King Hussein Foundation

The stepped care model is a hierarchical healthcare approach that matches treatment intensity to a patient's condition, ensuring efficient resource use while providing appropriate care. This study conducted a qualitative process evaluation to assess the feasibility, acceptability, and contextual suitability of a multicenter, parallel-group, superiority, randomized controlled trial addressing psychological distress among adults in Jordan. The trial applied the stepped care framework using two scalable WHO interventions adapted to the Jordanian context. Qualitative data was gathered through focus group discussions and phone interviews with 44 participants, facilitators, and assessors. Two themes emerged: (1) Navigating Transformations, highlighting participants' personal growth, including improved self-esteem, family dynamics, and coping mechanisms, alongside the benefits of group sessions and supportive relationships with facilitators; and (2) Navigating Challenges and Improvements, focusing on logistical and personal difficulties such as scheduling issues, and suggestions for improving accessibility and engagement. Findings support the feasibility of the stepped care model as a promising approach to providing accessible and effective mental health support in Jordan. The study calls for hybrid models integrating group and individual support while emphasizing the need for enhanced facilitator training and support systems.

The current study aimed to reveal the generalized anxiety level and its relationship to the quality of life of pregnant women visitors of maternal and child health centers in Irbid governorate. To achieve the objectives of the study, the descriptive correlational methodology was adopted, The researchers used the Sharif scale (2020) and the translation of an international scale, (Dule, et al, 2021). That were distributed to a sample consisted of (350) pregnant women visitors of maternal and child health centers in Irbid governorate. The study results showed that the level of most domains of the generalized anxiety among pregnant women visitors of maternal and child health centers was high. The level of most of quality of life among pregnant women visitors of maternal and child health centers was medium. The results also showed that there were no statisticaly significant differences on the variables of the study except the emotional domain, and these differences in favor of pregnant women of age (less than 30 years). In light of these results, the study recommended the need to reveal the level of quality of life among pregnant women to work on reinforcing and developing them.

The majority of studies of mental health interventions for young adolescents have only evaluated short-term benefits. This study evaluated the longer-term effectiveness of a non-specialist delivered group-based intervention (Early Adolescent Skills for Emotions; EASE) to improve young adolescents' mental health. In this single-blind, parallel, controlled trial, Syrian refugees aged 10-14 years in Jordan who screened positive for psychological distress were randomised to receive either EASE or enhanced usual care (EUC). Primary outcomes were scores on the Paediatric Symptom Checklist (PSC) assessed at Week 0, 8-weeks, 3-months, and 12 months after treatment. Secondary outcomes were disability, posttraumatic stress, school belongingness, wellbeing, and caregivers' reports of distress, parenting behaviour, and their perceived children's mental health. Between June, 2019 and January, 2020, 185 adolescents were assigned to EASE and 286 to EUC, and 149 (80.5%) and 225 (78.7%) were retained at 12 months, respectively. At 12 months there were no significant differences between treatment conditions, except that EASE was associated with less reduction in depression (estimated mean difference -1.6, 95% CI -3.2 to -0.1; p=.03; effect size, -0.3), and a greater sense of school belonging (estimated mean difference -0.3, 95% CI -5.7 to -0.2; p=.03; effect size, 5.0). Although EASE led to significant reductions in internalising problems, caregiver distress, and harsh disciplinary parenting at 3-months, these improvements were not maintained at 12 months relative to EUC. Scalable psychological interventions for young adolescents need to consider their ongoing mental health needs. Prospectively registered: ACTRN12619000341123.

