A Mixed Methods Exploration of Surf Therapy Piloted for Youth Well-Being in Post-Conflict Sierra Leone.

Jamie Marshall,Brendon Ferrier,Michaella Margaedah Samai,Mohamed Bangura,Mohamed Missalie,Russell Martindale,Sallu Kamuskay,Oullematu Jalloh,Isha Marah,Fanta Tonkara,Olufemi Messeh-Leone,Messeh Leone,Josephine Conteh,Sullayman Keita

doi:10.3390/ijerph18126267

Abstract

Young people in post-conflict and post-epidemic contexts such as Sierra Leone face a range of mental health challenges as part of their daily life. An innovative approach to Sport for Development that could offer support to youth mental health is surf therapy. This research used an uncontrolled mixed methods approach to explore surf therapy pilots run by five youth-focused and community development organizations around Freetown. Four sites provided useable pre/post data using the Stirling Children’s Well-Being Scale (n = 58, average age = 12.9). Three sites were associated with significant (p < 0.017) large effects (r = 0.65–0.84) on participant well-being. One site was associated with a non-significant (p < 0.380) small negative effect (r = −0.22). A synthesis of qualitative data within the five evaluations triangulated with quantitative findings and provided important context in terms of challenges to service delivery. This included low attendance as a plausible mediator for why one site saw very different results than other sites. Combined, these processes highlight the need for future research exploring possible dose-response relationships in surf therapy. This study also provides a foundation for more rigorous research in the future. These promising findings support continued and optimized delivery of surf therapy in Sierra Leone to support youth mental health.

Highlights

The primary aim of this synthesis was to supplement the statistical analysis by contextualizing surf therapy in Sierra Leone, while highlighting the pragmatic challenges that may have had an impact on intervention delivery
Such a correlation may indicate a minimum threshold of exposure to surf therapy that is required before a positive impact can occur
Previous research has highlighted how dosage has an important amplifying effect on activity-based youth development and that further research is required to explore if there are optimal dosages for different kinds of programs [18]. The findings from this initial exploration of surf therapy in Sierra Leone suggest prolonged engagement was key to a positive impact on well-being and should be an important consideration in intervention design

Summary

Introduction

Armed conflict such as civil war has been associated, both directly and indirectly, with negative mental health among children and young people [1]. The intergenerational nature of conflict-induced negative mental health means it lasts long after conflicts have officially ended and spreads within family dynamics [2]. This means young people who took no active part in historical conflicts are still experiencing associated negative mental health. Between 1991 and 2002, the West African country of Sierra Leone experienced devastating civil war, defined by widespread human rights abuses and collapsing infrastructure

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