University of Oxford Unveils Results of Groundbreaking Study in The Lancet, Validates World Relief’s Collaborative Hope Groups Approach

Study conducted in one of the first randomized controlled trials held in wartime conditions finds parental support groups in Ukraine cut violence against children in half, reduced depression and anxiety, increased hope

Contact: Lauren Rasmussen, media@wr.org, 802.310.4255

BALTIMORE, Md. – Today, the results of a wartime randomized controlled trial conducted by the University of Oxford studying a program designed, implemented, evaluated and replicated by World Without Orphans and World Relief in partnership with local refugee shelters, churches, charities and virtually, was unveiled in Lancet Regional Health Europe. Ukrainian parents who participated in Hope Groups programming, designed for families with active or recent exposure to conflict, reported violence against children reduced by half and reported less than half the anxiety and depression symptoms of parents who had not participated in the programming.

Over 117 million people have been forced to flee their homes, and in 2024, one in five children around the world was living in a conflict zone. The longer a crisis, the deeper the toll on children and caregivers, and decades of research documents the lifelong consequences of childhood trauma. Rather than waiting until a family reaches stability, it’s essential that parents are given the tools and support to take care of themselves and their children, even in the worst of circumstances.

To support families’ mental and physical wellbeing, World Relief – together with World Without Orphans, the University of Oxford, Imperial College London, VIVA Together for Children, the Global Reference Group for Children Affected by Crisis and local organizations worldwide – launched the Global Hope Groups Collaborative in 2025, with an aim to rapidly extend and replicate this evidence-based program within and beyond Ukraine. The Collaborative, through the Hope Groups model, brings the best of emergency crisis response technical programming in health, shelter and food, guided by the best of emerging science around how best to strengthen families and children in crisis. During the ‘early adopters’ period of 2025-2026, which World Relief has led, Hope Groups programming has reached 40,000 individuals – including children and their caregivers – in 32 countries and 5 languages.

“Over its 80 years, World Relief has been committed to serving those in crisis in the hardest-to-reach places in partnership with the church, and we are grateful to serve as the incubator for and the first international NGO implementor to offer the innovative Hope Groups model to the families we and our partners serve,” commented Lanre Williams-Ayedun, senior vice president of international programs at World Relief. “The results of the trial conducted by University of Oxford and published by Lancet Regional Health Europe illustrate the urgency of reaching families at the point of crisis and not waiting until circumstances have improved. We firmly believe that even in the worst moments, it’s possible to have hope, and these results prove that.”

Hope Groups’ 12-session programming was adapted to Ukrainian parents seeking to care for their children and keep them safe while grappling with their own trauma, grief and loss following the Russian invasion of Ukraine in 2022. Meetings take place in groups of five to seven in shelters, community centers, churches or homes when it is sufficiently safe, or over Telegram video calls when risk increases. Sessions are led by local facilitators recruited and trained through churches and community organizations.

To measure the effectiveness, researchers at Oxford’s Department of Social Policy and Intervention designed a randomized controlled trial of 510 parents and caregivers, conducting and evaluating the study in wartime conditions in partnership with Ukrainian facilitators, local Ukrainian organizations, World Without Orphans, and World Relief. It is among the first randomized trials to test whether group-based mental health, parenting and violence prevention programming can be effective during an active war across five key outcomes. The trial demonstrates that this is the only intervention published to date that is effective in a conflict setting across all five of the following outcomes: 1) parental depression and anxiety and 2) violence against children; 3) child behavioral issues and depression; 4) parenting practices; and 5) parental hopefulness amidst crisis and spiritual strength.

The parents in the trial were a mix of those displaced abroad, those displaced within Ukraine, and those still at home in areas under regular military attacks. At the start, around half met the clinical threshold for depression and around half for anxiety. Over three quarters went on to complete all 12 sessions, strikingly high continued participation for a population facing active war.

Compared with parents who did not receive programming, parents who participated in Hope Groups reported the following changes by the end of their sessions:

• 52.7% less physical or emotional violence against children
• 57.4% lower levels of depression and anxiety symptoms among parents and caregivers
• 33.1% stronger protective parenting practices
• 65.4% higher hopefulness about the future and coping with grief
• 56% lower levels of behavioral issues among their children
• 69% higher levels of behaviors to prevent violence against women

“These findings reinforce what we’ve been seeing on the ground: the combination of listening to crisis-affected caregivers, connecting them with global experts and collaborating with affected populations to adapt the Hope Groups programming’s sessions to a community’s context leads to enduring results,” commented Dr. Susan Hillis, co-chair of the Global Reference Group for Children in Crisis and co-lead for development and evaluation of the Hope Groups model. “Compared to other parenting interventions, no other study has shown outcomes this promising in the categories measured, and no other programming seeks to address issues of enduring hope in its subjects.”

As programming is ongoing, emerging evidence from ongoing studies shows the impacts are present long-term, as far out as 12 months after the program began. The trial’s researchers are calling on donors and humanitarian agencies to fund parenting and caregiver mental health support as a standard part of the response to war and displacement, rather than waiting for peace.

Over the next three years, the Global Hope Groups Collaborative is seeking to reach over 550,000 caregivers and children in regions facing massive crises, expanding through country-specific support, church networks in the U.S. and Brazil and through network capacity building. As the Collaborative scales to reach more families affected by crisis in distinct contexts – such as in the aftermath of Latin American earthquakes, or a church-based volunteer model in Brazil, or restoration after the war in Gaza – monitoring will continue to ensure program fidelity and maintained effectiveness to improve all key outcomes, strengthening millions affected by war and crisis together with global partners.

Full results can be found in the study, ‘Effectiveness of the Hope Groups Intervention on Mental Health, Parenting Practices, and Violence Against Children among Ukrainian Parents and Caregivers Affected by War and Displacement: A Cluster Randomised Controlled Trial’, which is published in Lancet Regional Health Europe and available at https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(26)00195-X/fulltext.