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New Study Finds Integrated Physical and Mental Health Intervention Reduces Non-Communicable Diseases among Jordanians and Syrian Refugees

  • February 17, 2021
  • Mental Health, Prevention, Syria Crisis
  • A mother and daughter participating in the study at a clinic in Irbid, Jordan, in 2018. Photo by Kathy Kukula/Americares.

Stamford, Conn. – Feb. 11, 2021 – Americares and the University of Illinois, Urbana-Champaign, today announced the results of a new ground-breaking research study that found integrating mental health services in non-communicable disease prevention programs reduced the risk of cardiovascular disease among Syrian refugees and host populations in Jordan.

Americares, in partnership with the University of Illinois and Royal Health Awareness Society, integrated a mental health and psychosocial support component into the society’s flagship Healthy Community Clinic program, a non-communicable disease prevention program offered in Jordan’s Ministry of Health clinics, to examine the efficacy of an integrated intervention designed to improve health outcomes in refugee and host community populations.

The study, published in the March issue of Preventive Medicine Reports, measured the health impact on 600 patients—including 213 Syrians and 382 Jordanians—across three health centers in Irbid, Jordan. Participants were separated into three groups: one received routine health care, another received routine health care plus 20 health education sessions focused on non-communicable disease prevention and management, and a third group received routine health care, health education as well as four mental health sessions to increase knowledge of grief and physical and emotional traumatic stress reactions. Participants also learned coping skills to reduce emotional distress through deep-breathing exercises and walking.

A mother and daughter participating in the study at a clinic in Irbid, Jordan, in 2018. Photo by Kathy Kukula/Americares.

A mother and daughter participating in the study at a clinic in Irbid, Jordan, in 2018. Photo by Kathy Kukula/Americares.

Participants who attended health education and mental health awareness sessions saw the greatest health improvements. Six months after completion of the program they maintained significant improvements in seven health measures including body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, HbA1c, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol. Notably, that group saw, on average, a 21.4 percent decrease in fasting blood sugar, a 17.2 percent decrease in LDL (bad cholesterol) and a 12 percent decrease in body mass index. Data collected at the conclusion of the 12-month program indicated that patients in the Healthy Community Clinic program with the mental health component showed improvement in eight health measures, including reductions in their body mass index, total cholesterol and fasting blood glucose.

“This study is among the first to illustrate how an integrated physical and mental health educational intervention can improve health outcomes and ultimately help reduce cardiovascular disease risk in refugees and low-income populations,” said Americares Senior Director of Monitoring and Evaluation and the co-principal investigator Dr. Shang-Ju Li. “We are thrilled to share this ground-breaking research and look forward to making even more progress as we continue to look for ways to improve health outcomes for people affected by poverty or disaster.”

Americares, a health-focused relief and development organization, conducted the study in partnership with University of Illinois Urbana-Champaign Associate Professor Tara Powell, PHD, MPH, MSW. The research and mental health awareness sessions were funded with generous support from the global health care company GSK.

“Integrated programs that can reduce participants’ risk of chronic diseases— which are often co-morbid with mental health diagnoses—are critical for countries such as Jordan that have high rates of chronic disease and low access to mental health services,” said Powell.

“We are very grateful for the partnership and support of Americares and the University of Illinois, to further expand the Healthy Community Clinic model in Jordan through integrating the aspect of mental health and, more importantly, back it up with robust scientific evidence to demonstrate the positive impact on people’s health,” said Director General of the Royal Health Awareness Society Hanin Odeh. “We strongly believe that the results will help advocate the integration of preventative services within the primary health care system for Jordanians and refugees alike.”

Nearly ten years of deadly conflict in Syria has created one of the world’s worst humanitarian crises. The United Nations Refugee Agency estimates that up to 5.6 million people have fled the country since 2011 and another 6.6 million have been internally displaced by the fighting. Many of these individuals are at risk for diabetes, hypertension, cancer, and other non-communicable diseases, as well as mental health disorders due to trauma, yet do not have access to health services to manage or prevent these conditions.

Americares has been responding to the Syria crisis since 2012, meeting urgent health needs in Syria as well as the health needs of Syrian refugees and host communities in neighboring countries. Americares work focuses on increasing access to lifesaving medicine and primary care services and supporting health workers. Over the years Americares has delivered more than 30 emergency medical aid shipments to partner organizations in the region, supported mobile medical clinics for internally displaced families and piloted innovative health programs that expand access to care.

Americares helps communities prepare for, respond to and recover from disasters; increase access to critical medicine and medical supplies; improve and expand clinical services; and prevent disease and promote good health. Since its founding more than 40 years ago, Americares has provided more than $19 billion in aid to 164 countries, including the United States.

To see a video about the study, click below: