Acculturative Challenges and Opportunities Among Arab-Speaking MENA Refugees in the United States

The study identifies acculturative challenges and opportunities experienced by Arab-speaking MENA refugees in the United States. The research team conducted 24 semi-structured interviews with refugee parents (11 fathers and 13 mothers) in Arabic. The findings reveal two main categories: (a) acculturative challenges and (b) opportunities and hopes for a better future in the United States. Refugees described several acculturative challenges, including the language barrier, unrealized mental health issues, intimate partner violence (IPV), and the added struggle of COVID-19. Refugees faced several challenges, but their stressors were mitigated by their hope for a better future for their children. Findings suggest practitioners must introduce early interventions targeted at family conflict resolution in Arabic. Future research should explore culturally acceptable mental health interventions and gender-specific resources for IPV.

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Meaning-focused coping as a cultural process: A mixed quantitative and PhotoVoice study of adolescents with Arab backgrounds overcoming stigma and harassment

Poor mental health among U.S. adolescents has reach epidemic proportions, with those from the Middle East and North African region exhibiting increased risk for distress and suicide ideation. This mixed-methods study analyzes quantitative data from first- and second-generation Arab adolescents (n=171) and qualitative data from a participatory study conducted with 11 adolescents of the same population to understand the role of cultural resources in coping. Drawing on the Intersectional Theory of Cultural Repertoires in Health, we show that: 1) cultural resources underlie meaning-making throughout coping; 2) coping strategies are inseparable from the influence of peer and familial relationships, as dictated through the social norms and other cultural resources; 3) collectively held repertoires of coping can promote belonging, affirm identity, and protect against discrimination; and 4) the outcomes of coping strategies, and the culturally informed meaning individuals make of these outcomes, influence their future coping behaviors.

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Supporting social emotional learning and wellbeing of displaced adolescents from the middle east: a pilot evaluation of the ‘forward with peers’ intervention

A growing literature points to the critical role schools can play in promoting improved psychosocial wellbeing and resilience among first- and second-generation Arab immigrant and refugee adolescents, but few evaluations have examined the effectiveness of culturally adapted, school-based interventions. We conducted a pilot evaluation of a culturally adapted social and emotional learning and life skills program, Forward with Peers (FwP), and examined its potential effectiveness for this population. FwP was evaluated across three high schools in the Detroit Metropolitan Area. Within each school, one Arabic class was randomly assigned to receive FwP programming and another served as a control. The pilot evaluation sought to examine changes in several mental health and psychosocial outcomes of interest. Improvements in overall perceived social support (P = 0.045) and perceived social support from someone special in one’s life (0.042) were statistically significant in the treatment as compared to the control group. Comparative improvements were also marginally significant for resilience (P = 0.095) and perceived social support from family (P = 0.074). Findings highlight the potential of FwP and support the growing interest in establishing efficacy of school-based, culturally appropriate SEL programming to improve psychosocial wellbeing among Arab refugee and immigrant adolescents. FwP’s demonstrated improvements in resilience and social support have the potential to prevent mental health disorders and bolster coping mechanisms to minimize adverse consequences in this vulnerable population. Employing a strengths-based approach, FwP offers an alternative intervention to traditional treatment-oriented supports for the proliferation of mental health disorders within this vulnerable population.

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Risk and Protective Factors for Well-being and Barriers to Help-Seeking Among Arab-Speaking MENA Immigrants and Refugees in North America: A Scoping Review

A study conducts a review of risk and protective factors for well-being and barriers to help-seeking among Arab-speaking MENA immigrants and refugees (IRs) in North America. Guided by Arksey and O’Malley’s Scoping Studies Methodological Framework, we use the Population, Concept, and Context (PCC) framework recommended by Joanna Briggs Institute (JBI) for scoping reviews to establish eligibility criteria selecting for original peer-reviewed articles published in English between 1999 and 2022. The search utilizes five databases: PubMed, CINAHL Plus, PsycINFO, Academic Search Complete, and Family Studies Abstracts. A total of 47 sources were selected based on the study criteria. Common themes are extracted which generate the identification of key risk and protective factors for well-being and barriers to help-seeking among the target population. The risk factors identified are acculturative stress, prevalence and impact of domestic violence, migration trauma, and intergenerational conflict. Protective factors identified are social support, ethnic and religious identity, and supportive parental and school experiences. Barriers to help-seeking include sociocultural, organizational, legal, and economic factors. Implications for future research and practice with Arab-speaking MENA IRs in North America are discussed.

