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Callaghan T, Colasante T, Muhammad S, Corbit J, Yavuz-Muren M, Raffaele C, Akter R, Al Janaideh R, Duan TY, Didkowsky N, Beuze JN, Homer B, Cameron CA, Malti T. Fostering Prosociality in Refugee Children: An Intervention With Rohingya Children. Monogr Soc Res Child Dev 2024; 89:7-109. [PMID: 39148465 DOI: 10.1111/mono.12477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 05/27/2024] [Accepted: 06/01/2024] [Indexed: 08/17/2024]
Abstract
Prosocial behavior is a distinguishing characteristic of human nature. Although prosocial behaviors emerge early in development, contextual factors play an important role in how these behaviors are manifested over development. A large body of research focuses on the trajectory of prosocial development across diverse cultures and investigating contexts that foster it. Against this backdrop of developmental research endeavoring to understand and enhance the cooperative side of humanity, is the catastrophic impact of profoundly negative forces on social-emotional development for children forced to flee from violent conflict. Close to half a million Rohingya children, whose families were forced to flee genocide in Myanmar, now live in the largest refugee camp in the world. To examine the resilience of human prosociality in the face of extreme adversity, we documented initial levels of prosociality in Rohingya refugee children living in a mega-camp (Cox's Bazar, Bangladesh) and the extent to which those levels were improved following a multifaceted intervention designed to foster prosociality. The research was a partnership between Rohingya community members with lived experience, humanitarian practitioners, and developmental researchers. A sample of 152 Rohingya children (5-12 years) participated in pre- and postintervention assessments of prosocial behaviors and related cognitive-affective processes. The 10-day collaboration-based intervention was implemented between November 2021 and January 2022 by Rohingya researchers. Birthplace was used as a proxy measure of trauma level. Children born in Myanmar (N = 88) directly experienced relatively higher levels of trauma (genocide, forced migration) than children who were born in the camp after their families fled from Myanmar (N = 64). Children were individually tested pre- and postintervention with a task battery, including a helping (Origami) and two sharing tasks (Dictator Game [DG], Forced Choice sharing) measuring prosocial behavior. Assessments of related cognitive-affective processes included measures of empathic responding and emotion perspective-taking in story tasks (Imagine, Judgment) and executive function (EF) skills (Younger: Hearts & Flowers; Older: Dimensional Change Card Sorting). Small group intervention sessions conducted over 10 days targeted these prosocial behaviors and cognitive-affective processes and were based on collaborative activities, emotion perspective taking and EF skills training with the same partner throughout the intervention phase. We used latent change modeling to examine initial levels (preintervention) and intervention-related changes in these measures from pre- to postintervention. Prosocial responding was found across all measures (preintervention) and improvements (pre- to postintervention change) were apparent across most measures. Age and birthplace variables were significant predictors of initial levels and intervention-related change. Initial levels: Regarding age, older children (9-12 years) showed higher levels than younger children (5-8 years) of sharing in the Forced Choice task but lower levels in the DG. Older children also showed higher levels of empathic responding when asked to report how they would feel and respond to another person's misfortune in the Imagine task. Regarding birthplace, prior to the intervention camp-born children showed higher levels than Myanmar-born children of helping in the Origami task and reported more behavioral responses indicating how they would respond to misfortune in the Imagine task. In contrast, Myanmar-born children had higher levels of sharing in the DG and consistently chose equality over inequality in the Forced Choice sharing task, even when their partner would receive more, indicating a pattern of generosity in these children. Myanmar-born children had lower levels than camp-born children on EF measures. Intervention-related change: Regarding age, older but not younger children were more likely to increase choices for equality over inequality on the Forced Choice sharing task following the intervention. Regarding birthplace and helping, camp-born children increased behaviors that helped their partner make origami shapes themselves ("how-to" helping), whereas Myanmar-born children increased behavior that took over folding for their partner ("do-for" helping). For sharing tasks, Myanmar-born but not camp-born children increased sharing in the DG and showed an increased pattern of generosity in Forced Choice sharing task. In the Imagine story task, children born in Myanmar were more likely than those born in camp to increase empathic responding (i.e., imagining how they would feel). Children born in Myanmar showed less improvement on EF measures than children born in the camp. Taken together, these findings provide evidence that in a context of extreme adversity, Rohingya children exhibited prosociality and benefitted from a multifaceted intervention. Our research adds credence to the view that human prosociality is a fundamental characteristic of humanity that not only survives but can be enhanced in even the most adverse of childhood environments. Our multifaceted intervention, which was implemented within a collaborative social context and targeted prosocial behaviors and related cognitive-affective processes, was designed to be easily implemented within existing psychosocial support programs in refugee contexts. As the numbers of children affected by violent conflict and forced migration rise alarmingly worldwide, there is a critical need to expand research partnerships that aim to improve developmental outcomes for these millions of children.
