Hope Groups: Parenting and Mental Health Support for Ukrainian Caregivers

Hope Groups: Psychosocial and Parenting Support Groups for Ukrainian Caregivers Affected by War

Today, over 2 billion people are affected by conflict or violence, and caregivers affected by war are particularly at-risk for poor mental health and violence against children. This will be among the first RCTs evaluating a psychosocial, parenting intervention amidst a war crisis. This research is testing if 'Hope Groups' work to help families in war. Hope Groups are peer-led psychosocial and parenting support groups of 4-7 participants for Ukrainian caregivers affected by war, compared to a wait-list control group.

Study Overview

• Status: Completed
• Conditions: Parenting Practices; Violence Against Children; Parental Mental Health
• Intervention / Treatment: Behavioral: Hope Groups; Other: Wait-list control arm

Detailed Description

This is a carbon-copy of a preregistration published to Open Science Framework on November 9, 2023: https://osf.io/uvj67/overview.

This study is a two-armed pragmatic cluster randomized controlled trial (CRCT) to test whether 'Hope Groups' (a peer-led psychosocial and parenting support group consisting of 12 sessions) improve caregiver mental health, positive parenting, and prevention of violence against women among the intervention group post-intervention, compared to a wait-list control group. Randomization will be performed at the cluster level (the clustered unit of randomization is each Hope Group consisting of 4-7 individuals) with a 1:1 allocation ratio and pair-matched on the hope group's facilitator. All facilitators recruit 2 or 4 groups, which enables pair-matching on facilitator to account for any strong, unmeasurable confounders within a facilitator's network (see more details in 'recruitment' section). Clusters will be randomized to either receive the Hope Group program now ('intervention group') or be placed on a waitlist to receive the Hope Group after trial endline ('control group').

After a facilitator has recruited all participants, and their participants have completed informed consent and baseline surveys, the trial data analyst will use a randomization package in RStudio to conduct the cluster pair-matched randomization (e.g., if a facilitator recruited 2 clusters, 1 group is randomized to intervention and 1 to control; if a facilitator recruited 4 groups, 2 groups are randomized to intervention and 2 to control). The trial analyst will set the seed to ensure randomization results are reproducible. The trial analyst will be blinded to the identifies of all participants within all clusters at the time of randomization. For each facilitator, their clusters will be randomized at the same time (using a randomization package in RStudio), in order to conceal allocation. After randomization is completed, the trial analyst will share the allocation of clusters with the study coordinator. The study coordinator will inform the facilitator, who will inform the intervention group(s) they will start the Hope Group intervention, and inform the control group(s) they are on a wait-list to start the Hope Group intervention after trial endline.

Endline surveys will be conducted for all clusters 1-week after Hope Group completion.

• Study Type: Interventional
• Enrollment (Actual): 510
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Ukraine
  • Kyiv, Ukraine
    • Ukraine Without Orphans

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Participant is Ukrainian (or speaks Ukrainian and has been affected by the war in Ukraine);
• Participant is aged 18 or older
• Participant is a parent or caregiver who spends at least 15 hours per week with at least one child
• Participant has not already participated in a 'Hope Group'.

Exclusion Criteria:

• NA

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention Arm; The intervention arm participates in a 12-session psychosocial, mental health, and parenting support group programme called "Hope Groups".	Behavioral: Hope Groups; Hope Groups are a 12-session psychosocial, mental health, and parenting support group.
Placebo Comparator: Control Arm; The control arm is a wait-list control group, who will receive the intervention after the trial concludes.	Other: Wait-list control arm; Wait-list control arm, with no treatment given during the RCT period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mental Health	Measured using PHQ-4 (the Four-Item Patient Health Questionnaire for Anxiety and Depression)	Baseline and 7-weeks post-baseline
Child Abuse (both Physical Abuse and Verbal/Emotional Abuse)	Measured using adapted questions from ICAST-Trial (International Society for the Prevention of Child Abuse and Neglect Screening Tool for)	Baseline and 7-weeks post-baseline
Parenting Practices	Supervision and Safety - 1.1 Measured using adapted questions from PPPS (Parent Protective Practices Scale); Positive Parenting -- 1.1. Playing with child - measured using an adapted question from APQ 1.2. Supporting child learning - measured using an adapted question from PSSS 1.3. Praising/Complimenting child -- measured using an adapted question from APQ 1.4. Calm Communication -- measured using an adapted question from PARYC	Baseline and 7-weeks post-baseline
Prevention of Violence against Women	Measured using adapted questions from "No Means No Worldwide", in order to make questions relevant to the Ukrainian context and our specific intervention	Baseline and 7-weeks post-baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Overall Caregiver Health	Including: Healthy Grieving -- measured using a question created by Ukrainian mental health professionals for Ukrainian war context;; Hopefulness -- measured using a question created for Ukrainian context amidst war;; Self Care -- measured using a question created for Ukrainian context amidst war	Baseline and 7-weeks post-baseline
Overall Child Health	Measured via: Internalizing Behavior -- measured using an adapted question from CABI (Child and Adolescent Behavior Inventory); Externalizing Behavior -- measured using an adapted question from CABI (Child and Adolescent Behavior Inventory); Child Mood (unhappy, downhearted, tearful); Child/Parent Communication about child's problems/struggles;	Baseline and 7-weeks post-baseline

Collaborators and Investigators

• Sponsor: University of Oxford
• Collaborators: World Without Orphans; Ukraine Without Orphans; Nehemiah Team Ukraine; There is Hope, Krakow

Publications and helpful links

Helpful Links

• Open Science Framework Preregistration
• Protocol

Study record dates

Study Major Dates

• Study Start (Actual): November 11, 2023
• Primary Completion (Actual): July 30, 2024
• Study Completion (Actual): February 28, 2025

Study Registration Dates

• First Submitted: February 19, 2026
• First Submitted That Met QC Criteria: March 9, 2026
• First Posted (Actual): March 13, 2026

Study Record Updates

• Last Update Posted (Actual): March 13, 2026
• Last Update Submitted That Met QC Criteria: March 9, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: R90037/RE001; https://osf.io/uvj67/overview (Registry Identifier: Open Science Framework. This registration is a carbon copy of a preregistration submitted to OSF on November 9, 2023.)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: IPD will be made available, including all primary and secondary outcomes and basic covariates (eg, sex, age, displacement status), but with identifiable information excluded (eg, initials, DOB, geographic location).
• IPD Sharing Time Frame: De-identified data will be made available to researchers upon reasonable request, subject to appropriate data-use conditions. This is available beginning March 1, 2026. Fully available anonymous data will be posted on Open Science Framework after the main results and moderator results are published, likely in 2027.
• IPD Sharing Access Criteria: De-identified data will be made available to researchers upon reasonable request to Sydney Tucker (sydney.tucker@spi.ox.ac.uk), subject to appropriate data-use conditions. Fully available anonymous data will be posted on Open Science Framework after the main results and moderator results are published (likely 2027), and can be directly accessed on Open Science Framework.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No