Many refugee children experience trauma in early childhood. Effective, tailored interventions are needed to improve refugee children’s access to preventive mental health. We interviewed refugee-serving stakeholders and parents participating in an evidence-based preventive mental health and wellness intervention adapted for Afghan refugee children and families who may have experienced trauma. Interview guide development was informed by two implementation science frameworks: the Consolidated Framework for Implementation Research and the Model for Adaptation Design and Impact. A three-person team coded transcripts via rapid qualitative analysis, and the study team reached consensus on themes. Six refugee-serving facilitators and five refugee parents discussed key determinants of successful implementation. Themes included: (i) modeling cultural humility to promote communication about emotions; (ii) needed linguistic support and referral networks to avoid miscommunications and missed communications; (iii) bridging connections between children, families and schools; (iv) different takeaways, or differing goals and expectations between facilitators and participants; and (v) timely, specific cultural considerations to overcome participation barriers. Overall, we found key determinants of successful implementation of a preventive mental health and wellness intervention for refugee children and families included adaptations to enhance cultural humility and sensitivity to cultural context while strengthening communication among facilitators, children and families.

中文翻译：

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探讨对阿富汗难民家庭成功实施预防性心理健康和保健干预措施的决定因素：定性分析

许多难民儿童在童年早期经历过创伤。需要采取有效、有针对性的干预措施来改善难民儿童获得预防性心理健康的机会。我们采访了难民服务的利益相关者和家长，参与了针对可能经历过创伤的阿富汗难民儿童和家庭的循证预防性心理健康和健康干预措施。访谈指南的制定基于两个实施科学框架：实施研究综合框架和适应设计和影响模型。三人团队通过快速定性分析编写了文字记录，研究团队就主题达成了共识。六名难民服务协调员和五名难民家长讨论了成功实施的关键决定因素。主题包括：(i) 树立文化谦逊的榜样，以促进情感交流；(ii) 需要语言支持和转介网络，以避免沟通不畅和错过沟通；(iii) 架起儿童、家庭和学校之间的桥梁；(iv) 促进者和参与者之间不同的结论或不同的目标和期望；(v) 及时、具体的文化考虑因素以克服参与障碍。总体而言，我们发现成功实施针对难民儿童和家庭的预防性心理健康和保健干预措施的关键决定因素包括进行调整以增强文化谦逊和对文化背景的敏感性，同时加强协调员、儿童和家庭之间的沟通。