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Affiliation(s)
- Tara Callaghan
- Psychology Department, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | | | | | - John Corbit
- Psychology Department, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | | | - Charles Raffaele
- Educational Communication and Technology Program, Steinhardt, New York University, New York, New York, USA
| | - Rozina Akter
- Psychology Department, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Redab Al Janaideh
- Centre for Leadership and Learning, York Regional District School Board, Aurora, Ontario, Canada
| | - Tz-Yu Duan
- Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Nora Didkowsky
- Psychology Department, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | | | - Bruce Homer
- Program in Educational Psychology, The Graduate Center, City University of New York, New York, New York, USA
| | - Catherine Ann Cameron
- Psychology Department, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tina Malti
- Psychology Department, University of Toronto, Alexander von Humbolt Professor, Leipzig University, Leipzig, Germany
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Sargsyan V, Tenorio A, Uwera M, Gasirikare A, Habyarimana JA, Salcido JS, Felner C, Rasheed MA. The benefits of nurturing care interventions on early child development and care: findings from a quasi-experimental study in a humanitarian setting. BMC Pediatr 2023; 23:419. [PMID: 37620801 PMCID: PMC10463768 DOI: 10.1186/s12887-023-04239-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND The study objective was to determine if a nurturing care parenting intervention delivered in a humanitarian setting in Rwanda would benefit early development, learning, and care outcomes for young children under five years and their caregivers compared to standard care. METHODOLOGY Rwanda's Mugombwa, Kansi, and Kigeme refugee camps and host communities implemented the parenting program. Via a quasi-experimental research design, the study assessed the effects of intervention delivered as a high dose (HD: 12 group sessions and four home visits) or low dose (LD: 6 group sessions and two home visits) on child and caregiver outcomes compared to the control group from similar settings receiving standard care. The Ages and Stages Questionnaires-3 (ASQ-3) assessed child development outcomes. The Multiple Indicator Cluster Survey questionnaire assessed parenting practices concerning early learning and stimulation. FINDINGS The assessment included 733 children and families in total: HD = 314, LD = 240, control = 179. The researchers found no significant difference in child development scores between the intervention and control groups. Significantly higher proportion of caregivers exposed to HD and LD packages had engaged in early learning and stimulation practices compared to the control group, respectively, with 211(67.2%), 148 (61.7%) vs. 66 (36.9%), p < 0.001 caregivers engaged in 4 or more activities in the past three days. Similarly, on responsive feeding items, a higher percentage of HD and LD group caregivers were engaged in positive behaviours compared to the control group: 164 (52.2%), 108 (45%) vs. 62 (34.6%), p = 0.001. The study found no difference between the study arms regarding caregiver mental health. CONCLUSION Parenting programmes in humanitarian settings can improve nurturing care practices, even with a low dose, which is essential to strengthening children's resilience in at-risk conditions. Further studies in humanitarian contexts are crucial to understand the implementation needs in sensitive contexts.
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Affiliation(s)
- Viktoria Sargsyan
- World Vision International, Global Educator Sector Team, Yerevan, Armenia.