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A Relational Approach to Understanding Psychosocial Wellbeing, Including Suicidal Ideation, among MENA-background Adolescents

Adolescent refugees from the Middle East and North Africa (MENA) region face significant acculturation challenges and stressors in the United States. This qualitative study draws upon the integrated motivational-volitional model to understand MENA-background adolescents’ psychosocial wellbeing and suicide risk in three U.S. cities. Local service providers served as key informants (n = 27), sharing in-depth reflections on supporting newcomer students in education, mental health, and refugee services. Analysis also includes focus group discussions with MENA-background adolescents (n = 11) who participated in a photovoice activity. Four key themes emerged: (1) acculturation stressors; (2) influence of family contexts; (3) community belonging, expectations, and support; and (4) school belonging. Service providers and students described adolescents’ challenges in navigating dual identities, conflicting expectations, and strong cultural norms surrounding gender and mental health. Implementation and evaluation of interventions to address both systemic and identity-based acculturative challenges are central to improving mental health and reducing suicide risk among this population.

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Seeking approval first: Mental health care utilization and engagements among
MENA adolescents in the United States

Like most adolescents, those from the Middle East and North African (MENA)
region face a host of stressors that threaten their mental health. However,
evidence suggests that this population may encounter specific barriers to access that inhibit or preclude help-seeking and engagement with mental health services. To better understand how these barriers limit MENA adolescents’ engagement
with mental health services, we conducted interviews with 27 school-based service providers for MENA students in three U.S. cities and analyzed four focus group discussions from a Photovoice project with seven Arab adolescents in Detroit, MI. Our findings identified four key themes around barriers to service access and utilization: (1) the importance of reputation and adhering to familial
and societal expectations, (2) student-parent communication around mental health and psychological distress, (3) the role of gender in seeking and engaging with mental health services, and (4) the quality and cultural appropriateness of mental health services. Strategies and recommendations for future research, policy, and practice to overcome these barriers are discussed.

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“We will need to build up the atmosphere of trust again”: Service providers’ perceptions of experiences of COVID-19 amongst resettled refugee adolescents

Adolescent resettled refugees across the United States have been significantly impacted by the COVID-19 pandemic, through socio-economic stressors in households, disproportionate morbidity and mortality in immigrant communities, and social isolation and loss of learning due to school closures and the shift to online learning. The Study of Adolescent Lives after Migration to America [SALaMA] investigates the mental health and wellbeing of adolescents who come from–or who have parents who came from–the Middle East and North Africa [MENA] region and settled in the U.S. There is a gap in understanding of the experiences during the pandemic of MENA-background adolescents in the U.S. The objective of this study was to describe the perspective of educators and other school-affiliated service providers on the impact of the COVID-19 pandemic on mental health and wellbeing of adolescent resettled refugees and access to and quality of education and support services for adolescent resettled refugees. The researchers collected data using in-depth interviews with key informants in Chicago, Illinois; Harrisonburg, Virginia; and Detroit Metropolitan Area [DMA], Michigan, Key informants were school administrators, managers of English language learning services and programs, teachers, therapists, staff of non-governmental organizations and/ or community-based organizations, and case workers. Data analysis was conducted utilizing directed content analysis to develop an initial codebook and identify key themes in the data. Findings revealed a number of pathways through which the pandemic impacted adolescent refugees and immigrants’ mental health and wellbeing, with online programming impacting students’ engagement, motivation and social isolation in terms of peer and provider relationships. Specific dynamics in refugee adolescents’ households increased stressors and reduced engagement through online learning, and access to space and resources needed to support learning during school closures were limited. Service providers emphasized multiple and overlapping impacts on service quality and access, resulting in reduced social supports and mental health prevention and response approaches. Due to the long-term impacts of school closures in the first two years of the pandemic, and ongoing disruption, these data both provide a snapshot of the impacts of the pandemic at a specific moment, as well as insights into ways forward in terms of adapting services and engaging students within restrictions and limitations due to the pandemic. These findings emphasize the need for educators and mental health service providers to rebuild and strengthen relationships with students and families. These findings indicate the need to consider, support and expand social support and mental health services, specifically for refugee adolescent students, in the context of learning and well-being during the COVID-19 pandemic.

