Miller Kenneth E, Ghalayini Heba, Arnous Maguy, Tossyeh Fadila, Chen Alexandra, van den Broek Myrthe, Koppenol-Gonzalez Gabriela V, Saade Joy, Jordans Mark J D
War Child Holland, Amsterdam, The Netherlands.
War Child Holland, Gaza, Palestine.
Glob Ment Health (Camb). 2020 Jun 2;7:e14. doi: 10.1017/gmh.2020.8. eCollection 2020.
There is robust evidence that compromised parenting, stemming from persistently high stress, mediates the impact of war and displacement on children's mental health and psychosocial wellbeing. Parenting interventions generally prioritize the acquisition of parenting knowledge and skills, while under-attending to parental stress and distress. This paper describes the development of the Caregiver Support Intervention (CSI), a nine-session group intervention for conflict-affected parents of children aged 3-13, that aims to strengthen parenting both indirectly, by lowering stress and improving psychosocial wellbeing among parents, and directly, by increasing knowledge and skill related to positive parenting.
We describe the multi-phase, iterative process by which we developed the CSI, and illustrate the essential role of community input in shaping the intervention and strengthening its cultural fit and perceived usefulness. We used focus group data from participants in successive cycles of implementation, feedback, and revision, as well as quantitative data and expert consultation to develop a culturally and empirically grounded intervention.
This mixed-method, iterative approach to intervention development enabled us to develop a psychosocial intervention for conflict-affected caregivers that is feasible, acceptable, and perceived by participants as useful in addressing their own wellbeing and their parenting. Focus group data support the underlying model in which caregiver wellbeing powerfully influences parenting.
Programs aimed at strengthening parenting in conflict-affected communities should substantively address caregiver wellbeing. An iterative approach incorporating community feedback can help ensure intervention acceptability and feasibility. We also illustrate the feasibility of involving men in parenting interventions.
有充分证据表明，持续的高压力导致的养育方式不当，在战争和流离失所对儿童心理健康和社会心理福祉的影响中起到了中介作用。养育干预通常将获取养育知识和技能作为优先事项，而对父母的压力和痛苦关注不足。本文描述了照顾者支持干预（CSI）的开发过程，这是一种针对3至13岁儿童的受冲突影响父母的九节小组干预，旨在通过降低父母的压力和改善其社会心理福祉来间接加强养育，并通过增加与积极养育相关的知识和技能来直接加强养育。
我们描述了开发CSI的多阶段迭代过程，并说明了社区投入在塑造干预措施、加强其文化适应性和感知有用性方面的重要作用。我们使用了来自连续实施、反馈和修订周期参与者的焦点小组数据，以及定量数据和专家咨询，来开发一种基于文化和实证的干预措施。
这种混合方法的迭代式干预开发方法使我们能够为受冲突影响的照顾者开发一种社会心理干预措施，该措施可行、可接受，并且参与者认为对解决他们自己的福祉和养育问题有用。焦点小组数据支持了照顾者福祉对养育有强大影响的潜在模型。
旨在加强受冲突影响社区养育的项目应切实解决照顾者的福祉问题。纳入社区反馈的迭代方法有助于确保干预措施的可接受性和可行性。我们还说明了让男性参与养育干预的可行性。
