ABSTRACT
Although resilience has been identified as an important mediator of negative mental health outcomes among refugee populations, there are few culturally specific measures of resilience among such communities and no such measure among Somalis. In this study we aimed to develop a culturally appropriate measure of resilience specific to Somali adults in San Diego, as an example of a vulnerable refugee community. A community-based, exploratory sequential mixed method investigation was conducted via focus group discussions (n = 4), cognitive interviews (n = 4), and iterative survey adaptation. Somali refugee adults in San Diego (N = 183) were surveyed with this novel scale, a standardized measure of resilience, and assessments of depression, anxiety, and PTSD. Results were analyzed via correlation coefficients and multivariate linear regression modeling. Qualitative findings supported the inclusion of items addressing both barriers and facilitators of good mental health, which resulted in the development of the Somali Distress and Resilience Survey (SDRS). Linear regression analysis revealed that the SDRS demonstrated significant associations with symptoms of depression and PTSD, while the standardized measure of resilience did not demonstrate associations with any of the mental health outcomes assessed. The SDRS identified obstacles to resilience among Somali individuals, placing them at risk of developing negative mental health outcomes. Our novel measure also demonstrated more robust relationships with these outcomes than a standardized measure of resilience, suggesting greater utility of the adapted scale. However, the SDRS's development raises larger questions about the limitations of developing and comprehensively evaluating novel resilience measures in a community-based setting.
ABSTRACT
OBJECTIVE: To examine perceptions and experiences of adversity and resilience among Somalis living in San Diego. METHOD: A community-driven, qualitative investigation was conducted through virtual focus group discussions (n = 4) with male and female Somali refugee adults in San Diego (a total of 22 individuals). Barriers to well-being and the historical, religious, and cultural supports that enable participants to overcome adversity were discussed. Qualitative data were analyzed in Dedoose using thematic analysis to identify the most salient themes and relationships between them. RESULTS: Participants identified the primary barriers to good mental health as difficulties in accessing resources (housing, employment, healthcare) and discrimination due to racism, xenophobia, and Islamophobia. In contrast, resilient responses to adversity are supported by a collective identity as survivors, their Islamic faith and its perspective on making sense of adversity, and a sense of communal oneness that encourages reciprocal helping behaviors. CONCLUSIONS: These findings suggest that resilient outcomes among Somalis in San Diego are more likely to be promoted by community-based interventions that promote existing strengths and supports rather than focusing on individual coping mechanisms. There is a benefit to investing in community organizations and programs that support resilience-based interventions to overcome common mental disorders in this high-risk population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Subject(s)
Refugees , Adult , Male , Humans , Female , Somalia , Refugees/psychology , Focus Groups , Adaptation, Psychological , IslamABSTRACT
OBJECTIVES: To combat misinformation, engender trust and increase health literacy, we developed a culturally and linguistically appropriate virtual reality (VR) vaccination education platform using community-engaged approaches within a Somali refugee community. DESIGN: Community-based participatory research (CBPR) methods including focus group discussions, interviews, and surveys were conducted with Somali community members and expert advisors to design the educational content. Co-design approaches with community input were employed in a phased approach to develop the VR storyline. PARTICIPANTS: 60 adult Somali refugees and seven expert advisors who specialise in healthcare, autism research, technology development and community engagement. SETTING: Somali refugees participated at the offices of a community-based organisation, Somali Family Service, in San Diego, California and online. Expert advisors responded to surveys virtually. RESULTS: We find that a CBPR approach can be effectively used for the co-design of a VR educational programme. Additionally, cultural and linguistic sensitivities can be incorporated within a VR educational programme and are essential factors for effective community engagement. Finally, effective VR utilisation requires flexibility so that it can be used among community members with varying levels of health and technology literacy. CONCLUSION: We describe using community co-design to create a culturally and linguistically sensitive VR experience promoting vaccination within a refugee community. Our approach to VR development incorporated community members at each step of the process. Our methodology is potentially applicable to other populations where cultural sensitivities and language are common health education barriers.