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“Hope for a better tomorrow”: Using photovoice
to understand how Arab adolescents enact
critical consciousness

We explore how Arab adolescents enact critical consciousness to improve their lives and better their community. Eleven first‐ and second‐generation Arab adolescents participated in a Photovoice study and were asked to reflect on and take photos that represented their well‐being, daily life, and sense of belonging and community. The participants discussed their photos over multiple group reflection sessions. Thematic
analysis highlights how Arab adolescents make positive change in their community, aided by their connections to community, their awareness of structural challenges they and their communities face, and their sense of agency to make positive change. We contribute to the literature by offering a window into the lived experiences of critical consciousness among Arab adolescents,
an underrepresented group in the critical consciousness literature. We also add to the growing body of evidence that highlights the importance of “everyday activism” when considering social change actions.

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How schools and other public services in the US can
promote refugee integration

Services and policies need to be more thoughtfully designed to enable young refugees’ social and economic integration. This requires a better understanding of what constitutes sustainable integration and what factors promote it. In this article the authors offer four overarching reflections that they hope may guide practice and inform policy debates on refugee integration.

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Opportunities and Obstacles for Achieving
Language Equity among Adolescents
Resettled from the Middle East and North

Adolescents resettled to the US from conflict-affected countries in the Middle East and North Africa region face a range of acculturative challenges, including language barriers, that may affect their wellbeing. This qualitative study aims to understand the variety of approaches US schools use to support the education of Arabic-speaking students. Utilizing Ruız’s influential typology of language orientations, our analysis reveals a range of school approaches aligning most closely with the ‘language-as-problem’ and ‘language-as-resource’ orientations. Participants identified several perceived effects of
these orientations on academic achievement and acculturation, and providers highlighted promising directions and potential barriers for bolstered language supports. Findings indicate that Arabic-speaking newcomer students experience persistent
language inequity but also locate promising pathways towards reducing these inequities. We discuss structural shifts schools can implement to bolster language as a resource and move towards larger systems change in which heritage language is a right.

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Intersectionality: experiences of gender socialization and racialization for Iraqi students resettled to the United States

Abstract: Individuals from conflict-affected countries, such as Iraq, face formidable challenges upon resettlement in the United States. Drawing upon intersectionality theory, we explore the lived experiences of adolescent boys and girls from Iraq resettled in Texas and Virginia. In this qualitative study, we focused on the school as an institution that is positioned to enforce or combat systemic and interpersonal inequalities among young refugees, especially in regards to gender and race. Our thematic analysis identifies the ways in which students’ teacher, peer, and familial interactions within schools shape the socialization of adolescent boys and girls from Iraq. Study findings reflect the importance of understanding how educational settings impact the intersectional experiences of conflict-affected youth resettled to the United States.

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School-based programs for Supporting the mental health and psychosocial wellbeing of adolescent forced migrants in high-income countries: A scoping review

As communities around the world continue to receive record-setting numbers of newcomers fleeing armed conflict, schools play a central role in supporting these families through the challenges of adjustment. Policymakers and educators in several high-income countries have begun to invest in efforts to support these young forced migrants not only academically, but also socially and emotionally. This study reviews the published and grey literature on 20 school-based programs aimed at improving the mental health and psychosocial wellbeing of adolescent forced migrants in high-income countries from 2000 to 2019. This review seeks to inform a more comprehensive and detailed understanding of the types of program options available to schools, while also identifying gaps in the current literature related to factors influencing program implementation. We find several common approaches and challenges to supporting adolescent forced migrants, as well as their families, communities, schools, and service providers. The reviewed programs faced recurring challenges related to intercultural exchange, gaining access to communities, promoting care-seeking, school capacity limitations, and sustainability. The lessons learned from these programs indicate that several steps can be taken to mitigate these challenges, including adapting services to individuals and their contexts, taking a multi-layered approach that addresses multiple levels of young people’s social ecologies, and building trusting, collaborative partnerships with schools, communities, and students.

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Ecologies of care: mental health and
psychosocial support for war-affected youth in the U.S.

