Sibling-Support for Adolescent Girls (SSAGE): A whole-family, gendertransformative approach to preventing mental illness among forcibly displaced adolescent girls

项目摘要 被迫流离失所的青少年面临更大的精神疾病和痛苦风险， 青春期女孩受到的影响尤其严重，部分原因是性别不平等加剧， 往往伴随着被迫流离失所。虽然家庭单位有可能防止 精神疾病和促进青少年健康发展，很少有家庭干预措施， 采用性别转变方法或包括男性兄弟姐妹，以最大限度地 为青春期女孩提供福利。因此，我们建议评估一个创新的整个家庭， 性别变革干预-兄弟姐妹对紧急情况下少女的支持 （SSAGE）-预防哥伦比亚青春期少女的精神健康障碍， 最近被迫离开委内瑞拉。拟议的R34研究将调整SSAGE 课程通过以人为本的设计与一系列利益相关者，包括委内瑞拉 难民、哥伦比亚回返者和有关民间社会组织。拟定的研究将 然后采用混合类型1有效性-实施试点随机对照试验 (RCT)以测试该计划的有效性和机制途径，以及探索 实施的决定因素，以建立可行性，可接受性和保真度， SSAGE。为了实现这些目标，我们将招募180名最近抵达的被迫流离失所者， 在一个随机对照试验中的青春期女孩，并检查该计划的有效性， 精神疾病（通过减少焦虑，抑郁，人际敏感， 躯体化症状）干预后一个月。我们将使用上下文适应和 试点措施，以收集关于假设机制途径的更多数据，包括 家庭依恋、性别平等家庭功能、自尊和应对策略。的 实施评估将采用混合方法来评估该计划的可行性， 可接受性、忠实性以及成功实施的障碍和促进因素。潜在发现 可以支持人道主义项目的实施，并为政策提供信息， 青少年女孩的心理健康，并防止各种疾病可能产生的结果， 面临流离失所、冲突和家庭中不平等的性别规范， 社区.

Project Summary Forcibly displaced adolescents face increased risks for mental illness and distress, with adolescent girls disproportionately affected in part due to the heightened gender inequity that often accompanies forced displacement. Although the family unit has the potential to prevent mental illness and promote healthy development in adolescents, few family interventions have employed a gender transformative approach or included male siblings in an effort to maximize benefits for adolescent girls. Therefore, we propose to assess an innovative whole-family and gender transformative intervention—Sibling Support for Adolescent Girls in Emergencies (SSAGE)—to prevent mental health disorders among adolescent girls in Colombia who were recently and forcibly displaced from Venezuela. The proposed R34 study will adapt the SSAGE curriculum through human-centered design with a range of stakeholders, including Venezuelan refugees, Colombian returnees and relevant civil society organizations. The proposed study will then employ a hybrid type 1 effectiveness-implementation pilot randomized control trial (RCT) to test the program’s effectiveness and mechanistic pathways as well as to explore determinants of implementation in order to establish the feasibility, acceptability, and fidelity of SSAGE. To address these aims, we will enroll 180 recently arrived, forcibly displaced adolescent girls in an RCT and examine the program’s effectiveness on the prevention of mental illness (through reduction in anxiety, depression, interpersonal sensitivity, and somatization symptoms) one-month post-intervention. We will use contextually adapted and piloted measures to collect additional data on the hypothesized mechanistic pathways, including family attachment, gender equitable family functioning, self-esteem, and coping strategies. The implementation evaluation will employ mixed methods to assess the program’s feasibility, acceptability, fidelity and barriers and facilitators to successful implementation. Potential findings can support humanitarian program implementation, as well as inform policy to support adolescent girls’ mental health and to prevent the myriad disorders that can arise as a result of exposure to displacement, conflict, and inequitable gender norms in their households and communities.