Overall Project Objective:
The main aim of the overall project is to conduct a systematic, comprehensive long-term follow-up of a cohort of Palestinian youth, now that they have reached adulthood (ages 30-40). Palestinians have been selected for study because of their very high level of participation in political resistance as adolescents and young adults during the first Intifada (1987-1993) and therefore as an important cohort of youth to study when investigating the impact of political conflict on development. The large majority of past studies on the impact of political conflict on youth has focused narrowly on negative psychological functioning as the sole or prime indicator of well-being. Moreover, there are very few long-term follow-up studies and those have typically been either very small in scope and/or of refugee populations. In contrast, the current study will assess a large, fully representative sample of former youth who have remained in their homeland.
The project makes use of a life event history approach that maps patterns of critical events that have occurred in the lives of the respondents since their high involvement in political conflict as adolescents (i.e., instead of just assessing their psychological functioning at a later period in life as some of the few longitudinal studies have done). Using a resource model (broadly defined to include social, economic, and political resources), the study will assess the degree and patterning of loss (and gain) of critical resources across the transition to adulthood. The project also departs from the traditional Western, deficit model’s predominant focus on psychological effects of conflict by facilitating the creation of a culturally-driven, holistic assessment of well-being. In so doing the project avoids the problematic concentration on psychological functioning of most past work, which, from a cultural perspective, inappropriately pathologizes stress that is normative in conflict situations and otherwise decontextualizes the individual by forcing an artificial isolation of the individual from his or her multiple contexts.
In addition to the substantive information that the project will produce, a further purpose of the study is to develop a multi-method methodology for conducting such work that will potentially be useful in research on people who are under severe conditions in other parts of the world.
PAL Phase 1:
Determining Local Definitions of Wellbeing and Quality of Life
In February, 2010, trained local fieldworkers from the Palestinian Center for Policy and Survey Research, Ramallah, West Bank, interviewed in Arabic 68 adults (33 men, mean age 34·8 years, range 21–53; 35 women, mean age 32·2 years, range 20–49) in the West Bank, East Jerusalem, and the Gaza Strip in 14 groups of five same-sex individuals (apart from two absentees). Participants were selected with purposive sampling to represent sex, region, refugee or non-refugee status, and (in the Gaza Strip) the main political factions of Fateh and Hamas. The focus of the interviews was on participants’ perceptions of what constitutes quality of life and wellbeing in their society. Various methods were used to elicit this information during the interview, including the description of close associates who were doing fairly and less well, and ad-hoc listing and prioritization of domains of wellbeing. The interviews of the 14 groups (including 68 individuals), each one lasting 60–90 min, were transcribed in Arabic and translated into and transcribed in English. Content analyses of the English transcripts were done with Atlas.ti (version 6.2.27) by three project staff, with several Palestinian key informants checking the coding of the transcripts. The study was approved by the institutional review boards of the University of Tennessee, Knoxville, TN, USA, and the Palestinian Centre for Policy and Survey Research. Interviewees provided written informed consent.
For initial results, see:
Barber, B. K. (2016). Gaza: The unprotected and neglected edge of Palestine. Journal of Palestine Studies http://www.palestine-studies.org/institute/news/abandoned-yet-central-gaza-and-resolution-israeli-palestinian-conflict
Barber, B. K., El Sarraj, E., McNeely, C., Daher, M., Giacaman, R., Arafat, C., Barnes, W., & Abu Mallouh, M. (2016). Feeling broken or destroyed: A mixed-methods study of contextualized suffering in the oPt. The Lancet.
Barber, B. K., Spellings, C., McNeely, C., Page, P. D., Giacaman, R., Arafat, C., Daher, M., El Sarraj, E., & Abu Mallouh, M. (2014). Politics drives human functioning, dignity, and quality of life. Social Science & Medicine, 122, 90-102. DOI: 10.1016/j.socscimed.2014.09.055
Barber, B. K., McNeely, C., & Spellings, C. S. (2012). Role of political factors in wellbeing and quality of life during long-term constraints and conflict: an initial study, Lancet, published online Oct 8 http://www.thelancet.com/health-in-the-occupiedpalestinian-territory-2012.