| | - Ana Tenorio
- World Vision International, Global Educator Sector Team, Yerevan, Armenia
| | | | | | | | | | - Christy Felner
- World Vision International, US Office, Washington, DC, USA
| | - Muneera A Rasheed
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Wilton KS, Murphy KM, Mahmud A, Azam S, Habib A, Ibrahim I, Della Neve E, Pena G, Mehrin SF, Shiraji S, Hamadani JD. Adapting Reach Up and Learn in Crisis and Conflict Settings: An Exploratory Multiple Case Study. Pediatrics 2023; 151:191218. [PMID: 37125885 DOI: 10.1542/peds.2023-060221k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2023] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVES In 2019, >71 million children aged <5 had spent their entire lives in conflict-affected settings. Compounding adversities including violence, poverty, and displacement have immediate and long-term effects on early childhood development, health, behavior, and well-being. In response, adaptations of Reach Up have been implemented in conflict and crisis settings. METHODS This article uses exploratory multiple case study methodology, drawing from implementation and qualitative data from 3 interventions: a mobile phone-based intervention promoting nurturing care among Rohingya and crisis-affected host communities in Bangladesh; Reach Up amid acute violence and displacement in Northeast Syria; and Reach Up group sessions and home visits integrated with health services for an indigenous population in Venezuela. RESULTS In Bangladesh, tailoring interactive voice response messages improved responsiveness to the developmental needs of young children, yet complementary in-person services were identified as a key program enhancement. In Syria, rapid adaptations of Reach Up addressed the needs of families in acute crisis, including social-emotional learning games for school-aged children. In Venezuela, Reach Up, coupled with complementary lactation counseling, yielded high rates of uptake and satisfaction, and children's language development was highlighted as a key area of growth. CONCLUSIONS Recommendations to promote early childhood development in crisis and conflict settings include: (1) cultural adaptation based on a holistic understanding of children and caregivers' needs; (2) the integration of child and family safety and linkages with complementary services on the basis of community needs and priorities, and (3) the importance of designing for scale through blended models and costing analyses.
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Affiliation(s)
| | | | - Ahsan Mahmud
- International Rescue Committee, New York, New York
| | - Syful Azam
- International Rescue Committee, New York, New York
| | - Anika Habib
- International Rescue Committee, New York, New York
| | - Iman Ibrahim
- International Rescue Committee, New York, New York
| | | | | | - Syeda Fardina Mehrin
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh
| | - Shamima Shiraji
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh
| | - Jena Derakhshani Hamadani
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh
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For the Parent, by the Parent: Creating a Program to Empower Parents of Refugee Background in Canada Using Novel Participatory Approaches. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121816. [PMID: 36553260 PMCID: PMC9777196 DOI: 10.3390/children9121816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Families of refugee background have complex, multigenerational mental health and developmental needs that are not accounted for in current programming frameworks in Canada. Providing appropriate support services and educational resources that address the unique concerns of families of refugee background will allow for improved family cohesion and developmental outcomes for children. Parenting programs have been shown to be successful in improving parental stress, parental efficacy, and children's mental health and well-being. This study gathers data about the experiences of caregivers of refugee background in order to develop a novel, multi-dimensional parenting program model using Community-Based Participatory Research (CBPR) principles. METHODOLOGY This was a qualitative, CBPR study using a formative research framework. In-depth interviews (IDIs) were conducted with caregivers of refugee background and service providers that work closely with this population. Data were recorded, transcribed, and coded using deductive and inductive coding methods by two independent coders. RESULTS A total of 20 IDIs were conducted (7 caregivers and 13 service providers). The main topics that were identified to be incorporated into the program include: features of child development, how to address resettlement issues, child advocacy, and parenting after resettlement. Participants felt that tackling language barriers, addressing the overlapping responsibilities of caregivers attending the sessions, providing incentives, increasing awareness of the program, and using an anti-racist and anti-oppressive approach was key to the program's success. Participants emphasized the need for trauma-informed mental health supports within the program model. CONCLUSION This study describes the key considerations for a novel parenting program for families of refugee background, by engaging them as key stakeholders in the program design process. Future iterations of this project would involve a pilot and evaluation of the program.
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Wolf S, Aurino E, Suntheimer NM, Avornyo EA, Tsinigo E, Behrman JR, Aber JL. Medium-term protective effects of quality early childhood education during the COVID-19 pandemic in Ghana. Child Dev 2022; 93:1912-1920. [PMID: 35818839 PMCID: PMC9349592 DOI: 10.1111/cdev.13824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The COVID‐19 pandemic led to extended school closures globally. Access to remote learning opportunities during this time was vastly unequal within and across countries. Higher‐quality early childhood education (ECE) can improve later academic outcomes, but longer‐term effects during crises are unknown. This study provides the first experimental evidence of how previously attending a higher‐quality ECE program affected child engagement in remote learning and academic scores during pandemic‐related school closures in Ghana. Children (N = 1668; 50.1% male; Mage = 10.1 years; all Ghanaian nationals) who attended higher‐quality ECE at age 4 or 5 years had greater engagement in remote learning (d = .14) in October 2020, but not better language and literacy and math scores. Previous exposure to higher‐quality ECE may support educational engagement during crises.
