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Characterization of premigration and postmigration multidomain factors and psychosocial health among refugee children and adolescents after resettlement in Australia

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Abstract
IMPORTANCE A better understanding of the psychosocial health of resettled child and adolescent refugees and associated premigration and postmigration factors may help this population integrate effectively. OBJECTIVE To estimate the associations of premigration and postmigration multidomain factors with psychosocial health after resettlement among young refugees of different ages. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used wave 3 data from the Building a New Life in Australia (BNLA) cohort study, as they represented the first time a BNLA study included a child module targeting children and adolescents in the migrating unit as a nested component of the broader study. The study population consisted of children aged 5 to 10 years and adolescents aged 11 to 17 years. The caregivers of the children, the adolescents themselves, and the adolescents’ caregiverswere invited to complete the child module.Wave 3 datawere collected from October 1, 2015, to February 29, 2016. Statistical analysiswas performed from May 10 to September 21, 2022. EXPOSURES Premigration and postmigration multidomain factors, including individual (child and caregiver), family, school, and community levels, were measured. MAIN OUTCOMES AND MEASURES Social and emotional adjustment and posttraumatic stress disorder (PTSD) were the dependent variables measured by the Strengths and Difficulties Questionnaire (SDQ) and an 8-item PTSD scale.Weighted multilevel linear or logistic regression models were used. RESULTS Of the 220 children aged 5 to 10 years (mean [SD] age, 7.4 [2.0] years), 117 (53.2%) were boys; of the 412 adolescents aged 11 to 17 years (mean [SD] age, 14.1 [2.0] years), 215 (52.2%) were boys. Among the children, compared with no exposure, exposure to premigration traumatic events (β = 2.68 [95%CI, 0.51-4.85]) and having family conflicts after resettlement (β = 6.30 [95% CI, 2.97-9.64]) were positively associated with SDQ total difficulties score; school achievement was negatively associated with SDQ total difficulties score (β = −5.02 [95%CI, −9.17 to −0.87]). Among the adolescents, being treated unfairly (β = 3.32 [95%CI, 1.41-5.22]) and parenting harshness after resettlement (β = 0.25 [95%CI, 0.11-0.40]) were positively associated with SDQ total difficulties score; engagement in extracurricular activities (β = −3.67 [95%CI, −6.83 to −0.50]) was negatively associated with SDQ total difficulties score. Exposure to premigration traumatic events (adjusted odds ratio [aOR], 2.49 [95%CI, 1.10-5.63]), being treated unfairly (aOR, 3.77 [95%CI, 1.60-8.91]), and facing English language barriers (aOR, 6.41 [95%CI, 1.98-20.79]) after resettlement were positively associated with the presence of PTSD. CONCLUSIONS AND RELEVANCE In this study of refugee children and adolescents, apart from premigration traumatic experiences, several postmigration family- and school-related factors and social integration factors were associated with psychosocial health after resettlement. The findings suggest that family- and school-centered psychosocial care and social integration programs targeting related stressors merit increased attention for improving the psychosocial health of refugee children and adolescents after resettlement.
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General Medicine

