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PubMed2026

'Sawa Aqwa' (Stronger Together): A multi-site randomized controlled trial of a brief family systemic intervention for adolescent mental health in Lebanon.

BACKGROUND: There are no evaluated family-based mental health and psychosocial support (MHPSS) interventions for adolescents in Southwest Asia (known as the Middle East), and few whole-family interventions in low- and middle-income countries, despite consistent evidence for the impact of family support on mental health and well-being. This study aims to evaluate the effectiveness of a brief family systemic mental health intervention, deliverable by non-specialists in mental health. METHODS: We conducted an assessor-blind type I hybrid effectiveness-implementation multi-site randomized controlled trial comparing the locally developed family intervention to a waitlist control group for randomly allocated families residing in North Lebanon and Beqa'a governorates. Eligible families presented with medium-to-high risk for child protection concerns (abuse, neglect, child labor, early marriage) and had at least one adolescent aged 12-17 who demonstrated psychological distress. Outcomes at the family, caregiver, and adolescent level were measured pre- and post-intervention, and at 3-month follow-up. RESULTS: Intent-to-treat analyses found a significant between-group effect of the intervention on adolescent-reported family functioning, caregiver mental health, and parenting. No change was found for adolescent psychological distress. Further analyses found effects on adolescent well-being for those who completed the intervention, and that father attendance was associated with better outcomes for adolescent well-being in the intervention group. No other significant moderators were found. At the 3-month follow-up for the intervention condition, family functioning and caregiver well-being significantly dropped from endline. CONCLUSIONS: The study demonstrates mixed results for a non-specialist-delivered family-systemic intervention developed in the context of humanitarian crises in Lebanon. While the intervention did not result in benefits in adolescent-reported symptoms of psychological distress, the intervention group did show greater improvements than the control group on a number of other outcomes, showing the potential impact of working with the wider family system to support adolescents in humanitarian settings.

Humans↗

PubMed2025

VANTAGE: van-based real-time HIV sequencing for transmission mapping and drug resistance profiling in war-affected Ukraine.

We deployed the VANTAGE (VAN for Transmissible Agent Genomic Epidemiology) mobile system in Lviv, Ukraine, demonstrating end-to-end sequencing of dried blood spot samples within a clinic van usually serving de-occupied and frontline regions. HIV-1 pol sequences were obtained from 50% of samples, all subtype A6. Median time to 100× coverage was 38 min. Phylogenetic analysis revealed a local transmission cluster including a displaced person and the non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance mutation E138A, supporting real-time HIV genomic surveillance in humanitarian crises.

Humans↗

PubMed2025

A study of the link between food-water insecurities and self-reported psychotic experiences among young adults in Gaza Strip: What role does social support play under conditions of war and extreme suffering?

BACKGROUND: The war in Gaza, coupled with severe restrictions on humanitarian access and assistance, have led to a rapid and large-scale exacerbation of food insecurity (FI) and water insecurity (WI) in Gaza, which can cause a myriad of deleterious effects on both physical and mental health. Previous evidence suggests that environmental stressors (such as FI and WI), coupled with lack of support, can compromise coping ability and trigger psychosis. Elucidation of these pathways can inform efforts to reduce the incidence of psychosis in war settings in particular, and in global communities more generally. This study aimed to assess the mediating role of social support on the association between food-water insecurities and psychotic experiences (PEs). METHODS: This study was carried-out over a period of one month (September 2024) by using a free online form builder. Data were collected at a single time point using snowball sampling. A total of 476 adults aged 18–35 years and living in Gaza at the time of the survey took part in this study. The Prodromal Questionnaire- Brief, the Food Insecurity Experience Scale, the Four-Item Household Water Insecurity Experiences Scale, and the Single Item Measure of Social Supports have been administered to participants. RESULTS: A total of 110 participants (23.1%) reported low tangible social support (i.e., having no or 1 person in the social support network), 27.3% were classified as moderately-to-severely food insecure and 41% were categorized as water-insecure. The mediation analysis was adjusted for the following covariates: marital status, living arrangement and age. Higher food-water insecurity experiences were significantly associated with lower social support. Higher food-water insecurity experiences were also significantly associated with higher PEs. Higher social support was significantly associated with lower PEs. The results of the mediation analysis showed that social support mediated the link of FI (indirect effect: Beta = 0.06; Boot SE = 0.03; Boot CI 0.01; 0.12) and WI (indirect effect: Beta = 0.04; Boot SE = 0.02; Boot CI 0.01; 0.08) to PEs. CONCLUSION: Our findings support the case for bolstering social support networks in war-affected communities facing survival challenges such as FI and WI. This study points to the urgent need for increased food aid and improved water supplies in the short term, and sustainable food and water systems in the long term, to support mental health. In times of war, mental health prevention and interventions strategies might do well to increase social support and resources in order to help buffer such intense environmental stressors and prevent the emergence of psychosis. CLINICAL TRIAL NUMBER: Not applicable.

Humans↗