Advertisement

Interdisciplinary Wellbeing Construct Developed Among Resettled Refugees

  • Renée Martin-WillettEmail author
  • M. Blevins
  • L. Bailey
  • Z. McCormick
  • M. H. Aliyu
Article
  • 103 Downloads

Abstract

US refugee resettlement emphasizes wellbeing; however, the definition of “wellbeing” is debated and the unreliability of surveys for refugees has been underscored. This pilot study utilized community engaged research principles to develop a composite measurement scale from the domains of somatic experience, occupational balance, social inclusion, and self-identification, leveraging consumer technology to pragmatically administer the material to a diverse group with varied literacy. Following qualitative data collection from March 2014 to February 2015, 65 participants from Bhutan or Myanmar were recruited from an agricultural program or through their resettlement caseworker to participate in a tablet-based survey from February to July 2015. Fifty-six (86%) participants were evaluable. Seventeen measures reduced into three sub-scales, and analyses demonstrated a statistically significant correlation between the slopes of somatic experience and occupational balance (p = 0.039). Somatic experience exhibited statistically significant differences between the two ethnic groups, but no other significant differences were observed by age, gender, time, or between the agricultural and home-based participants. Our results suggest the utility of the survey among diverse groups and the potential for a novel multi-dimensional wellbeing construct to be used in community-based settings.

Keywords

Refugees Resettlement Wellbeing Composite measurement scales Health technology Community-engaged research 

Notes

Acknowledgements

This research, subsequent data analysis, and manuscript preparation were conducted at Vanderbilt University. Thanks are due to the study staff that helped enable this project, including Damber Kharel, Ja Ring Laipai, Doi Ling, Bhumika Piya, and Anamika Sharma. Thanks also to the Bhutanese and Burmese resettled refugee communities in Nashville, Amy Richardson and the Nashville Refugee Task Force, Mitra Chamlagai and Anna Beth Walters of Nashville World Relief, and the faculty of the Vanderbilt Center for Medicine, Health and Society.

