BackgroundWhile homesickness in refugees is a recurring theme in clinical practice, respective research in this population is scarce. The Utrecht Homesickness Scale (UHS) allows distinguishing between certain aspects of homesickness, namely genuine separation distress like missing family and friends or yearning for home on the one side and problems regarding adjustment to the new situation on the other; so far, the instrument was applied mainly in samples of university students, and never in refugees.ObjectiveWe aimed to explore homesickness in a refugee population and its association with mental health symptoms and migration-related factors. In addition, we wanted to evaluate the UHS’s factor structure in a sample other than students.MethodsIndividuals from different countries (N = 99) seeking asylum in Germany were assessed for homesickness, migration-related variables (e.g., number of losses and stage of the asylum proceedings), and mental health symptoms (symptoms of depression, posttraumatic stress and prolonged grief). After exploratory factor analysis, standardized mean factors scores were fed into subsequent correlational and regression analyses to identify the most prominent predictors of homesickness scores.ResultsThe participants showed substantial levels of homesickness. We found a three-factor solution that implied distinct factors regarding (1) adjustment difficulties and loneliness, (2) ruminations about home, and (3) missing family and/or friends. The total homesickness score was associated with mental health but regression analyses with the three mean factor scores showed differential associations with mental health and migration-related variables. While adjustment difficulties and loneliness were—besides time since arrival in Germany—associated with mental health problems (depressive and posttraumatic stress symptoms), ruminating about home was predicted by migration-related variables (number of losses and asylum status). For the factor scores regarding missing family and/or friends, the regression model was not significant.ConclusionThe assessment of homesickness in refugee populations is feasible and of clinical importance, especially when distinguishing between separation distress and difficulties with adjusting to the new situation.
BACKGROUND Most individuals seeking asylum in Germany live in collective housing and are thus exposed to a higher risk of contagion during the COVID-19 pandemic. OBJECTIVE In this study, we aimed to test the feasibility and efficacy of a culture-sensitive approach combining mobile app–based interventions and a face-to-face group intervention to improve knowledge about COVID-19 and promote vaccination readiness among collectively accommodated Arabic-speaking adolescents and young adults. METHODS We developed a mobile app that consisted of short video clips to explain the biological basis of COVID-19, demonstrate behavior to prevent transmission, and combat misconceptions and myths about vaccination. The explanations were provided in a YouTube-like interview setting by a native Arabic-speaking physician. Elements of gamification (quizzes and rewards for solving the test items) were also used. Consecutive videos and quizzes were presented over an intervention period of 6 weeks, and the group intervention was scheduled as an add-on for half of the participants in week 6. The manual of the group intervention was designed to provide actual behavioral planning based on the health action process approach. Sociodemographic information, mental health status, knowledge about COVID-19, and available vaccines were assessed using questionnaire-based interviews at baseline and after 6 weeks. Interpreters assisted with the interviews in all cases. RESULTS Enrollment in the study proved to be very challenging. In addition, owing to tightened contact restrictions, face-to-face group interventions could not be conducted as planned. A total of 88 participants from 8 collective housing institutions were included in the study. A total of 65 participants completed the full-intake interview. Most participants (50/65, 77%) had already been vaccinated at study enrollment. They also claimed to comply with preventive measures to a very high extent (eg, “<i>always</i> wearing masks” was indicated by 43/65, 66% of participants), but practicing behavior that was not considered as effective against COVID-19 transmission was also frequently reported as a preventive measure (eg, mouth rinsing). By contrast, factual knowledge of COVID-19 was limited. Preoccupation with the information materials presented in the app steeply declined after study enrollment (eg, 12/61, 20% of participants watched the videos scheduled for week 3). Of the 61 participants, only 18 (30%) participants could be reached for the follow-up interviews. Their COVID-19 knowledge did not increase after the intervention period (<i>P</i>=.56). CONCLUSIONS The results indicated that vaccine uptake was high and seemed to depend on organizational determinants for the target group. The current mobile app–based intervention demonstrated low feasibility, which might have been related to various obstacles faced during the delivery. Therefore, in the case of future pandemics, transmission prevention in a specific target group should rely more on structural aspects rather than sophisticated psychological interventions.