PAL Phase 2:
Quantitatively Assessing the Complexity of Adult Functioning
Over 600 survey items were written and gathered from existing literatures to represent all elements of functioning identified from the group interviews described in Paper 1. Items were then systematically reduced by research team members and key informants during multiple interpretative sessions. The final survey, which included a combination of established scales and culturally-driven items, was administered in Summer 2011 via household interview to a representative sample of Palestinians in the West Bank, East Jerusalem, and the Gaza Strip who were youth during the first intifada (N=508).
For initial results, see:
McNeely, C. Barber, B. K., Spellings, C., Giacaman, R., Arafat, C., Daher, M., El Sarraj, E., & Abu Mallouh, M. (2014): Human insecurity, chronic economic constraints and health in the occupied Palestinian territory, Global Public Health: An International Journal for Research, Policy and Practice, DOI: 10.1080/17441692.2014.903427
McNeely, C., Barber, B. K., Spellings, C., Giacaman, R., Arafat, C., El Sarraj, E., . . . Abu Mallouh, M. (2013). Prediction of health with human insecurity and chronic economic constraints in the occupied Palestinian territory: a cross-sectional survey. The Lancet, 382, S25.
Center associate faculty Clea McNeely presented a paper on the project’s new measure of adult functioning of Palestinian at the Lancet 2013 Cairo meeting
PAL Phase 3:
Assessing Life Event Histories and their Association with Adult Functioning
In this phase of the project, an Event History Calendar (EHC) was developed to assess patterns of events experienced by Palestinian youth of the first intifada (1987-1993) as they have transitioned into adulthood (currently in their 30s). The EHC was developed using information from eight Palestinian key informants and 14 group interviews (with a total of 68 Palestinian adults). The instrument was written in English and back-translated to Arabic, and was piloted with 26 participants in the Gaza Strip and the West Bank in 2010. The final instrument was administered to a representative sample of 1,800 using a three-stage probability sampling strategy (individuals within households within population clusters). Highly experienced native field workers were trained in EHC methodology and conducted the interviews in pairs in respondents’ homes in late 2011. The response rate was 97%.
For initial results, see:
Barber, B. K., McNeely, C. M. Doty, S. B., Belli, R. F., Shikaki, K., Hammad, O., & Ladeweh, W. (2016). Long-term exposure to political violence: The particular injury of persistent humiliation. Social Science & Medicine (in press).
McNeely, C., Barber, B. K., Giacaman, R., El Sarraj, E., Daher, M., Arafat, C., Abu-Mallouh, M., & Belli, R. (2016). Long-term consequences of political imprisonment for men in the oPt: A retrospective cohort study. The Lancet,
McNeely, C.M., Barber, B. K., Giacaman, R., Arafat, C., Daher, M., El Sarraj, E., Abu-Mallouh, M., & Belli, R. (2015). Political imprisonment and adult functioning: A life event history analysis of Palestinians. Journal of Traumatic Stress, 28, 223-231. DOI: 1002/jts.22015
Barber, B. K., McNeely, C., Olsen, J. A., Spellings, C., & Belli, R. F. (2014). Health of Palestinians and chronic humiliation–Authors’ reply. The Lancet, 383, Issue 9924, pp. 106-1207. doi:10.1016/S0140-6736(14)60598-5. http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673614605985.pdf?id=haaVD7b1guG54hV9Da5uu
Barber, B. K., McNeely, C., Olsen, J. A., Spellings, C., & Belli, R. F. (2013). Effect of chronic exposure to humiliation on wellbeing in the occupied Palestinian territory: an event-history analysis. The Lancet, 382, Supplement 4(0), S7. doi: http://dx.doi.org/10.1016/S0140-6736(13)62579-9