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Health Realization Community Coping Intervention for Somali Refugee Women

  • Cheryl L. Robertson
  • Linda Halcon
  • Sarah J. Hoffman
  • Nadifa Osman
  • Amin Mohamed
  • Eunice Areba
  • Kay Savik
  • Michelle A. Mathiason
Original Paper

Abstract

Health Realization (HR) is a strengths-based stress and coping intervention used to promote the use of internal and external coping resources. Our three-arm comparison group trial examined the effects of a culturally adapted Somali HR intervention on coping and mental health outcomes in 65 Somali refugee women post-resettlement. Subjects participated one of three conditions: HR intervention, nutrition attention-control, and evaluation-control. The HR intervention significantly affected multiple dimensions of coping: WAYS-distancing (p = 0.038), seeking social support (p = 0.042), positive reappraisal (p = 0.001); and Refugee Appraisal and Coping Experience Scale-Internal subscale (p = 0.045). The HR intervention also demonstrated improvement in depression symptom ratings (p = 0.079). We discuss findings from the pilot, challenges encountered conducting a three-arm comparison group trial, and implications for further research involving the HR intervention with culturally diverse refugee communities.

Keywords

Somali Refugee Health Realization Coping intervention Resilience 

Notes

Funding

This research was supported in part by a grant from the NIH/NINR.