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Affiliation(s)
- Sharon Wolf
- Graduate School of Education, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Noelle M Suntheimer
- Graduate School of Education, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | - Jere R Behrman
- Department of Economics and Sociology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - J Lawrence Aber
- Global TIES for Children, New York University, New York City, New York, USA
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Leckman JF, Ponguta LA, Pavarini G, Hein SD, McCarthy MF, Staiti H, Hanöz-Penney S, Rubinstein J, Pruett KD, Yazgan MY, Fallon NS, Hartl FJ, Ziv M, Salah R, Britto PR, Fitzpatrick S, Panter-Brick C. Love and peace across generations: Biobehavioral systems and global partnerships. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 8:100092. [PMID: 35757671 PMCID: PMC9216554 DOI: 10.1016/j.cpnec.2021.100092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 01/02/2023] Open
Abstract
Children's environments - especially relationships with caregivers - sculpt not only developing brains but also multiple bio-behavioral systems that influence long-term cognitive and socioemotional outcomes, including the ability to empathize with others and interact in prosocial and peaceful ways. This speaks to the importance of investing resources in effective and timely programs that work to enhance early childhood development (ECD) and, by extension, reach communities at-scale. Given the limited resources currently devoted to ECD services, and the devastating impact of COVID-19 on children and communities, there is a clear need to spur government leaders and policymakers to further invest in ECD and related issues including gender and racial equity. This essay offers concrete examples of scholarly paradigms and leadership efforts that focus on child development to build a peaceful, equitable, just, and sustainable world. As scholars and practitioners, we need to continue to design, implement, assess, and revise high-quality child development programs that generate much-needed evidence for policy and programmatic changes. We must also invest in global partnerships to foster the next generation of scholars, practitioners, and advocates dedicated to advance our understanding of the bio-behavioral systems that underlie love, sociality, and peace across generations. Especially where supported by structural interventions, ECD programs can help create more peaceful, just, and socially equitable societies.
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Affiliation(s)
- James F. Leckman
- Child Study Center, Yale University, New Haven, CT, USA
- Departments of Psychiatry, Psychology and Pediatrics, Yale University, New Haven, CT, USA
- Early Childhood Peace Consortium, New York, NY, USA
- Ethox Centre, Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Liliana Angelica Ponguta
- Child Study Center, Yale University, New Haven, CT, USA
- Early Childhood Peace Consortium, New York, NY, USA
| | - Gabriela Pavarini
- Early Childhood Peace Consortium, New York, NY, USA
- Ethox Centre, Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sascha D. Hein
- Early Childhood Peace Consortium, New York, NY, USA
- Freie Universität, Berlin, Germany
| | - Michael F. McCarthy
- Child Study Center, Yale University, New Haven, CT, USA
- Early Childhood Peace Consortium, New York, NY, USA
- Warner School of Education and Human Development, University of Rochester, Rochester, NY, USA
| | | | - Suna Hanöz-Penney
- Early Childhood Peace Consortium, New York, NY, USA
- Mother Child Education Foundation (AÇEV), Istanbul, Turkey
| | - Joanna Rubinstein
- Early Childhood Peace Consortium, New York, NY, USA
- United Nations Sustainable Development Solutions Network, Paris, France
| | - Kyle D. Pruett
- Child Study Center, Yale University, New Haven, CT, USA
- Early Childhood Peace Consortium, New York, NY, USA
| | - M. Yanki Yazgan
- Child Study Center, Yale University, New Haven, CT, USA
- Early Childhood Peace Consortium, New York, NY, USA
- Güzel Günler Clinic, Istanbul, Turkey
| | - N. Shemrah Fallon
- Child Study Center, Yale University, New Haven, CT, USA
- Early Childhood Peace Consortium, New York, NY, USA
| | - Franz J. Hartl
- Early Childhood Peace Consortium, New York, NY, USA
- University Web Operations, Yale University, New Haven, CT, USA
| | - Margalit Ziv
- The International Networking Group on Peacebuilding with Young Children, Belfast, Northern Ireland, UK
| | - Rima Salah
- Child Study Center, Yale University, New Haven, CT, USA
- Early Childhood Peace Consortium, New York, NY, USA
| | - Pia Rebello Britto
- Early Childhood Peace Consortium, New York, NY, USA
- Country Representative, UNICEF, Lao’s People Democratic Republic (Lao PDR)
| | - Siobhán Fitzpatrick
- Early Childhood Peace Consortium, New York, NY, USA
- The International Networking Group on Peacebuilding with Young Children, Belfast, Northern Ireland, UK
- The Early Years – the Organization for Young Children, Belfast, Northern Ireland, UK
| | - Catherine Panter-Brick
- Early Childhood Peace Consortium, New York, NY, USA
- Jackson Institute for Global Affairs and Department of Anthropology, Yale University, New Haven, CT, USA
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A bioecocultural approach to supporting adolescent mothers and their young children in conflict-affected contexts. Dev Psychopathol 2021; 33:714-726. [PMID: 33517930 DOI: 10.1017/s095457942000156x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
