Association between doses of the ‘Welcome to School’ intervention and mental health and resilience among young newcomer immigrants and refugees

Abstract

Aims:

Youth with an immigrant or refugee background face elevated mental health risks. Schools have been proposed as a suitable setting for mental health interventions for this group, but evidence on effects is limited, and even less is known on dosage impact. Using variations in intervention exposure due to COVID-19 school closures, this study examined the association between the number of modules of the Welcome to School intervention and mental health and resilience outcomes among young immigrant and refugee newcomers.

Methods:

In 2019–2020, 11–22-year-old newcomer immigrants and refugees in Denmark, Belgium and Norway were cluster randomised by schools/classes into a control and intervention group. Mental health and resilience outcomes were measured at baseline and following the intervention using the strengths and difficulties questionnaire and the child and youth resilience measure. Due to COVID-19 school closures, the intervention group received different amounts of the 14-modules Welcome to School intervention. Using data from 147 participants, multiple linear regression analyses were performed.

Results:

Adjusting for age, gender, resettlement country, and migration reasons, the analyses showed that the emotional symptoms score decreased by 0.19 (95% confidence interval 0.06; 0.32) per Welcome to School module received. No significant dose–response associations were found for resilience scores or the other studied mental health outcomes (i.e. total difficulties, conduct problems, hyperactivity, peer problems, and prosocial behaviour).

Conclusions:

The Welcome to School intervention appears to have the potential to reduce emotional difficulties among young newcomers in case of sufficient intervention dose. Further studies are needed to assess the effectiveness of the full intervention.