Background: Youth resettling to the U.S. from conflict-affected countries in the Middle East and North Africa (MENA) face countless challenges. As they cope with their experiences of armed conflict and forced migration, these girls and boys must also adjust to the language and social norms of their new society, often encountering prejudice and discrimination along the way. Previous studies indicate that schools can play a central role in facilitating this adjustment while also promoting mental health and psychosocial wellbeing. This qualitative study aims to understand the lived experiences of MENA newcomers resettled in Austin, Texas and Harrisonburg, Virginia and to assess how schools, families, and communities support their mental and psychosocial wellbeing.

Methods: We held six focus group discussions across the two cities with a total of 30 youths (13–23 years) from Iraq, Syria, and Sudan. We also conducted semi-structured interviews with 30 caregivers and 27 key informants, including teachers, administrators, service providers, and personnel from community-based organizations.

Results: Guided by Bioecological Theory, our thematic analysis identifies several means by which various actors work together to support resettled adolescents. We highlight promising efforts that seek to enhance these supports, including sheltered instruction, school-parent collaboration, peer support programming, social and emotional learning initiatives, and integrated mental health centers.

Conclusion: While this study underscores the resilience of newcomers and the value of local support systems, it also reflects the importance of investment in schools, mental health systems, and resettlement programs that can enable newcomers to achieve their full potential.

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SALaMA study protocol: a mixed methods study to explore mental health and psychosocial support for conflict-affected youth in Detroit, Michigan

Background: Families resettling to the U.S. from conflict-affected countries in the Middle East and North Africa (MENA) face countless challenges. These families must cope with experiences of armed conflict and forced migration while also assimilating to a new society. According to the ‘immigrant paradox,’ time spent in a new country can compound the effects of migration and assimilation challenges and lead to deteriorated mental health. This study aims to assess the psychosocial wellbeing of MENA-born or first-generation adolescents attending school in the Detroit metropolitan area (DMA) to understand how schools, families, and communities play a role in supporting these adolescents’ wellbeing.

Methods: The quantitative component of this mixed methods study will involve a self-administered survey with a sample of students whose responses will be linked to academic records and behavioral assessments. The survey will utilize validated instruments to measure depressive and anxiety symptoms (Hopkins Symptom Checklist-37A), hope (Children’s Hope Scale), resilience (Child and Youth Resilience Measure-12), externalizing and prosocial behavior (Hopkins Symptom Checklist-37A, Strengths and Difficulties Questionnaire), school belonging (Psychological Sense of School Membership), and peer relationships (Multidimensional Scale of Perceived Social Support). Differences in outcomes will be analyzed across two strata: students born in the MENA region and first-generation students whose parents immigrated to the US from the MENA region. The qualitative component will involve semi-structured key informant interviews with parents, school administrators, educators, and mental health providers, and focus group discussions (FGDs) with a purposive sample of adolescents born – or whose parents were born – in the MENA region. The FGDs will include a participatory ranking activity where participants will be asked to free-list and rank ideas about how schools can better support students like them. Thematic content analysis will be conducted to identify common themes.

Discussion: This study will contribute evidence about the wellbeing of adolescents who come from – or whose parents come from – conflict-affected countries currently living in the U.S. Findings can be used to inform program and policy development to enable schools and their community partners to serve this population more effectively.

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Stressful Life Events and Their Unique Associations with Psychosocial Outcomes: a Gendered Analysis Among High School Adolescents

Introduction: There is substantial evidence linking stressful life events (SLEs) in childhood to poor mental health later in life, but few studies explore how various types of SLEs differentially impact mental health. The purpose of this study is to assess associations between SLEs and psychosocial outcomes in a diverse adolescent population in the USA and to examine whether and how these relationships are gendered.

Methods: The sample comprises 181 high school students ages 13–21 years in Harrisonburg, Virginia. This study analyzed associations between 12 SLEs and eight psychosocial outcomes using ordinary least-squares and logistic regressions. Relationships were estimated for the full sample and for males and females, separately.