An estimated 12 million girls aged 15-19 years, and 777,000 girls younger than 15 give birth globally each year. Contexts of war and displacement increase the likelihood of early marriage and childbearing. Given the developmentally sensitive periods of early childhood and adolescence, adolescent motherhood in conflict-affected contexts may put a family at risk intergenerationally. We propose that the specifics of normative neuroendocrine development during adolescence, including increased sensitivity to stress, pose additional risks to adolescent girls and their young children in the face of war and displacement, with potential lifelong consequences for health and development. This paper proposes a developmental, dual-generational framework for research and policies to better understand and address the needs of adolescent mothers and their small children. We draw from the literature on developmental stress physiology, adolescent parenthood in contexts of war and displacement internationally, and developmental cultural neurobiology. We also identify culturally meaningful sources of resilience and provide a review of the existing literature on interventions supporting adolescent mothers and their offspring. We aim to honor Edward Zigler's groundbreaking life and career by integrating basic developmental science with applied intervention and policy.
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Shahabuddin ASM, B. Sharkey A, Jackson D, Rutter P, Hasman A, Sarker M. Carrying out embedded implementation research in humanitarian settings: A qualitative study in Cox's Bazar, Bangladesh. PLoS Med 2020; 17:e1003148. [PMID: 32673316 PMCID: PMC7365392 DOI: 10.1371/journal.pmed.1003148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 06/15/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Embedded implementation research (IR) promotes evidence-informed policy and practices by involving decision-makers and program implementers in research activities that focus on understanding and solving existing implementation challenges. Although embedded IR has been conducted in multiple settings by different organizations, there are limited experiences of embedded IR in humanitarian settings. This study highlights some of the key challenges of conducting embedded IR in a humanitarian setting based on our experience with the Rohingya refugee population in Cox's Bazar, Bangladesh. METHODS AND FINDINGS We collected qualitative data in between January and July 2019. First, we visited Rohingya refugee camps and interviewed representatives from different humanitarian organizations. Second, we conducted interviews with researchers from BRAC University who were engaged with data collection and analysis in a broader embedded IR study on maternal, newborn, child, and adolescent health (MNCAH) program implementation challenges. Data were analyzed using a thematic analysis approach. Two researchers developed and agreed on codes and relevant themes based on the objectives of this study. The findings of this study highlight several challenges encountered while conducting embedded IR in the Rohingya emergency setting in Cox's Bazar, which may have implications for other humanitarian settings. The overall context of the camps was complex, with more than 100 organizations devoted to providing health services for approximately 1 million refugees. Despite the presence of the Bangladesh government, United Nations agencies and other international organizations played key roles in making programmatic and policy decisions for the Rohingya. Because health service delivery modalities and policies and related implementation challenges for MNCAH programs for the refugees changed rapidly, the embedded IR approach used was flexible and able to adapt to changes identified, with research questions and methods modified accordingly. Access to the camps, reaching Rohingya respondents, overcoming language barriers in order to get quality information, and the limited availability of local research collaborators were additional challenges. Working with researchers or research institutes that are familiar with the context and have experience in conducting implementation and health systems research can help with collection of quality data, identifying key stakeholders and bringing them on board to ensure the execution of the project, and ensuring utilization of the research findings. Study limitations include possible constraints in generalizing our conclusions to other humanitarian settings. Implementation research conducted in additional humanitarian settings can contribute to the evidence on this topic. CONCLUSIONS Findings indicate that embedded IR can be done effectively in humanitarian settings if the challenges are anticipated, and appropriate strategies and in-country partners put in place to address or mitigate them, before commencing the funding or starting of the project. Understanding the context and analyzing the role of relevant stakeholders prior to conducting the research, considering a simple descriptive method appropriate to answering real-time IR questions, and working with local researchers or research institutes with specific skill sets and prior experience conducting research in humanization contexts may reduce costs and time spent, and ensure collection of quality data relevant for policy and practice.
