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The Effectiveness of Hope Groups, a Mental Health, Parenting Support, and Violence Prevention Program for Families Affected by the War in Ukraine: Findings from a Pre-Post Study
28 Pages Posted: 2 Jan 2024
More...Abstract
Background: Nearly one in six children lived in war zones in 2021. Evidence-based psychosocial and parenting support has potential to mitigate negative impacts for parents and children co-exposed to war and displacement. In the current war in Ukraine, local mental health experts co-created and evaluated, in collaboration with global experts, the effectiveness of psychosocial and parenting support groups, called ‘Hope Groups’, on improvements in mental health, positive parenting, and violence against children after the 2022 Russian invasion.
Methods: Participants (n=577) included Ukrainian caregivers co-residing with children, and non-resident informal caregivers. Internally displaced, externally displaced, and those living at-home in war-torn regions were invited to groups by trained Ukrainian peer facilitators. Using a pre-post design, we compared individual level frequency measures at baseline, midline, and endline using paired t-tests and multi-level regression models to assess changes in 4 mental health, and 9 parenting and child health outcomes.
Findings: Compared to baseline, every mental health, parenting, and child health outcome improved significantly at midline and endline. Mental health ratings showed endline reductions in depressive symptoms of 56.8% (95% CI: -59.0,-54.3), and increases in hopefulness, coping with grief, and self-care, ranging from 62.0% (95% CI: 53.6,71.3) to 77.0% (95% CI: 66.3,88.3). Significant improvements in parenting and child health outcomes included monitoring children, reinforcing positive behavior, supporting child development, protecting child, nonviolent discipline, and child verbalizing emotions. By endline, emotional violence, physical violence, and child despondency had dropped by 57.7% (95% CI: -63.0%,-51.9), 64.0% (95% CI: -79.0,-39.5), and 51.9% (95% CI: -45.1,-57.9), respectively. Outcomes stratified by displacement status remained significant, as did those according to facilitator type (lay versus professional).
Interpretation: This study shows preliminary evidence for feasibility and effectiveness of Hope Groups for war-affected Ukrainian caregivers, on improved mental health, positive parenting, and reduced violence against children.
Funding: UK Research and Innovation (GCRF), LEGO Foundation, Oak Foundation, World Without Orphans, Moderna Charitable Foundation.
Declaration of Interest: I do not have any competing interests.
Ethical Approval: The University of Oxford Ethics Committee approved this study (Approval #R84832/RE001). Informed consent was obtained on web-based links using mobile phones.
Keywords: War, Armed Conflict, Refugees, Internally Displaced, Children, Abuse, Violence, Intervention, Psychosocial, Parenting, Mental Health
Suggested Citation: Suggested Citation