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MLA
Guo, Lan, et al. “Characterization of Premigration and Postmigration Multidomain Factors and Psychosocial Health among Refugee Children and Adolescents after Resettlement in Australia.” JAMA NETWORK OPEN, vol. 6, no. 4, American Medical Association (AMA), 2023, doi:10.1001/jamanetworkopen.2023.5841.
APA
Guo, L., Li, L., Xu, K., Wang, W., Ni, Y., Li, W., … Zhang, W. H. (2023). Characterization of premigration and postmigration multidomain factors and psychosocial health among refugee children and adolescents after resettlement in Australia. JAMA NETWORK OPEN, 6(4). https://doi.org/10.1001/jamanetworkopen.2023.5841
Chicago author-date
Guo, Lan, Li Li, Ke Xu, Wanxin Wang, Yanyan Ni, Wenyan Li, Jianhua Gong, Ciyong Lu, and Wei Hong Zhang. 2023. “Characterization of Premigration and Postmigration Multidomain Factors and Psychosocial Health among Refugee Children and Adolescents after Resettlement in Australia.” JAMA NETWORK OPEN 6 (4). https://doi.org/10.1001/jamanetworkopen.2023.5841.
Chicago author-date (all authors)
Guo, Lan, Li Li, Ke Xu, Wanxin Wang, Yanyan Ni, Wenyan Li, Jianhua Gong, Ciyong Lu, and Wei Hong Zhang. 2023. “Characterization of Premigration and Postmigration Multidomain Factors and Psychosocial Health among Refugee Children and Adolescents after Resettlement in Australia.” JAMA NETWORK OPEN 6 (4). doi:10.1001/jamanetworkopen.2023.5841.
Vancouver
1.
Guo L, Li L, Xu K, Wang W, Ni Y, Li W, et al. Characterization of premigration and postmigration multidomain factors and psychosocial health among refugee children and adolescents after resettlement in Australia. JAMA NETWORK OPEN. 2023;6(4).
IEEE
[1]
L. Guo et al., “Characterization of premigration and postmigration multidomain factors and psychosocial health among refugee children and adolescents after resettlement in Australia,” JAMA NETWORK OPEN, vol. 6, no. 4, 2023.
@article{01GXZTSYTKXS51N8CEHC7KVTD6,
  abstract     = {{IMPORTANCE A better understanding of the psychosocial health of resettled child and adolescent
refugees and associated premigration and postmigration factors may help this population integrate
effectively.
OBJECTIVE To estimate the associations of premigration and postmigration multidomain factors
with psychosocial health after resettlement among young refugees of different ages.
DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used wave 3 data from the
Building a New Life in Australia (BNLA) cohort study, as they represented the first time a BNLA study
included a child module targeting children and adolescents in the migrating unit as a nested
component of the broader study. The study population consisted of children aged 5 to 10 years and
adolescents aged 11 to 17 years. The caregivers of the children, the adolescents themselves, and the
adolescents’ caregiverswere invited to complete the child module.Wave 3 datawere collected from
October 1, 2015, to February 29, 2016. Statistical analysiswas performed from May 10 to September
21, 2022.
EXPOSURES Premigration and postmigration multidomain factors, including individual (child and
caregiver), family, school, and community levels, were measured.
MAIN OUTCOMES AND MEASURES Social and emotional adjustment and posttraumatic stress
disorder (PTSD) were the dependent variables measured by the Strengths and Difficulties
Questionnaire (SDQ) and an 8-item PTSD scale.Weighted multilevel linear or logistic regression
models were used.
RESULTS Of the 220 children aged 5 to 10 years (mean [SD] age, 7.4 [2.0] years), 117 (53.2%) were
boys; of the 412 adolescents aged 11 to 17 years (mean [SD] age, 14.1 [2.0] years), 215 (52.2%) were
boys. Among the children, compared with no exposure, exposure to premigration traumatic events
(β = 2.68 [95%CI, 0.51-4.85]) and having family conflicts after resettlement (β = 6.30 [95%
CI, 2.97-9.64]) were positively associated with SDQ total difficulties score; school achievement was
negatively associated with SDQ total difficulties score (β = −5.02 [95%CI, −9.17 to −0.87]). Among
the adolescents, being treated unfairly (β = 3.32 [95%CI, 1.41-5.22]) and parenting harshness after
resettlement (β = 0.25 [95%CI, 0.11-0.40]) were positively associated with SDQ total difficulties
score; engagement in extracurricular activities (β = −3.67 [95%CI, −6.83 to −0.50]) was negatively
associated with SDQ total difficulties score. Exposure to premigration traumatic events (adjusted
odds ratio [aOR], 2.49 [95%CI, 1.10-5.63]), being treated unfairly (aOR, 3.77 [95%CI, 1.60-8.91]),
and facing English language barriers (aOR, 6.41 [95%CI, 1.98-20.79]) after resettlement were
positively associated with the presence of PTSD.
CONCLUSIONS AND RELEVANCE In this study of refugee children and adolescents, apart from
premigration traumatic experiences, several postmigration family- and school-related factors and
social integration factors were associated with psychosocial health after resettlement. The findings
suggest that family- and school-centered psychosocial care and social integration programs targeting
related stressors merit increased attention for improving the psychosocial health of refugee children
and adolescents after resettlement.}},
  articleno    = {{e235841}},
  author       = {{Guo, Lan and Li, Li and Xu, Ke and Wang, Wanxin and Ni, Yanyan and Li, Wenyan and Gong, Jianhua and Lu, Ciyong and Zhang, Wei Hong}},
  issn         = {{2574-3805}},
  journal      = {{JAMA NETWORK OPEN}},
  keywords     = {{General Medicine}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{14}},
  publisher    = {{American Medical Association (AMA)}},
  title        = {{Characterization of premigration and postmigration multidomain factors and psychosocial health among refugee children and adolescents after resettlement in Australia}},
  url          = {{http://doi.org/10.1001/jamanetworkopen.2023.5841}},
  volume       = {{6}},
  year         = {{2023}},
}

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