Results: For boys, having ever been forced to leave one’s family was associated with declines in resilience (B = − 4.646; 95% CI (− 8.79, − 0.50)) and increases in externalizing symptoms (B= 0.392; 95% CI (0.15, 0.63)). Furthermore, boys who experienced a drastic change in their family reported lower levels of school belonging (B = − 9.272; 95% CI (− 17.45, − 1.09)). For girls, having ever been forced to leave one’s family was associated with decreases in depressive (B = − 0.961; 95% CI (− 1.88, − 0.05)) and anxiety symptomology (B = − 0.868; 95% CI (− 1.68, − 0.06)). Overall, students who experienced a life-threatening emergency exhibited greater depressive (B = 0.445; 95% CI (0.15, 0.74)) and anxiety symptoms (B = 0.287; 95% CI (0.05, 0.52)), and depressive symptomology was also associated with having ever been physically hurt by someone (B = 0.224; 95% CI (0.01, 0.44)).

Conclusions: Findings provide insights into how exposures might engender different mental health processes and outcomes, and how these processes may manifest differently across gender.

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We are here for the future of our kids: Parental involvement in refugee adolescents’ educational endeavors in America

Every year, thousands of young refugees and their families face challenges as they adjust to schools in the US. This article explores how families resettled to the US from conflict-affected, Arab-majority countries in the Middle East and North Africa region, such as Iraq and Syria, view education, and how parents support their children’s education following the experiences of resettlement. To centre the voices and lived experiences of these families, we analysed focus group discussions with 30 adolescents and in-depth interviews with 30 parents and 27 key informants. Analysis using constant comparative method and thematic analysis showed that, upon resettlement, education remained highly valued by families. Our study finds that, despite the challenges associated with families’ newcomer status, parents in this study provided educational support to their children by engaging with the school and with their children’s learning at home. We offer suggestions on how schools and organizations can bolster parents’ ability to support their children’s education.

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Psychosocial Well-Being, Mental Health, and Available Supports in an Arab Enclave: Exploring Outcomes for Foreign-Born and U.S.-Born Adolescents

Introduction: Few studies have assessed the impact of displacement, resettlement, and discrimination on well-being outcomes for adolescent refugees resettled within the U.S. Conducted in three charter schools in the intergenerational Arab enclave of the Detroit Metropolitan Area, this mixed-methods study assessed the mental health and psychosocial support for both U.S.- and foreign-born adolescents from the Middle East and North Africa region.

Methods: A quantitative survey was used to collect data on 176 students. Key outcomes included hope, prosocial behaviors, resilience, depressive, anxiety, externalizing symptoms, stressful life events, perceived social support, and sense of school belonging. Differences in outcomes between U.S.- and foreign-born students were compared using T-tests. Regression analysis explored whether outcomes were gendered and correlated with years in the U.S. for foreign-born students. Qualitative data collection included key informant interviews with school staff and community service providers, student focus group discussions, and caregiver interviews. Interview transcripts were analyzed using thematic analysis and the constant comparative method.

Results: No statistically significant differences between the foreign-born and U.S.-born groups were observed. However, analysis revealed that resilience decreased for male students with time spent in the U.S. Qualitative themes illuminated these results; shared cultural heritage allowed newcomer students to access relevant language and psychosocial support, while inter- and intra-group peer relationships strengthened students’ dual language skills and identity formation. However, shifting gender expectations and role hierarchies for newcomer students revealed boys’ increased stressors in the family domain and girls’ better accessed support in the school context.

Conclusion: The existence of an immigrant paradox in this enclave setting was not supported. Instead, findings highlight the reciprocal value of peer-based mentorships and friendships between U.S.- and foreign-born students with similar cultural backgrounds, the importance of social and emotional curricula and cultural competency training within schools, and the gendered effects of acculturation.

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Correlates of Suicide Ideation and Resilience Among Native- and Foreign-Born Adolescents in the United States

Purpose: Nearly 20% of U.S. adolescents have considered suicide. Yet, gaps remain in under-standing correlates of resilience and suicide risk, especially among populations born outside the United States who may face unique migration- and acculturation-related stressors. This study adds to the literature by exploring correlates of suicide ideation among a diverse population.

Methods: This study analyzes quantitative data (N = 357) from the Study of Adolescent Lives after Migration to America, in Detroit and Harrisonburg. More than 40% of the sample was born outside the United States, with the majority born in the Middle East and North Africa. Path analysis was used to model dual outcomes of resilience and suicide ideation using measures of hope, school belonging, stressful life events, and being born outside the United States.