Background Most individuals seeking asylum in Germany live in collective housing and are thus exposed to a higher risk of contagion during the COVID-19 pandemic. Objective In this study, we aimed to test the feasibility and efficacy of a culture-sensitive approach combining mobile app–based interventions and a face-to-face group intervention to improve knowledge about COVID-19 and promote vaccination readiness among collectively accommodated Arabic-speaking adolescents and young adults. Methods We developed a mobile app that consisted of short video clips to explain the biological basis of COVID-19, demonstrate behavior to prevent transmission, and combat misconceptions and myths about vaccination. The explanations were provided in a YouTube-like interview setting by a native Arabic-speaking physician. Elements of gamification (quizzes and rewards for solving the test items) were also used. Consecutive videos and quizzes were presented over an intervention period of 6 weeks, and the group intervention was scheduled as an add-on for half of the participants in week 6. The manual of the group intervention was designed to provide actual behavioral planning based on the health action process approach. Sociodemographic information, mental health status, knowledge about COVID-19, and available vaccines were assessed using questionnaire-based interviews at baseline and after 6 weeks. Interpreters assisted with the interviews in all cases. Results Enrollment in the study proved to be very challenging. In addition, owing to tightened contact restrictions, face-to-face group interventions could not be conducted as planned. A total of 88 participants from 8 collective housing institutions were included in the study. A total of 65 participants completed the full-intake interview. Most participants (50/65, 77%) had already been vaccinated at study enrollment. They also claimed to comply with preventive measures to a very high extent (eg, “always wearing masks” was indicated by 43/65, 66% of participants), but practicing behavior that was not considered as effective against COVID-19 transmission was also frequently reported as a preventive measure (eg, mouth rinsing). By contrast, factual knowledge of COVID-19 was limited. Preoccupation with the information materials presented in the app steeply declined after study enrollment (eg, 12/61, 20% of participants watched the videos scheduled for week 3). Of the 61 participants, only 18 (30%) participants could be reached for the follow-up interviews. Their COVID-19 knowledge did not increase after the intervention period (P=.56). Conclusions The results indicated that vaccine uptake was high and seemed to depend on organizational determinants for the target group. The current mobile app–based intervention demonstrated low feasibility, which might have been related to various obstacles faced during the delivery. Therefore, in the case of future pandemics, transmission prevention in a specific target group should rely more on structural aspects rather than sophisticated psychological interventions.
Theoretischer Hintergrund: In der aktuellen Pandemie stellten Gemeinschaftsunterkünfte für Asylbewerber mehrmals Hotspots für COVID-19-Ausbrüche dar. Solche Ausbrüche werden durch beengte Wohnverhältnisse, Fehlinformationen der Bewohner und kulturelle Barrieren für präventives Verhalten begünstigt. Die geplante Studie zielte darauf ab, weit verbreitete Missverständnisse über COVID-19 aufzuklären, relevante Informationen auf eine altersgerechte Art zu vermitteln und geeignete Kanäle zu nutzen, indem Serious Games zur Erreichung von Lernzielen eingesetzt wurden. Zielpopulation waren Asylbewerber in Gemeinschaftsunterkünften im Alter von 16 bis 26 Jahren, die ein Smartphone besaßen.Methode: In einer Phase II-analogen randomisierten, zweiarmigen offenen Präventionsstudie wurde eine Lern-App mit einem sechswöchigen Programm und Gamification-Elementen entwickelt (CAYPVAR-App). Für eine randomisierte Hälfte der Teilnehmer war eine zusätzliche psychologische Gruppenintervention zur individuellen Verhaltensplanung bei der Umsetzung und Aufrechterhaltung von präventiven Verhaltensweisen in der jeweiligen institutionellen und/oder sozialen Umgebung geplant. Als Studienendpunkte wurden das Wissen über COVID-19 und Verhaltensintentionen sowie die Impfbereitschaft erfasst.Ergebnisse: Es konnten insgesamt N = 146 Probanden aus acht Einrichtungen rekrutiert werden und n = 88 Personen in die Studie eingeschlossen werden. Es nahmen n = 18 Personen am Abschlussinterview teil. Im folgenden Bericht werden keine weiteren quantitativen Daten berichtet (siehe Frick et al., 2022), sondern Feldbeobachtungen während der Studiendurchführung diskutiert.Diskussion und Schlussfolgerung: Die pandemische und asylpolitische Lage zum Zeitpunkt der Studiendurchführung erschwerten den Zugang zu der Zielpopulation. Eine Verhaltensprävention war unter diesen Umständen schwer umzusetzen. Bei der Übertragungsprävention in der untersuchten Gruppe sollten strukturelle Aspekte stärker berücksichtigt werden als der Versuch einer Verhaltensänderung durch psychologische Interventionen.
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