War Child Holland, Helmholtzstraat 61g, 1098LE Amsterdam, The Netherlands.
War Child Holland, Lebanon.
Child Abuse Negl. 2020 Aug;106:104512. doi: 10.1016/j.chiabu.2020.104512. Epub 2020 May 11.
The impact of armed conflict and displacement on children's mental health is strongly mediated by compromised parenting stemming from persistently high caregiver stress. Parenting interventions for refugees emphasize the acquisition of parenting knowledge and skills, while overlooking the deleterious effects of chronic stress on parenting. War Child Holland's Caregiver Support Intervention (CSI) aims to strengthen parenting by lowering stress and improving psychosocial wellbeing among refugee parents, while also increasing knowledge and skill related to positive parenting. The CSI is a nine-session group intervention delivered by non-specialist providers.
We describe the findings of a two-arm pilot randomized controlled trial of the CSI with Syrian refugees in Lebanon. The primary aim was to test the feasibility of our study methodology prior to conducting a definitive RCT.
We recruited 78 families (151 parents), who were randomized to the CSI or a waitlist control group. Data were collected at baseline and post-intervention.
Randomization was successful, retention was high (99 %), as was intervention completion (95 % among women, 86 % among men). Implementation fidelity was excellent. Blinding was largely, though not completely effective. The CSI group showed significantly increased parental warmth and responsiveness, decreased harsh parenting, lowered stress and distress, improved psychosocial wellbeing, and improved stress management. CSI parents reported increased child psychosocial wellbeing. Control families showed no significant change on any variable.
Findings demonstrate the feasibility of our methodology for a definitive RCT, and suggest that the CSI shows promise as a scalable approach to strengthening parenting in refugee communities. Trial registration # ISRCTN33665023.
武装冲突和流离失所对儿童心理健康的影响在很大程度上受到持续高照料者压力导致的育儿能力受损的影响。难民的育儿干预强调育儿知识和技能的获得，而忽略了慢性压力对育儿的有害影响。荷兰战争儿童组织的照顾者支持干预（CSI）旨在通过降低压力和改善难民父母的心理社会幸福感来加强育儿能力，同时提高与积极育儿相关的知识和技能。CSI 是一项由非专业人员提供的九节小组干预措施。
我们描述了在黎巴嫩对叙利亚难民进行 CSI 的两臂试点随机对照试验的结果。主要目的是在进行确定性 RCT 之前测试我们研究方法的可行性。
我们招募了 78 个家庭（151 名父母），他们被随机分配到 CSI 或候补对照组。在基线和干预后收集数据。
随机化成功，保留率高（99%），完成率也高（女性 95%，男性 86%）。实施保真度极佳。尽管不完全有效，但大部分情况下的盲法是有效的。CSI 组的父母表现出明显增加的温暖和响应能力，减少了严厉的育儿方式，降低了压力和困扰，改善了心理社会幸福感，并改善了压力管理。CSI 父母报告说孩子的心理社会幸福感有所提高。对照组在任何变量上均未显示出显著变化。
研究结果表明，我们的方法对于确定性 RCT 是可行的，并表明 CSI 有望成为加强难民社区育儿能力的可扩展方法。试验注册号 ISRCTN33665023。