References

  1. 1.
    Bentley JA, Thoburn TW, Steart DG, Boynton LD. The indirect effect of somatic complaints on report of posttraumatic psychological symptomatology among Somali refugees. J Trauma Stress. 2011;24(4):479–82.  https://doi.org/10.1002/jts.20651.CrossRefPubMedGoogle Scholar
  2. 2.
    Bhui K, Mohamud S, Warfa N, Curtis S, Stansfeld S, Craig T. Forced residential mobility and social support: impacts on psychiatric disorders among Somali migrants. BMC Int Health Hum Rights. 2012;12(1):4–14.  https://doi.org/10.1186/1472-698X-12-4.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Jaranson JM, Butcher J, Halcon L, Johnson DR, Robertson C, Savik K, Spring M, Westermeyer J. Somali and Oromo refugees: correlates of torture and trauma history. Am J Public Health. 2004;94(4):591–8.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Beiser M, Wickrama KA. Trauma, time and mental health: a study of temporal reintegration and depressive disorder among Southeast Asian refugees. Psychol Med. 2004;34(5):899–910.  https://doi.org/10.1017/S0033291703001703.CrossRefPubMedGoogle Scholar
  5. 5.
    Sulaiman-Hill CMR, Thompson SC. “Thinking too much”: psychological distress, sources of stress and coping strategies of resettled Afghan and Kurdish refugees. J Muslim Mental Health. 2012;6(2):63–86.  https://doi.org/10.3998/jmmh.10381607.0006.205.CrossRefGoogle Scholar
  6. 6.
    Mölsä ME, Hjelkde KH, Tiilikainen M. Changing conceptions of mental distress among Somalis in Finland. Transcult Psychiatry. 2010;47(92):276–301.  https://doi.org/10.1177/1363461510368914.CrossRefPubMedGoogle Scholar
  7. 7.
    Pavlish C, Noor S, Brandt J. Somali immigrant women and the American health care system: discordant beliefs, divergent expectations, and silent worries. Soc Sci Med. 2010;71(2):353–61.  https://doi.org/10.1016/j.socscimed.2010.04.010.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Matheson K, Jorden S, Anisman H. Relations between trauma experiences and psychological, physical and neuroendocrine functioning among Somali refugees: mediating role of coping with acculturation stressors. J Immigr Minor Health. 2008;10(4):291–304.  https://doi.org/10.1007/s10903-007-9086-2.CrossRefPubMedGoogle Scholar
  9. 9.
    Stewart M, Simich L, Beiser M, Makumbe K, Makwarimba E, Shizha E. Impacts of a social support intervention for Somali and Sudanese refugees in Canada. Ethn Inequalities Health Soc Care. 2011;4(4):186–99.  https://doi.org/10.1108/17570981111250840.CrossRefGoogle Scholar
  10. 10.
    Kroll J, Yusef A, Il, Fujiwars K. Psychoses, PTSD, and depression in Somali refugees in Minnesota. Soc Psychiatry Psychiatr Epidemiol. 2011;46(6):481–93.  https://doi.org/10.1007/s00127-010-0216-0.CrossRefPubMedGoogle Scholar
  11. 11.
    Lazarus RS. Psychological stress and the coping process. New York: McGraw-Hill; 1966.Google Scholar
  12. 12.
    Selye H. The physiology and pathology of exposure to stress. Oxford: Acta, Inc; 1950.Google Scholar
  13. 13.
    Katz JL, Weiner H, Gallagher TF, Hellman L. Stress, distress, and ego defenses. Arch Gen Pediatr. 1970;23:131–42.CrossRefGoogle Scholar
  14. 14.
    Cardozo BL, Bilukha OO, Crawford CA, Shaikh I, Wolfe MI, Gerber ML, Anderson M. Mental health, social functioning, and disability in postwar Afghanistan. JAMA 2004;292(5):575–84.  https://doi.org/10.1001/jama.292.5.575.CrossRefPubMedGoogle Scholar
  15. 15.
    Garvin BJ, Ryan-Wenger N. Coping with Health/Illness concerns: knowledge, synthesis, and implications in the literature, 1991–1995. In: Werner JS, Frost MH, editors. Stress and coping: state of the science and implications for nursing theory, research, and practice 1991–1995. Glenview: Midwest Nursing Research Society; 2000. pp. 97–119.Google Scholar
  16. 16.
    Jorden S, Matheson K, Anisman H. Supportive and unsupportive social interactions in relation to cultural adaptation and psychological distress among Somali refugees exposed to collective or personal traumas. J Cross Cult Psychol. 2009;40(5):853–75.  https://doi.org/10.1177/0022022109339182.CrossRefGoogle Scholar
  17. 17.
    Halcón LL, Robertson CL, Monsen KA, Claypatch CC. A theoretical framework for using health realization to reduce stress and improve coping in refugee communities. J Holist Nurs. 2007;25(3):186–94.  https://doi.org/10.1177/0898010107303275.CrossRefPubMedGoogle Scholar
  18. 18.
    Folkman S. Positive psychological states and coping with severe stress. Soc Sci Med. 1997;45:1207–21.CrossRefPubMedGoogle Scholar
  19. 19.
    Folkman S, Lazarus RS. Coping as a mediator of emotion. J Pers Soc Psychol. 1988;54(3):466–75.  https://doi.org/10.1037/0022-3514.54.3.466.CrossRefPubMedGoogle Scholar
