The Research Program on Children and Global Adversity is guided by a “risk and resilience” framework that focuses on core threats to the security of children. In considering intervention models, this approach first seeks to leverage naturally existing protective processes, then to supplement them with evidence based services. The program works from a social ecological perspective, which differs from individualized approaches in that it considers the socially-mediated impacts of adversity on children and families, and actively works to identify supports at the family, peer and community level. The program works from a child rights perspective that regards health, security, and opportunities for development as the birthright of every child, regardless of nationality, location, or socioeconomic status. The RPCGA’s research agenda is grounded in an integrated view of “health” as encompassing primary care, early childhood development, nutrition, mental health, and prevention services. The program targets children under the age of 18 as well as youth under the age of 25.

The program focuses on implementation science as it relates to the following core areas of a child’s basic security and developmental needs:

• Safety and protection from harm
• Physical and mental health
• Family and connection to others
• Education, livelihoods and opportunities to be productive

The team is presently engaged in two in-depth research studies, one on mental health care for children in Rwanda affected by HIV/AIDS, and the other exploring psychosocial adjustment and social reintegration among former child soldiers in Sierra Leone. A third study of Somali Bantu refugee children and families is planned for the spring of 2009.

The RPCGA team recently completed a qualitative study in Rwinkwavu, Rwanda in collaboration with Partners In Health. This research was funded by the Peter C. Alderman Foundation and the Harvard Research Enabling Grants Program. The goal of the study was to identify common mental health problems facing HIV/AIDS-affected children, and to describe these problems using local terms and concepts. Initial findings from this research were presented at the 2008 International AIDS Conference in Mexico City. The team is now launching a process to adapt and pilot an evidence-based mental health intervention in this setting. Future stages of this research will involve the validation of mental health measures adapted to this setting and a future randomized controlled trial of interventions, which, if proven effective, will be incorporated into existing healthcare services provided by Partners In Health.

In 2002, Dr. Betancourt began a research project with former child soldiers and other war-affected youth in Sierra Leone, and returned in 2003/2004 to collect follow-up data on the same cohort of youth. In the spring and summer of 2008, the RPCGA team completed its third wave of data collection, examining the risk and protective factors that shape social reintegration and psychosocial adjustment among former child soldiers and other war-affected youth over time. This research explores a number of issues that are relevant to young adulthood, and is the first longitudinal study of its kind to involve male and female former child soldiers. Among the issues examined in this study are the challenges and successes that these youth experience in securing a livelihood, caring for families, completing school, avoiding high-risk behavior, and contributing to civil society. The goals of the research are to identify naturally existing supports and protective processes that can be targeted in the design of psychosocial interventions, and to highlight priority issues for policy makers and program developers. This research contributes to one of the major goals of the RPCGA by developing an evidence base to help drive policy reform that supports improved protections and services for children facing adversity. To this end, Dr. Betancourt presented findings from the first two waves of data to the United Nations Special Representative of the Secretary-General for Children and Armed Conflict in July 2008. Building on this work, the RPCGA is also exploring the potential to conduct a pilot intervention study with war-affected youth in Sierra Leone. A mixed-methods paper on the psychosocial aspects of education for former child soldiers and the current state of the education system in Sierra Leone was published recently in Comparative Education Review (Betancourt et al, 2008).

This work will be conducted in collaboration with Children’s Hospital Boston/Center for Refugee Trauma (CHB/CRT) in association with the National Child Traumatic Stress Network (NCTSN). The intent of the project is to understand perceptions of relevant mental health problems and services needs among Somali Bantu refugees in the city of Boston and its neighbors, Lynn and Chelsea, where several hundred Somali Bantu families have resettled since 2004. Data collection is planned for 2009 and will involve interviews with more than 200 Somali refugees including Somali Bantu youth 10-17 years old and their caregivers. Five types of qualitative data collection will be pursued: focus groups, family interviews, free listing interviews, key informant interviews and observations. A local research team of Somali Bantu refugees will be recruited and trained to work closely with our team as well as with a Community Advisory Board (CAB). Interviewees will be recruited from collaborating refugee offices (refugee resettlement offices and Boston area refugee mutual assistance organizations). Additional collaborators in this research include the International Rescue Committee’s Boston Resettlement Office and the National Somali Bantu Project at Portland State University.