This study examined the prevalence of intimate partner violence (IPV) victimization and associated factors among male refugees within a refugee community. A sample of 441 Syrian refugee men from Al- Za'atari refugee camp and other cities was conveniently recruited, and data was collected in 2022 using the revised conflict tactics scale. The findings revealed that psychological IPV was the most prevalent form of abuse, while negotiation, injury, and physical IPV were rare. The age and education level of the men were related to the prevalence of negotiation, psychological victimization, and physical victimization committed by women. Certain demographic variables were found to predict the prevalence of psychological and physical victimization, injury, and the absence of negotiation. The study highlights the importance of recognizing that male refugees can be victims of IPV and emphasizes the need for supportive resources and assistance. Improving living conditions in refugee camps and providing employment opportunities are strongly recommended to address this issue.

Delirium is a common problem among patients in Intensive Care Units (ICUs); however, it remains underdiagnosed. We aimed to determine the impact of a nursing education program on Jordanian nurses' knowledge, practice, attitudes, self-efficacy, and ability to detect delirium among ICU patients. We conducted a nonequivalent, quasi-experimental design from January 2019 to January 2020. A total of 175 nurses who work in an ICU were included at the baseline and divided into two groups: (1) intervention (86 nurses), who received education for 6 hours each day across two different days and (2) a control group (89 nurses), who maintained their usual routine of care. Data were collected by means of a booklet of questionnaires about the nurses' knowledge and practice, attitudes, and self-efficacy. Data from 160 nurses were included in the analysis. The education program intervention (n = 81) significantly increased nurses' knowledge and practice, positive attitudes, and self-efficacy compared with the control group (n = 79, p < 0.001). In addition, nurses who received the educational intervention were able to detect more cases of delirium (28%, from a total of 51 patients) than the controls, who detected three (6.50%) out of a total of 31 patients (p = 0.003). The ICU nurses who received the delirium-focused educational program increased their knowledge and practice, positive attitudes, and their self-efficacy; in addition, their ability to detect delirium was increased. The implementation of such a program is recommended for the health policymakers and stakeholders.

PurposeThis study aims to identify and explore experiences, perspectives, barriers and enablers to women’s career progression to management positions in the health-care sector and to assess women’s and men’s perceptions of the policies and practices of the health-care system concerning gender equality and nondiscrimination between women and men.Design/methodology/approachA cross-sectional survey was conducted among health-care professionals in ten selected hospitals, including physicians, registered nurses/midwives and pharmacists with or without managerial positions.FindingsThis study included a total of 2,082 female and 1,100 male health-care professionals. Overall, 70% of women and men reported that opportunities for advancement are based on knowledge and skills in their institution. However, 58.9% of women (p < 0.001) reported that women are more likely to face barriers to career advancement than men do in their workplace. Lack of women in general/line management and discrimination against women by supervisors at the point of promotion were the main barriers to women's career progression, as they were reported by two-thirds of women. The main barrier, as perceived by men (62.3%) was that women have family and domestic responsibilities.Practical implicationsTo overcome barriers in women's career progression, there is a need to establish a career planning and capacity-building program for women in the health sector.Originality/valueJordanian female health-care professionals face different barriers that affect their career progression, including inequity and discrimination in the workplace, negative views about women’s abilities, lack of qualifications and training, hostile cultural beliefs and family responsibilities.

Interactive community-based theatre is used to engage with audience members and allow for free exchange of ideas relevant to context. It aims to bring about a new understanding of an issue while challenging people’s attitudes and perceptions. Its application within the field of sexual and reproductive health has been limited, particularly in low and middle-income contexts. This paper presents the rationale for a research-arts partnership in Jordan and describes the process and some lessons learned from the development and country-wide performances of a research-informed interactive play. The play, Mish ‘Ayb (Not a Shame) was designed to address social barriers to accessing sexual and reproductive services in a patriarchal society. The sensitive portrayal by Jordanian actors of real-life scenarios pertaining to specific health issues encouraged identification of the audience with the actors, thereby building trust. This process helped to uncover cultural norms that facilitate and impede people’s access to health services and information. Qualitative research designs that incorporate interactive theatre present a strong potential avenue to explore sensitive topics related to sexuality, particularly in patriarchal contexts.

