Risk and protective factors for the mental health of displaced Ukrainian families in the Netherlands : study protocol of a 4- year longitudinal study

Background Over 6 million people have fled their homes in response to the full- scale invasion of Russian armed forces into Ukraine and are forcibly displaced since the start on 4 February 2022. Refugees, both adults and children, have a high risk of developing mental health disorders, in particular post- traumatic stress disorder, depression and anxiety disorders. Research into the mental health of Ukrainian families and their needs is urgently needed. The primary aim of this study is to increase our understanding of the consequences of potentially traumatic events for the mental health of parents and children. This may inform the development of mental health and psychosocial support interventions which can be readily implemented in the family context.

Methods and analysis We will conduct a four- wave longitudinal online survey study among Ukrainian families displaced to the Netherlands. This study is a part of the Nadiya data collection, intended to assess the mental health responses of Ukrainian refugee families to the stress of war, forced migration, family separation and adaptation to new circumstances in their hosting country. Participants are assessed at four time points, approximately 6 months apart. Data collection for T1 started in May 2023. We aim to recruit a total of n=1500 participants at T1, of which n=1000 adults (18 years and older) and n=500 children (8–11 years) and teenagers (12–17 years). To investigate symptom profiles and associated risk and protective factors among parents and children, we will use latent class growth modelling.

Ethics and dissemination The data collection procedure has been approved by the Ethical Committee of the Faculty of Social Sciences of Utrecht University. Data will be deposited, stored and shared using Utrecht University’s institutional research data repository Yoda. This research project is part of the Global Collaboration on Traumatic Stress; all authors are affiliated with this network. The f indings will be published in peer- reviewed, open access journals and further disseminated through conference presentations, news updates at the project website and on the websites of the Dutch Society for Traumatic Stress Studies (www.ntvp.nl), and the European Society of Traumatic Stress Studies, as well as through media contributions.

STRENGTHS AND LIMITATIONS OF THIS STUDY

⇒ This 4- year longitudinal study includes a sample of both parents and children, drawn from community as well as clinical populations.

⇒ Using latent class analysis and multilevel growth mixture modelling, we can identify different symptom trajectories as well as predictors of these trajectories.

⇒ We measure a broad range of mental health indicators, accounting for expected heterogeneity in responses.

⇒ The inclusion of sufficient adolescents and children might be a challenge, as well as sample attrition during the three follow- up measures.

⇒ Another limitation of this study is the reliance on self- report questionnaires.