Results: Suicide ideation and resilience were negatively correlated (ß = -.236[.069]; p < .001). Adolescents with greater hope (ß = .367; p < .001) and school belonging (ß = .407; p< .001) reported higher resilience, while lower levels of school belonging correlated with higher levels of suicide ideation (ß = -.248; p = .009). More stressful life events were associated with suicide ideation (ß = .243; p < .001), while fewer were correlated with resilience (ß = -.106; p = .003). Being born outside the United States was associated with suicide ideation (ß = .186; p = -.015), with this finding driven by those from the Middle East and North Africa region, who faced significantly increased risk of suicide ideation (ß = .169; p = .036).

Results: Suicide ideation and resilience were negatively correlated (ß = -.236[.069]; p < .001). Adolescents with greater hope (ß = .367; p < .001) and school belonging (ß = .407; p< .001) reported higher resilience, while lower levels of school belonging correlated with higher levels of suicide ideation (ß = -.248; p = .009). More stressful life events were associated with suicide ideation (ß = .243; p < .001), while fewer were correlated with resilience (ß = -.106; p = .003). Being born outside the United States was associated with suicide ideation (ß = .186; p = -.015), with this finding driven by those from the Middle East and North Africa region, who faced significantly increased risk of suicide ideation (ß = .169; p = .036).

Conclusions: Findings suggest that adolescents born in the Middle East and North Africa region may represent a vulnerable group needing targeted and culturally responsive interventions to destigmatize mental health and psychosocial well-being, boost existing sources of resilience, and encourage help-seeking behaviors.

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Supporting mental health and psychosocial wellbeing through social and emotional learning: A participatory study of conflict-affected youth resettled to the U.S.

Background: A growing literature has drawn attention to the central role that schools play in supporting the adjustment of resettled refugee youth and promoting their mental health and psychosocial wellbeing. In particular, the recent proliferation of school-based social and emotional learning (SEL) initiatives presents an opportunity to strengthen supports for resettled adolescents. This participatory research study aims to understand how high school students resettled from countries in the Middle East and North Africa region are experiencing the challenges and opportunities of acculturation and the ways in which they believe schools can better support them in this process.

Methods: We analyzed primary data collected during focus group discussions as part of the SALaMA study. During these discussions, we used participatory ranking methodology to elicit adolescents’ suggestions on how high schools can better support students both academically and psychosocially after resettlement. Fourteen focus group discussions were held with male (n = 38) and female (n = 31) adolescents aged 14–20 years, who were selected purposively across six public high schools in Harrisonburg, Virginia, Austin, Texas, and Detroit, Michigan. Participants offered suggestions and then ranked them in order of importance using consensus ranking.

Results: Thematic analysis of the PRM results across sites produced a wealth of suggestions centered around three broad themes, namely: skills related to navigating social and academic challenges, culturally responsive teaching, and socially and culturally equitable learning environments.

Conclusions: Findings reported illustrate limitations of the conventional, universal SEL model and shed light on how schools can adapt transformative SEL strategies to serve their students better, especially newcomers from conflict- affected countries.

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The role of culturally responsive social and emotional learning in supporting refugee inclusion and belonging: A thematic analysis of service provider perspectives

Young refugees resettled to the U.S. from the Middle East and North Africa (MENA) region face significant acculturative stressors, including language barriers, unfamiliar norms and practices, new institutional environments, and discrimination. While schools may ease new- comer adjustment and inclusion, they also risk exacerbating acculturative stress and social exclusion. This study seeks to understand the opportunities and challenges that schoolwide social and emotional learning (SEL) efforts may present for supporting refugee incorpo- ration, belonging, and wellbeing. We completed semi-structured interviews with a purposive sample of 40 educators and other service providers in Austin, Texas, Harrisonburg, Virginia, and Detroit Metropolitan Area, Michigan as part of the SALaMA project. We conducted a thematic analysis with transcripts from these interviews guided by the framework of cultur- ally responsive pedagogy. The findings revealed that students and providers struggled with acculturative stressors and structural barriers to meaningful engagement. Schoolwide SEL also provided several mechanisms through which schools could facilitate newcomer adjust- ment and belonging, which included promoting adult SEL competencies that center equity and inclusion, cultivating more meaningfully inclusive school climates, and engaging fami- lies through school liaisons from the newcomer community. We discuss the implications of these findings for systemwide efforts to deliver culturally responsive SEL, emphasize the importance of distinguishing between cultural and structural sources of inequality, and con- sider how these lessons extend across sectors and disciplinary traditions.

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