  20. 20.
    DuBois DK. A community health assessment of a culturally diverse housing project in St. Paul. Minn Med. 1998;81(4):49–51.PubMedGoogle Scholar
  21. 21.
    Fritz MJ, Hedemark LL. Somali refugee health screening in Hennepin County. Minn Med. 1998;81:43–7.PubMedGoogle Scholar
  22. 22.
    Hodes R. Cross-cultural medicine and diverse health beliefs. Ethiopians abroad. West J Med. 1997;166(1):29–36. Retrieved from http://www.ncbi.nlm.nih.gov.ezp3.lib.umn.edu/pmc/articles/PMC1303953/.
  23. 23.
    Halcón LL, Robertson CL, Monsen KA. Evaluating health realization for coping among refugee women. J Loss Trauma. 2010;15(5):408–25.  https://doi.org/10.1080/15325024.2010.507645.CrossRefGoogle Scholar
  24. 24.
    Frank O, Snijders T. Estimating the size of hidden populations using snowball sampling. J Off Stat. 1994;10(1):53–67.Google Scholar
  25. 25.
    Lepkowski JM. Sampling the difficult-to-sample. J Nutr. 1991;121(3):416–23.CrossRefPubMedGoogle Scholar
  26. 26.
    Spring M, Westermeyer J, Halcon L, Savik K, Robertson C, Johnson DR, Butcher JN, Jaranson J. Sampling in difficult to access refugee and immigrant communities. J Nerv Ment Dis. 2003;191(11):813–9.  https://doi.org/10.1097/NMD.0b013e318225eebf.CrossRefPubMedGoogle Scholar
  27. 27.
    Waters J, Biernaski P. Targeted sampling: options for the study of hidden populations. Soc Probl. 1989;36(4):416–30.  https://doi.org/10.2307/800824.CrossRefGoogle Scholar
  28. 28.
    Derogatis LR. Symptom Checklist 90–R: administration, scoring, and manual. 3rd ed. Minneapolis: National Computer Systems; 1994.Google Scholar
  29. 29.
    Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer Publishing Company, Inc; 1984.Google Scholar
  30. 30.
    Brislin R. Back-translation for cross-cultural research. J Cross Cult Psychol. 1970;1:185–216.  https://doi.org/10.1177/135910457000100301.CrossRefGoogle Scholar
  31. 31.
    Araya M, Chotai J, Komproe IH, de Jong J. Gender differences in traumatic life events, coping strategies, perceived social support and sociodemographics among postconflict displaced persons in Ethiopia. Soc Psychiatry Psychiatr Epidemiol. 2007;2(4):307–15.  https://doi.org/10.1007/s00127-007-0166-3.CrossRefGoogle Scholar
  32. 32.
    Huijts I, Kleijn W, van Emmerik AAP, Noordhof A, Smith AJM. Dealing with man-made trauma: the relationship between coping style, posttraumatic stress, and quality of life in resettled, traumatized refugees in the Netherlands. J Trauma Stress. 2012;25(1):71–8.  https://doi.org/10.1002/jts.21665.CrossRefPubMedGoogle Scholar
  33. 33.
    Ruwanpura E, Mercer SW, Ager A, Duveen G. Cultural and spiritual constructions of mental distress and associated coping mechanisms of Tibetans in exile: implications for Western interventions. J Refug Stud. 2006;19(2):187–202.CrossRefGoogle Scholar
  34. 34.
    Musani S, Hoffman SJ, Stich J. The role of culture in health. J Transcult Nurs (under review).Google Scholar
  35. 35.
    Robertson CL, Savik K, Mathiason-Moore M, Mohamed A, Hoffman SJ. Modeling psychological functioning in refugees. J Am Psychiatr Nurse Assoc. 2017;22:225–32.CrossRefGoogle Scholar
  36. 36.
    Sedgeman J. (2008). Effects of a mind-consciousness-thought (MCT) intervention on stress and well-being in freshman nursing students. Retrieved from ProQuest LLC. (UMI Microform 3326919).Google Scholar
  37. 37.
    Kelley TM. A neo-cognitive model of crime. J Offender Rehabil. 1990;16:1–26.CrossRefGoogle Scholar
  38. 38.
    Kelley TM. An advanced criminology based on psychology of mind. J Offender Rehabil. 1993;19(1):67–81.Google Scholar
  39. 39.
    Kelley TM. Neo-cognitive learning theory: implications for prevention and early intervention strategies with at-risk youth. Adolescence 1993;28:439–60.PubMedGoogle Scholar
  40. 40.
    McCombs B, Marzano RM. Putting the self in self-regulation learning: the self as agent in integrating will and skill. Educ Psychol. 1990;25:51–69.CrossRefGoogle Scholar
  41. 41.
    Mills R, Alpert G, Dunham R. Working with high-risk youth in prevention and early intervention programs: toward a comprehensive wellness model. Adolescence 1988;23:643–60.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Cheryl L. Robertson
    • 1
  • Linda Halcon
    • 1
  • Sarah J. Hoffman
    • 1
  • Nadifa Osman
    • 1
    • 2
  • Amin Mohamed
    • 1
  • Eunice Areba
    • 1
  • Kay Savik
    • 1
  • Michelle A. Mathiason
    • 1
  1. 1.School of NursingUniversity of MinnesotaMinneapolisUSA
  2. 2.Government of SomaliaMogadishuSomalia

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