RESPOND - Improving regional health system responses to the challenges of migration through tailored interventions for asylum-seekers and refugees

Hadler, Patrícia; Neuert, Cornelia; Lenzner, Timo; Stiegler, Angelika; Sarafoglou, Andrea; Bous, Patricia; Reisepatt, Niklas; Menold, Natalja

doi:10.17173/pretest69

Cited by 4 publications

(4 citation statements)

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“…The surveyed participants were representative for the overall population in the state Baden-Wuerttemberg with respect to nationality, age, and sex as reported elsewhere [ 2 ]. All instruments used are internationally established and if not were validated separately [ 2 , 26 ] and, if needed, underwent a rigorous translation and pre-testing process [ 24 ]. Individual level was accurately linked to collected contextual data or to geo-referenced data at highest level of resolution, as such minimising the risk of misclassification bias.…”

Section: Discussionmentioning

confidence: 99%

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Exploring contextual effects of post-migration housing environment on mental health of asylum seekers and refugees: A cross-sectional, population-based, multi-level analysis in a German federal state

Mohsenpour,

Biddle,

Bozorgmehr

2023

PLOS Glob Public Health

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Asylum seekers and refugees (ASR) in Germany are dispersed quasi-randomly to state-provided, collective accommodation centres. We aimed to analyse contextual effects of post-migration housing environment on their mental health. We drew a balanced random sample of 54 from 1 938 accommodation centres with 70 634 ASR in Germany’s 3rd largest federal state. Individual-level data on depression and anxiety as well as sociodemographic- and asylum-related covariates, were collected and linked to contextual geo-referenced data on housing environment (‘Small-area Housing Environment Deterioration’ index, number of residents, remoteness, urbanity, and German Index of Multiple Deprivation). We fitted two-level random-intercept models to exploratively estimate adjusted contextual effects. Of 411 surveyed participants, 45.53% and 44.83%, respectively, reported symptoms of depression or anxiety. 52.8% lived in centres with highest deterioration, 46.2% in centres with > = 50 residents, 76.9% in urban, and 56% in deprived districts. 7.4% of centres were remote. We found statistically significant clustering in reporting anxiety on the level of accommodation centres. The model resulted in an intraclass correlation of 0.16 which translated into a median odds ratio of 2.10 for the accommodation-level effects. No significant clustering was found for symptoms of depression. The highest degree of deterioration, large accommodation size, remoteness, and district urbanity showed higher, but statistically not significant, odds for reporting anxiety or depression. District deprivation demonstrated higher odds for anxiety and lower odds for depression yet remained statistically insignificant for both. Evidence for contextual effects of housing environment on mental health of ASR could not be established but residual confounding by length of stay in the accommodation centre cannot be ruled out. Confirmatory analyses with prior power calculations are needed to complement these exploratory estimates.

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Section: Discussionmentioning

confidence: 99%

“…Asylum seekers were involved in the design of the questionnaire by means of pre-testing selected instruments and incorporating their feedback on comprehensibility and linguistic diversity [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

Exploring contextual effects of post-migration housing environment on mental health of asylum seekers and refugees: A cross-sectional, population-based, multi-level analysis in a German federal state

Mohsenpour,

Biddle,

Bozorgmehr

2023

PLOS Glob Public Health

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“…Prior to data collection, the translated version of the HSR instrument was included in a cognitive pretest (Hadler et al, 2017). Using probing and think-aloud techniques, these pretests evaluated the intelligibility of the items and assessed potential unintended misunderstandings with nine refugees in five languages, including English and Arabic.…”

Section: Methodsmentioning

confidence: 99%

“…It was developed in German and English and translated into the refugee languages (among others into Arabic, which is relevant to this paper) using a team approach (Behr, 2009). The questionnaire was subsequently assessed in the form of a cognitive pretest and refined accordingly (Hadler et al, 2017).…”

Section: Methodsmentioning

confidence: 99%

Reducing Cross-Cultural Comparability Bias Obtained with Measurement Invariance Analysis by Means of Anchoring Vignettes in Heterogeneous Refugee Samples

Menold

Biddle

Hermanni

et al. 2023

Preprint

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Background: Configural, metric, and scalar measurement invariance have been indicators of bias-free statistical cross-group comparisons, although they are difficult to verify in the data. Low comparability of translated questionnaires or the different use of response formats by respondents might lead to rejection of measurement invariance and point to comparability bias in studies that use different languages. Anchoring vignettes have been proposed as a method to control for the different use of response formats by respondents (RC-DIF) as implemented by means of rating scales. We evaluate the question whether the comparability bias obtained by means of measurement invariance analysis can be reduced by means of anchoring vignettes or by considering socio-demographic heterogeneity as an alternative approach. Methods: We use the Health System Responsiveness (HSR) questionnaire in English and Arabic in a refugee population. We collected survey data in English (n = 183) and Arabic (n=121) in a random sample of refugees in the third largest German federal state. We conducted multiple-sample Confirmatory Factor Analyses (MGCFA) to analyse measurement invariance and compared the results when 1) using rescaled data on the basis of anchoring vignettes (non-parametric approach), 2) including information on DIF from the analyses with anchoring vignettes as covariates (parametric approach) and 3) including socio-demographic covariates. Results: For the HSR, every level of measurement invariance between Arabic and English questionnaires was rejected. Implementing rescaling on the basis of anchoring vignettes provided superior results over the initial MGCFA analysis, since configural, metric and scalar invariance could not be rejected. When using solely socio-demographic covariates, scalar measurement invariance could not be rejected, but configural and metric invariance had to be rejected. Conclusions: Surveys may consider anchoring vignettes as a method to obtain more satisfactory results of measurement invariance analyses; however, socio-demographic information cannot be included in the models as a standalone method. More research on the efficient implementation of anchoring vignettes and further development of methods to incorporate them when modelling measurement invariance is needed.

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Kultursensitive Befragungen und Diagnostik: Gestaltung und Anwendung von Verfahren im interkulturellen Setting

Maehler

Behr

Schneider

2021

Handbuch Stress Und Kultur

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RESPOND - Improving regional health system responses to the challenges of migration through tailored interventions for asylum-seekers and refugees

Cited by 4 publications

References 0 publications

Exploring contextual effects of post-migration housing environment on mental health of asylum seekers and refugees: A cross-sectional, population-based, multi-level analysis in a German federal state

Exploring contextual effects of post-migration housing environment on mental health of asylum seekers and refugees: A cross-sectional, population-based, multi-level analysis in a German federal state

Reducing Cross-Cultural Comparability Bias Obtained with Measurement Invariance Analysis by Means of Anchoring Vignettes in Heterogeneous Refugee Samples

Kultursensitive Befragungen und Diagnostik: Gestaltung und Anwendung von Verfahren im interkulturellen Setting

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