugees across migration contexts and settings.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8854318/

Parent Support Programmes for Families Who are Immigrants Parent support programmes for families who are immigrants potentially improve positive parental practices and families' wellbeing.

8. marybunn.com marybunn.com/cafes2

CAFES2 — The Flourish Lab This research study is developing and evaluating a family strengthening program called CAFES2 to help Arabic-speaking refugee families in Chicago. This family ...

9. researchgate.net researchgate.net/publication/5439457_Evaluating_A_Multiple-Family_Group_Access_Intervention_for_Refugees_with_PTSD

Evaluating A Multiple-Family Group Access Intervention for ... This study investigated a nine-session multiple-family group called Coffee and Families Education and Support with refugee families from Bosnia- ...

10. apa.org apa.org/pubs/info/reports/refugees-full-report.pdf

Resilience and recovery after war: refugee children and ... Weine and colleagues (2006) used the youth coffee and family education and support (cAfes) intervention to develop a conceptual framework for family-focused ...