Occupation-Centered Interventions to Enhance Participation in Everyday Activities for Refugee Children: A Systematic Review

IMPORTANCE: Child refugees face high developmental risks, often linked to disruptions in their everyday activities, an issue that may be addressed through occupation-centered interventions. OBJECTIVE: To examine the existing evidence on the effects of occupation-centered interventions targeting displaced families and children on children's participation in everyday activities. DATA SOURCES: Randomized controlled trials (RCTs), quasi-experimental studies, pre-post designs, and qualitative research on family- and child-focused occupation-centered interventions, written in English, and published between January 2000 and August 2024, were extracted from PubMed, Scopus, EBSCO, and PsycINFO. STUDY SELECTION AND DATA COLLECTION: Seven RCTs, five non-RCTs, two qualitative studies, and one mixed-method study met the inclusion criteria. The studies' participants were refugee or asylum-seeking minors and adults. Children's participation in any occupation was assessed before and after administration of occupation-centered interventions. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRSIMA) methodology was followed. Quality appraisal was performed with the Cochrane risk-of-bias tool, the Furlan 12-Question Tool, a Joanna Briggs Institute critical appraisal tool, the GRADE-Confidence in the Evidence from Reviews of Qualitative Research tool, and the Mixed Methods Appraisal Tool. FINDINGS: Findings for outcomes concerning participation in all domains of occupations were inconsistent. The limited number of studies and their methodological constraints inhibited conclusive findings. CONCLUSIONS AND RELEVANCE: Interventions centered on occupation may benefit refugee children's participation in everyday activities. Rigorous and context-sensitive future research is needed to strengthen the evidence, particularly for occupation-centered interventions. Plain-Language Summary: Occupation-centered interventions use everyday activities to help children and adults live healthy and meaningful lives. This review looks at whether these approaches help refugee children take part in their daily activities. Current research shows they may help to improve refugee children's participation, but more studies are needed to draw stronger conclusions. Refugee children may benefit from interventions that respect their cultural and social backgrounds, just as taking part in familiar and meaningful activities supports their development, well-being, and sense of belonging in a new community.