A Randomised Controlled Trial of the I-Deal Life Skills Intervention with Syrian Refugee Adolescents in Northern Lebanon

摘要

Armed conflict and displacement pose threats to children’s mental health and psychosocial wellbeing. We report on the findings of an evaluation of I-Deal, a life skills intervention aimed at fostering resilience among early adolescent refugees. We used a parallel group randomised controlled trial to compare I-Deal to a structured recreational activity group (SRA). 325 adolescents in Akkar, Lebanon, 74% of them Syrian, were randomised to I-Deal or SRA. The primary outcome was psychosocial wellbeing; secondary outcomes included psychological distress, prosocial behaviour, hope, self-esteem and social connectedness. Assessments were conducted at baseline, endline and 3-month follow-up. Due to low reliabilities, only wellbeing, distress and hope were included in the analyses. These outcomes showed similar results: no statistically significant changes over time, no significant differences between groups and no significant interaction between group and time. Our findings do not support the effectiveness of I-Deal. Several factors are considered that may help explain the lack of effect, including the aspects of the intervention design, possible measurement error suggested by low reliabilities on several instruments and a ceiling effect on our primary outcome. A replication using rigorously piloted instruments, the selection of outcomes more specifically tailored to the intervention and a nonactive control condition could help provide definitive evidence regarding the effectiveness of the I-Deal intervention. Key implications for practice This study contributes to the growing literature on the effectiveness of life skills interventions for refugee adolescents. The lack of any intervention effects in this study raises important questions about the appropriate focus and role of preventive and promotive interventions with refugee adolescents. Methodological issues in the study underscore the vital importance of using validated and well piloted measures of appropriately selected intervention outcomes.