{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:50:56Z","timestamp":1791478256036,"version":"4.3.4"},"reference-count":40,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T00:00:00Z","timestamp":1684281600000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec id=\"S2056472423000583_sec_a1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Most staff stay healthy during humanitarian work, although some worsen. Mean scores on health indicators may be masking individual participants struggling with health issues.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423000583_sec_a2\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>To investigate different field assignment-related health trajectories among international humanitarian aid workers (iHAWs) and explore the mechanisms used to stay healthy.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423000583_sec_a3\" sec-type=\"methods\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>Growth mixture modelling analyses for five health indicators using pre-\/post-assignment and follow-up data.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423000583_sec_a4\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Among 609 iHAWs three trajectories (profiles) were found for emotional exhaustion, work engagement, anxiety and depression. For post-traumatic stress disorder (PTSD) symptoms, four trajectories were identified. The \u2018healthy\/normative\u2019 trajectory had the largest sample size for all health indicators (73\u201386%). A stable (moderate) \u2018ill health\u2019 trajectory was identified for all health indicators (7\u201317%), except anxiety. An \u2018improving\u2019 trajectory was found for PTSD and anxiety symptoms (5\u201314%). A minority of staff (4\u201315%) worsened on all health indicators. Deterioration continued for PTSD, depressive symptoms and work engagement 2 months post-assignment. A strong sense of coherence was associated with higher odds of belonging to the \u2018healthy\u2019 trajectory. Female biological sex was associated with higher odds of belonging to the \u2018worsening\u2019 depression and anxiety trajectories. Extended duration of field assignment was related to higher odds of belonging to the \u2018worsening\u2019 depressive symptoms trajectory.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423000583_sec_a5\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>Most iHAWs stayed healthy during their assignment; a stable \u2018ill health\u2019 trajectory was identified for most health indicators. Sense of coherence is an important mechanism for understanding the health of all iHAWs in the different health trajectories, including the \u2018healthy\u2019 profile. These findings give new possibilities to develop activities to prevent worsening health and help strengthen iHAWs\u2019 ability to remain healthy under stress.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2023.58","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T08:27:06Z","timestamp":1684312026000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":6,"title":["Health trajectories of international humanitarian aid workers: growth mixture modelling findings from a prospective cohort study"],"prefix":"10.1192","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4078-1887","authenticated-orcid":false,"given":"Kaz","family":"de Jong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saara. 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