Funding

This work was supported by the Anne Potter Wilson Award, Vanderbilt Institute of Global Health and the Meharry-Vanderbilt Community Engaged Scholar Award, Meharry-Vanderbilt Community Engaged Research Core.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. Al-Amer, R., Ramjan, L., Glew, P., Darwish, M., & Salamonson, Y. (2015). Translation of interviews from a source language to a target language: examining issues in cross-cultural health care research. Journal of Clinical Nursing, 24(9–10), 1151–1162.CrossRefGoogle Scholar
  2. Al Sayah, F., Ishaque, S., Lau, D., & Johnson, J. A. (2013). Health related quality of life measures in Arabic speaking populations: a systematic review on cross-cultural adaptation and measurement properties. Quality of Life Research, 22(1), 213–229.Google Scholar
  3. Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191.CrossRefGoogle Scholar
  4. Berry, J. W. (2005). Acculturation: living successfully in two cultures. International Journal of Intercultural Relations, 29, 697–712.CrossRefGoogle Scholar
  5. Berry, J. W., & Sabatier, C. (2011). Variations in the assessment of acculturation attitudes: their relationships with psychological wellbeing. International Journal of Intercultural Relations, 35(5), 658–669.CrossRefGoogle Scholar
  6. Birman, D., & Chan, W. Y. (2008). Screening and assessing immigrant and refugee youth in school-based mental health programs. Issue brief no. 1. Washington, DC: Center for Health and Health Care in Schools.Google Scholar
  7. Bloch, A. (2007). Methodological challenges for national and multi-sited comparative survey research. Journal of Refugee Studies, 20(2), 230–247.CrossRefGoogle Scholar
  8. Block, K., Warr, D., Gibbs, L., & Riggs, E. (2012). Addressing ethical and methodological challenges in research with refugee-background young people: reflections from the field. Journal of Refugee Studies, 26(1), 69–87.CrossRefGoogle Scholar
  9. Booth-Kewley, S., Edwards, J. E., & Rosenfeld, P. (1992). Impression management, social desirability, and computer administration of attitude questionnaires: does the computer make a difference? Journal of Applied Psychology, 77(4), 562–566.CrossRefGoogle Scholar
  10. Brown, K. E., et al. (2011). Refugee assistance: little is known about the effectiveness of different approaches for improving refugees’ employment outcomes. Report to Congressional Committees, GAO-11-369.Google Scholar
  11. Brown, K. E., et al. (2012). Refugee resettlement: greater consultation with community stakeholders could strengthen program. Report to Congressional Committees, GAO-12-729; 2012.Google Scholar
  12. Camfield, L., & Ruta, D. (2007). ‘Translation is not enough’: using the Global Person Generated Index (GPGI) to assess individual quality of life in Bangladesh, Thailand, and Ethiopia. Quality of Life Research, 16(6), 1039–1051.CrossRefGoogle Scholar
  13. Chase, L. (2012). Psychosocial resilience among resettled Bhutanese refugees in the US. Forced Migration Review, 40, 47.Google Scholar
  14. Cornwell, E. Y., & Waite, L. J. (2009). Social disconnectedness, perceived isolation, and health among older adults. Journal of Health and Social Behavior, 50(1), 31–48.CrossRefGoogle Scholar
  15. Czymoniewicz-Klippel, M. T., Brijnath, B., & Crockett, B. (2010). Ethics and the promotion of inclusiveness within qualitative research: case examples from Asia and the Pacific. Qualitative Inquiry, 16(5), 332–341.CrossRefGoogle Scholar
  16. Dunnigan, T., McNall, M., & Mortimer, J. T. (1993). The problem of metaphorical nonequivalence in cross-cultural survey research: comparing the mental health statuses of Hmong refugee and general population adolescents. Journal of Cross-Cultural Psychology, 24(3), 344–365.CrossRefGoogle Scholar
  17. Dür, M., et al. (2014). Development of a new occupational balance-questionnaire: incorporating the perspectives of patients and healthy people in the design of a self-reported occupational balance outcome instrument. Health and Quality of Life Outcomes, 12(1), 1.CrossRefGoogle Scholar
  18. Ellis, B. H., Kia-Keating, M., Yusuf, S. A., Lincoln, A., & Nur, A. (2007). Ethical research in refugee communities and the use of community participatory methods. Transcultural Psychiatry, 44(3), 459–481.CrossRefGoogle Scholar
  19. Epstein, J., Santo, R. M., & Guillemin, F. (2015). A review of guidelines for cross-cultural adaptation of questionnaires could not bring out a consensus. Journal of Clinical Epidemiology, 68(4), 435–441.CrossRefGoogle Scholar
  20. Fassin, D., & Rechtman, R. (2009). The empire of trauma: an inquiry into the condition of victimhood. Princeton: Princeton University Press.Google Scholar
  21. Fazel, M., Wheeler, J., & Danesh, J. (2005). Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. The Lancet, 365(9467), 1309–1314.CrossRefGoogle Scholar
  22. Fitzmaurice, G. M., Laird, N. M., & Ware, J. H. (2012). Applied longitudinal analysis. Hoboken: John Wiley & Sons.Google Scholar
  23. Gadeberg, A. K., & Norredam, M. (2016). Urgent need for validated trauma and mental health screening tools for refugee children and youth. European Child Adolescent Psychiatry., 10, 1007.Google Scholar
  24. Gómez, A., Puigvert, L., & Flecha, R. (2011). Critical communicative methodology: informing real social transformation through research. Qualitative Inquiry, 17(3), 235–245.CrossRefGoogle Scholar
  25. Gregson, S., Zhuwau, T., Ndlovu, J., & Nyamukapa, C. A. (2002). Methods to reduce social desirability bias in sex surveys in low-development settings: experience in Zimbabwe. Sexually Transmitted Diseases, 29(10), 568–575.CrossRefGoogle Scholar
  26. Harvard Program in Refugee Trauma–History. (2017). Retrieved from http://hprt-cambridge.org/about/history/history-more/.
