We are Elrha, a force for change in the humanitarian community. The research and innovation we support equips the humanitarian community with the knowledge of what works, so people affected by crises get the right help when they need it most.
Our purpose is clear: to empower the humanitarian community to improve humanitarian response. We make this happen by supporting and championing the outcomes of robust research and proven innovations.
We empower the humanitarian community. Find out how we can support you...

Principal Investigator: Catherine Panter-Brick, Yale University

Purpose

This research assessed the health impact of Advancing Adolescents, a psychosocial intervention of structured, group-based activities for youth affected by the Syria and Iraq crises. This programme is a brief, scalable intervention, implemented by Mercy Corps in Jordan, Lebanon, Iraq, Syria, and Turkey as part of the No Lost Generation initiative.  It is strategic in focusing on adolescence, a key time for protecting the next generation and building its future, and innovative in serving both refugee & host communities.

The  impact evaluation was a randomized controlled trial, measuring the impacts of profound stress attunement for 11-15 year old Syrian refugee and Jordanian youth, living in five urban centers in northern Jordan.  It examined psychosocial, physiological and cognitive outcomes – stress in the mind, the body, and the brain – as well as levels of resilience, at three time-points (pre-intervention, post-intervention, 1-year follow-up).

Youth-focused interventions in humanitarian crises had never previously measured stress alleviation in ways that go beyond subjective self-reports, through measuring ‘stress under the skin’ or ‘toxic stress’ in the brain.  This mixed-method study was the first to do so, including measures of stress biomarkers and tablet-based tests of cognitive function.  Robust scientific assessments are essential in order to inform potential scale up strategies.

Photo of the team

Outcomes

The study evaluated two iterations of the Advancing Adolescents programme and assessed:

  • psychosocial outcomes, including mental health, stress, and insecurity
  • biological outcomes, including hair cortisol and immune function;
  • cognitive outcomes, using tablet-based tests of inhibitory control and working memory;
  • levels of individual, relational, and cultural resilience
  • genetic signatures of exposure to war-related trauma.

Want to know more?

Visit Yale University’s project website to learn more.

Key Findings

  • A structured approach to stress attunement, implemented by trained community workers can be effective in reducing psychosocial stress and insecurity for war-affected youth;
  • A brief intervention is also effective in regulating stress physiology: cortisol levels were reduced hair cortisol by a third;
  • Culturally-relevant tools such as the Human Insecurity Scale and the Child Youth Resilience Measure are among the most useful for evaluating risk and resilience in humanitarian contexts;
  • A strong partnership between local and international actors is essential to overcome challenges in the field and deliver a robust, ethical, and multi-disciplinary impact evaluation.

The study demonstrated the effectiveness of methods of assessment that go beyond self-reports.  The use of hair cortisol, as a marker of chronic physiological stress, is a compelling indicator of stress regulation, which is an important outcome for crisis-affected populations.

Key Outputs

Publications

Peer Reviewed Mental Heath and Psychosocial Support

C-reactive protein, Epstein-Barr virus, and cortisol trajectories in refugee and non-refugee youth: Links with stress, mental health, and cognitive function during a randomised controlled trial

Peer Reviewed Mental Heath and Psychosocial Support

Hair cortisol concentrations in war-affected adolescents: A prospective intervention trial

Peer Reviewed Mental Heath and Psychosocial Support

Insecurity, distress and mental health: experimental and randomized controlled trials of a psychosocial intervention for youth affected by the Syrian crisis

Peer Reviewed Mental Heath and Psychosocial Support

Resilience in Context: A Brief and Culturally Grounded Measure for Syrian Refugee and Jordanian Host-Community Adolescents

Peer Reviewed Mental Heath and Psychosocial Support

Association of MAOA genetic variants and resilience with psychosocial stress: A longitudinal study of Syrian refugees

Article Mental Heath and Psychosocial Support

What strong partnerships achieve: innovations in research and practice

Article Mental Heath and Psychosocial Support

FAAH, SLC6A4, and BDNF variants are not associated with psychosocial stress and mental health outcomes in a population of Syrian refugee youth

Next Steps

  • Mercy Corps has incorporated key study findings into regional programming, and expanded the inclusion of psychosocial support as part of larger livelihoods interventions in Lebanon, Iraq, Jordan and Palestine
  • Mercy Corps adopted three Arabic-language tools – the Child Youth Resilience Measure, the Human Insecurity scale and the Strength and Difficulties Questionnaire – in ongoing programming in the Middle East Region, as this study demonstrated their relevance for research monitoring and impact evaluations.

Latest Updates

Challenges of implementing a rigorous, innovative research methodology in a humanitarian setting: national partner perspectives

Mar 2016

It is one thing to design a research project in a series of meetings between collaborators; it is quite another to implement the resulting program of work in the field

View
2016Mar

Measuring resilience in Syrian refugee youth

Feb 2016

The youth and community centre in Mafraq we were visiting bore all the familiar hallmarks of facility serving contemporary global youth: poster-bedecked rooms depicting preoccupations with cute animals, music idols…

View
Feb

Subscribe to our newsletters....

Subscribe
 
Elrha © 2018 - 2019 Elrha is a registered charity in England and Wales (1177110).
Elrha Please upgrade your browser

You are seeing this because you are using a browser that is not supported. The Elrha website is built using modern technology and standards. We recommend upgrading your browser with one of the following to properly view our website:

Windows Mac

Please note that this is not an exhaustive list of browsers. We also do not intend to recommend a particular manufacturer's browser over another's; only to suggest upgrading to a browser version that is compliant with current standards to give you the best and most secure browsing experience.