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Affiliation(s)
- A. S. M. Shahabuddin
- Implementation Research and Delivery Science Unit, Health Section, UNICEF, New York, New York, United States of America
- * E-mail:
| | - Alyssa B. Sharkey
- Implementation Research and Delivery Science Unit, Health Section, UNICEF, New York, New York, United States of America
| | - Debra Jackson
- Implementation Research and Delivery Science Unit, Health Section, UNICEF, New York, New York, United States of America
| | - Paul Rutter
- Health Section, UNICEF Regional Office for South Asia, Kathmandu, Nepal
| | - Andreas Hasman
- Health Section, UNICEF Regional Office for South Asia, Kathmandu, Nepal
| | - Malabika Sarker
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
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Lakkis NA, Osman MH, Aoude LC, Maalouf CJ, Issa HG, Issa GM. A Pilot Intervention to Promote Positive Parenting in Refugees from Syria in Lebanon and Jordan. Front Psychiatry 2020; 11:257. [PMID: 32372979 PMCID: PMC7179657 DOI: 10.3389/fpsyt.2020.00257] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/17/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Early childhood development (ECD) is a crucial milestone that shapes a child's health, wellbeing, education, and personality. Several factors come into play, and each requires the nurturing care of caregivers. Although the importance of ECD is well understood, the implementation of ECD programs is scarce, especially in poor and vulnerable communities. OBJECTIVE To improve parents' wellbeing, parenting stress levels, parenting behavior, and discipline strategies after the implementation of a newly designed parenting intervention. PARTICIPANTS AND SETTING Parents from Syria (125 mothers and fathers) in three refugee camps in Lebanon and Jordan. METHODS This was a pilot cohort study in which parents' wellbeing, parenting stress levels, parenting behavior, and discipline strategies were evaluated before and after participating in training in the form of interactive and educational sessions to ameliorate their relations and interactions with their children. RESULTS By the end of this study, parents' mental health and wellbeing improved (p < 0.001, Cohen's d: 0.61) and their parenting index score was reduced (p < 0.001, Cohen's d: 1.24). Some of their dysfunctional interactions with their children as well as the perceived difficulties and conduct problems in their children aged 3 to 6 years were also reduced significantly. CONCLUSION The intervention used in this study succeeded in improving some aspects of parenting practices and disciplines and in improving the parents' wellbeing; however, more research is needed to assess its long-term effects on parents and their children. Moreover, some adjustments need to be made in the intervention to be more adapted to the context of refugees and underprivileged communities.
