Table 2 Example 2, Longitudinal study of refugee children

Longitudinal study of refugee children and their health, development and social-emotional well-being. [38,39,40]

This prospective cohort study examined physical health, development, and social and emotional well-being of newly arrived refugee children (ages 6 months to 15 years) settling in a regional part of NSW

Participants were recruited between 2009 and 2013 and followed up for approximately two and a half years post arrival. Participants came from 10 countries of origin (predominantly from World Health Organization (WHO) African and South-East Asia regions); representing 10 language groups (most commonly Burmese, Karen, Swahili and Arabic)

Funding source:

Financial Markets Foundation for Children and South Eastern Sydney Local Health District

Recruitment and consent: Sixty-one subjects were enrolled in the study at Year 1 through an existing model of care. Only two children per family were enrolled to minimize participant burden on families. Refugee Health Nurses (RHNs) (clinician researchers) enrolled and obtained consent from participants with the support of face-to-face professional health care interpreters (HCIs). Individual HCI were briefed and provided with orientation to the research instruments prior to the assessments being undertaken. There was 100% retention at Year 2 (average 13 months post arrival) and 85% retention at Year 3 (average 31 months post arrival)

Data collection and analysis: General practitioners conducted early health assessments at Year 1 (as per the existing model of care). The research team conducted follow up assessments at Year 2 and Year 3 in the child’s home by the RHN with the support of a face-to-face HCI. Outcome measures included the play based/observational Australian Developmental Screening Test (ADST); and the parent-completed Strengths and Difficulties Questionnaire (SDQ). Translated and validated versions of the SDQ were used where available and appropriate. Structured parent interviews including items from the Social Readjustment Rating Scale (SRRS) assessed family and settlement risk and protective factors

Findings: This study demonstrated that a longitudinal cohort study in refugee children is feasible and acceptable, and retention rates can be high. Development and social-emotional well-being of resettled refugee children improved for the majority of children over 2 to 3 years. However, a minority had persistently poor social-emotional outcomes. The study identified a number of risk and protective factors over the first years of refugee settlement including post-arrival factors that are modifiable through policy and practice interventions

Significance and impact: This study is one of the first of its kind to examine the prevalence of child, family and settlement factors that may impact on refugee children’s health, development and social-emotional well-being over the first years of refugee settlement. The study fills a gap in the evidence base for policy and practice development. The study influenced the NSW government response to Iraqi and Syrian refugees fleeing the Syrian crisis, with funding provided for specialized early childhood nursing services (a health service gap identified by the study)