  27. Hollifield, M., Warner, T. D., Lian, N., Krakow, B., Jenkins, J. H., Kesler, J., Stevenson, J., & Westermeyer, J. (2002). Measuring trauma and health status in refugees: a critical review. Journal of the American Medical Association, 288(5), 611–621.CrossRefGoogle Scholar
  28. Hollifield, M., Verbillis-Kolp, S., Farmer, B., Toolson, E. C., Woldehaimanot, T., Yamazaki, J., Holland, A., St. Clair, J., & SooHoo, J. (2013). The Refugee Health Screener-15 (RHS-15): development and validation of an instrument for anxiety, depression, and PTSD in refugees. General Hospital Psychiatry, 35(2), 202–209.CrossRefGoogle Scholar
  29. Johnson-Agbakwu, C. E., Allen, J., Nizigiyimana, J. F., Ramirez, G., & Hollifield, M. (2014). Mental health screening among newly-arrived refugees seeking routine obstetric and gynecologic care. Psychological Services, 11(4), 470–476.CrossRefGoogle Scholar
  30. Joinson, A. (1999). Social desirability, anonymity, and Internet-based questionnaires. Behavior Research Methods, 31(3), 433–438.Google Scholar
  31. Kirmayer, L. J. (2001). Cultural variations in the clinical presentation of depression and anxiety: implications for diagnosis and treatment. Journal of Clinical Psychiatry, 62, 22–30.Google Scholar
  32. Kroenke, K., Spitzer, R. L., & Williams, J. B. (2002). The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic medicine, 64(2), 258–266.Google Scholar
  33. Lee, S. K., Sulaiman-Hill, C. R., & Thompson, S. C. (2014). Overcoming language barriers in community-based research with refugee and migrant populations: options for using bilingual workers. BMC International Health and Human Rights, 14(1), 11.CrossRefGoogle Scholar
  34. Mackenzie, C., McDowell, C., & Pittaway, E. (2007). Beyond ‘do no harm’: the challenge of constructing ethical relationships in refugee research. Journal of Refugee Studies, 20(2), 299–319.CrossRefGoogle Scholar
  35. Maitland, C., & Xu, Y. (2015). A social informatics analysis of refugee mobile phone use: a case study of Za’atari Syrian Refugee Camp.Google Scholar
  36. Marshall, D. (2015). Building a new life in Australia: the longitudinal study of humanitarian migrants. Canberra: Australian Government Department of Social Services.Google Scholar
  37. Martin-Willett, R., McCormick, Z., Aliyu, M. H. (2017). Novel tablet-based personal interviewing application use among newly resettled refugees. Health and Technology, 1–5.Google Scholar
  38. McCloskey, D., et al. (2011). Principles of community engagement. Washington D.C.: NIH Publication Number 11–7782.Google Scholar
  39. Mollica, R. F., Caspi-Yavin, Y., Bollini, P., Truong, T., Tor, S., & Lavelle, J. (1992). The Harvard Trauma Questionnaire: validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. The Journal of Nervous and Mental Disease, 180(2), 111–116.CrossRefGoogle Scholar
  40. Paudel, D., et al. (2013). Successful use of tablet personal computers and wireless technologies for the 2011 Nepal demographic and health survey. Global Health: Science and Practice, 1(2), 277–284.Google Scholar
  41. Polcher, K., & Calloway, S. (2016). Addressing the need for mental health screening of newly resettled refugees: a pilot project. Journal of Primary Care & Community Health, 7(3), 199–203.CrossRefGoogle Scholar
  42. Porter, M., & Haslam, N. (2005). Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. Journal of the American Medical Association, 294(5), 602–612.CrossRefGoogle Scholar
  43. Refugee Agricultural Partnership Program. (2012). Office of Refugee Resettlement, Department of Health and Human Services, Washington D.C. Retrieved at http://www.acf.hhs.gov/programs/orr/resource/refugee-agricultural-partnership-program.
  44. Rhema, S. H., Gray, A., Verbillis-Kolp, S., Farmer, B., & Hollifield, M. (2014). Mental health screening. In Refugee health care (pp. 163–171). New York: Springer.CrossRefGoogle Scholar
  45. Salvador-Carulla, L., Lucas, R., Ayuso-Mateos, J. L., & Miret, M. (2014). Use of the terms “wellbeing” and “quality of life” in health sciences: a conceptual framework. The European Journal of Psychiatry, 28(1), 50–65.CrossRefGoogle Scholar
  46. Shannon, P. J., Vinson, G. A., Cook, T. L., & Lennon, E. (2016). Characteristics of successful and unsuccessful mental health referrals of refugees. Administration and Policy in Mental Health, 43(4), 555–568.CrossRefGoogle Scholar
  47. Statistics on Literacy. (2016). Education, United Nations Educational, Scientific and Cultural Organization, Paris, France. Retrieved at http://www.unesco.org/new/en/education/themes/education-building-blocks/literacy/resources/statistics.
  48. Stenner, P., & Taylor, D. (2008). Psychosocial welfare: reflections on an emerging field. Critical Social Policy, 28(4), 415–437.CrossRefGoogle Scholar
  49. Steptoe, A., Deaton, A., & Stone, A. A. (2015). Subjective wellbeing, health, and ageing. The Lancet, 385(9968), 640–648.CrossRefGoogle Scholar
  50. Taylor, D. (2011). Wellbeing and welfare: a psychosocial analysis of being well and doing well enough. Journal of Social Policy, 40(04), 777–794.CrossRefGoogle Scholar
  51. Topp, C. W., Østergaard, S. D., Søndergaard, S., & Bech, P. (2015). The WHO-5 well-being index: a systematic review of the literature. Psychotherapy and Psychosomatics, 84(3), 167–176.CrossRefGoogle Scholar
  52. UNHCR Global Appeal 2015. (2015). Geneva: United Nations High Commissioner for Refugees. Accessed at http://www.unhcr.org/ga14/index.xml. Accessed 2 Nov 2017.
  53. WHOQOL Group. (1995). The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Social Science & Medicine, 41(10), 1403–1409.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.Vanderbilt Institute of Global HealthVanderbilt UniversityNashvilleUSA
  2. 2.Center for Medicine, Health and SocietyVanderbilt UniversityNashvilleUSA
  3. 3.University of Colorado BoulderBoulderUSA
  4. 4.Department of BiostatisticsVanderbilt UniversityNashvilleUSA
  5. 5.The Nashville Food ProjectNashvilleUSA
  6. 6.Trailblazing Technology, Inc.NashvilleUSA

Personalised recommendations