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Affiliation(s)
- Najla A. Lakkis
- Department of Family Medicine, American University of Beirut Medical Center (AUB-MC), Beirut, Lebanon
| | - Mona H. Osman
- Department of Family Medicine, American University of Beirut Medical Center (AUB-MC), Beirut, Lebanon
| | | | | | - Hanane G. Issa
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Ponguta LA, Issa G, Aoudeh L, Maalouf C, Nourallah S, Khoshnood K, Zonderman AL, Katsovich L, Moore C, Salah R, Al‐Soleiti M, Britto PR, Leckman JF. Implementation Evaluation of the Mother‐Child Education Program Among Refugee and Other Vulnerable Communities in Lebanon. New Dir Child Adolesc Dev 2019; 2019:91-116. [DOI: 10.1002/cad.20314] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Milner KM, Bernal Salazar R, Bhopal S, Brentani A, Britto PR, Dua T, Gladstone M, Goh E, Hamadani J, Hughes R, Kirkwood B, Kohli-Lynch M, Manji K, Ponce Hardy V, Radner J, Rasheed MA, Sharma S, Silver KL, Tann C, Lawn JE. Contextual design choices and partnerships for scaling early child development programmes. Arch Dis Child 2019; 104:S3-S12. [PMID: 30885961 PMCID: PMC6557220 DOI: 10.1136/archdischild-2018-315433] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/18/2018] [Accepted: 01/18/2019] [Indexed: 12/29/2022]
Abstract
Translating the Nurturing Care Framework and unprecedented global policy support for early child development (ECD) into action requires evidence-informed guidance about how to implement ECD programmes at national and regional scale. We completed a literature review and participatory mixed-method evaluation of projects in Saving Brains®, Grand Challenges Canada® funded ECD portfolio across 23 low- and middle-income countries (LMIC). Using an adapted programme cycle, findings from evaluation related to partnerships and leadership, situational analyses, and design for scaling ECD were considered. 39 projects (5 'Transition to Scale' and 34 'Seed') were evaluated. 63% were delivered through health and 84% focused on Responsive Caregiving and Early Learning (RCEL). Multilevel partnerships, leadership and targeted situational analysis were crucial to design and adaptation. A theory of change approach to consider pathways to impact was useful for design, but practical situational analysis tools and local data to guide these processes were lacking. Several RCEL programmes, implemented within government services, had positive impacts on ECD outcomes and created more enabling caregiving environments. Engagement of informal and private sectors provided an alternative approach for reaching children where government services were sparse. Cost-effectiveness was infrequently measured. At small-scale RCEL interventions can be successfully adapted and implemented across diverse settings through processes which are responsive to situational analysis within a partnership model. Accelerating progress will require longitudinal evaluation of ECD interventions at much larger scale, including programmes targeting children with disabilities and humanitarian settings with further exploration of cost-effectiveness, critical content and human resources.
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Affiliation(s)
- Kate M Milner
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UK
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Raquel Bernal Salazar
- Economics Department, Universidad de los Andes, Bogota, Colombia
- Centro de Estudios de Desarrollo Economico (CEDE), Universidad de los Andes, Bogota, Colombia
| | - Sunil Bhopal
- Maternal & Child Health Intervention Research Group, Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Northern School of Paediatrics, Newcastle-upon-Tyne, UK
| | - Alexandra Brentani
- Departamento de Pediatria, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Tarun Dua
- Department of Mental Health and Substance Abuse, World Health Organisation, Geneva, Switzerland
| | - Melissa Gladstone
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Esther Goh
- Bernard van Leer Foundation, The Hague, The Netherlands
| | - Jena Hamadani
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, Bangladesh
| | - Rob Hughes
- Maternal & Child Health Intervention Research Group, Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Children's Investment Fund Foundation, London, UK
| | - Betty Kirkwood
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Maya Kohli-Lynch
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Karim Manji
- Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Victoria Ponce Hardy
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - James Radner
- Munk School of Global Affairs and Public Policy, University of Toronto, Toronto, Ontario, Canada
- Center on the Developing Child, Harvard University, Cambridge, Massachusetts, USA
| | | | | | | | - Cally Tann
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UK
- Neonatal Medicine, University College London Hospitals NHS Trust, London, UK
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UK
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12
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Yousafzai AK, Aboud FE, Nores M, Kaur R. Reporting guidelines for implementation research on nurturing care interventions designed to promote early childhood development. Ann N Y Acad Sci 2018; 1419:26-37. [DOI: 10.1111/nyas.13648] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/25/2018] [Accepted: 02/05/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Aisha K. Yousafzai
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health; Harvard University; Boston Massachusetts
| | - Frances E. Aboud
- Department of Psychology; McGill University; Montreal Quebec Canada
| | - Milagros Nores
- National Institute for Early Education Research; Rutgers University; New Brunswick New Jersey
| | - Raghbir Kaur
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health; Harvard University; Boston Massachusetts
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13
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Britto PR, Singh M, Dua T, Kaur R, Yousafzai AK. What implementation evidence matters: scaling-up nurturing interventions that promote early childhood development. Ann N Y Acad Sci 2018; 1419:5-16. [DOI: 10.1111/nyas.13720] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 03/19/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Pia R. Britto
- Early Childhood Development; UNICEF; New York New York
| | | | - Tarun Dua
- Department of Mental Health and Substance Abuse; World Health Organization; Geneva Switzerland
| | - Raghbir Kaur
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health; Harvard University; Boston Massachusetts
| | - Aisha K. Yousafzai
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health; Harvard University; Boston Massachusetts
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