Despite the adverse effects of sexual harassment, measurement gaps persist. Using a sequential, mixed-methods approach, we adapted and validated the Sexual Experiences Questionnaire (SEQ) to measure sexual harassment victimization among college-going women in Jordan. From a 213-item pool and qualitative data from students at the study site, we removed 50 items and collapsed or rephrased 163 items into selected 27 items for examination. After expert reviewers and study-site staff assessed content validity, we replaced three items. Items were tested using cognitive interviews (n = 7) and then administered in a survey to 567 women students. We sequentially performed exploratory factor analysis (EFA) with a random split-half sample (N1 = 283), confirmatory factor analysis (CFA) with the second sample (N2 = 284), and confirmatory bifactor analysis. Five items with cross-factor loadings were dropped. Model fit for the final four-factor EFA and CFA was adequate (EFA: RMSEA: 0.013, CFI: 0.996, TLI: 0.994; CFA: RMSEA 0.020, CFI: 0.988, TLI: 0.986). Three factors were similar to those identified in the SEQ-gender harassment, sexual coercion, and unwanted sexual attention-but we also identified a fourth factor-physical-contact sexual harassment. The bifactor analysis suggested that the scale was unidimensional (general factor ECV=.701 and PUC =.727). The unidimensional scale was positively associated with depressive symptoms. Using an adapted SEQ, sexual harassment is a measurable construct in the Jordanian university context. Further validation of this tool and efforts to capture each dimension of sexual harassment in the Arab region is needed.

ABSTRACT Background: Most refugees are less than 18 years and at heightened risk of common mental disorders (CMDs) relative to other youth. Limited evidence exists for psychosocial programsfor youth in low-resource settings. Early Adolescent Skills for Emotions (EASE) was developed by the World Health Organization to address this gap. Objectives: This study tested the safety, feasibility, and trial procedures of the EASE intervention among Syrian refugee youth in preparation for a definitive randomized controlled trial (RCT). Methods: A feasibility RCT was conducted in Amman, Jordan with Syrian children aged 10–14 years who reported psychological distress. Following community screening, youth and their caregivers were randomized to receive either the EASE intervention or enhanced treatment as usual (ETAU). EASE comprised seven group sessions teaching children coping skills, and caregivers received three group sessions to augment the youth sessions. Assessments were conducted at baseline and 1 week following the last EASE session (8 weeks following baseline). Following the trial, a qualitative process evaluation with staff and beneficiaries took place. Primary outcomes were safety and feasibility indicators, and distress was measured by the Paediatric Symptom Checklist. Results: In November 2018, 179 children were screened; 61 (33%) met criteria for distress (34.1%), two were excluded for suicidal risk, and 59 were randomized (EASE = 33, ETAU = 26). Of those who received EASE, 26 children (79%) completed the intervention. Group attendance was high and no adverse events were reported in either arm. Psychological distress did not show signs of abating in either group over time. Conclusion: This feasibility trial demonstrated the safety and acceptability of the intervention. Important lessons were learnt regarding entry criteria into the study and engagement of caregivers in the intervention. A fully powered randomized controlled trial will be conducted to evaluate the efficacy of EASE.

Abstract Young people constitute more than half of global refugee populations, yet there is limited research into the impact of displacement on transitions into adult life. With the average period of protracted displacement extending beyond 20 years, insight is needed into how the experience of being a refugee shapes the expectations and lives of young people. This article examines the effects of weak and restricted labour markets on the transitions of young refugees into adulthood. Drawing from research undertaken with displaced children and youth in Uganda and Jordan, the article explores how a lack of work opportunities affects individual ability to achieve financial independence and, more widely, to obtain the social recognition associated with adulthood. The research finds how a dependence on precarious work and the effects of legal restrictions on employment curtail transitions to adulthood, highlighting the importance of national and humanitarian policy support to help young refugees establish stable livelihoods.