Development and evaluation of a tailored mHealth parenting program for multicultural families: a three-arm cluster randomized controlled trial

Objective

Health management of children during early childhood requires substantial information. Multicultural families find it difficult to obtain and use parenting-relevant information for their young children. This study aimed to develop, implement, and evaluate a tailored Health parenting program and lay-health workers' support to improve children's health in multicultural families in Korea.

Methods

In this study, we employed the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model as the conceptual framework, guiding the creation of a tailored mHealth application supplemented by a lay-health worker support module. The efficacy of the program was assessed through an experimental three-arm cluster randomized controlled trial. A total of 101 participants were stratified into three distinct groups as follows: (1) Experimental Group A, which received the mHealth program alongside the lay-health worker support component; (2) Experimental Group B, exposed solely to the mHealth program; and (3) Control Group, devoid of any intervention. Within these groups, 101 marriage migrant women hailing from Vietnam, the Philippines, and China were incorporated, with each group comprising 33, 30, and 38 participants, respectively. The study's primary endpoint encompassed a comprehensive assessment of health-promoting behaviors, proficiency in eHealth literacy, and the family strength.

Results

The analysis revealed noteworthy interactions among the three distinct groups over the course of time, with implications for health-promotion behaviors (p = 0.041), eHealth literacy (p = 0.037), and family strength (p = 0.044). Specifically, the experimental groups exhibited substantially elevated levels of the specified outcome variables when contrasted with the control group. Notably, the positive effects persisted even up to 12 weeks subsequent to the conclusion of the intervention, underscoring the program's capacity to foster enduring improvements in the observed metrics.

Conclusion

This study highlights the benefits of offering contextually appropriate information to target groups constrained by challenges in information access, evaluation, and utilization. Notably, drawing from their positive experiences in this process, we underscore the importance of employing lay health workers. These workers play a crucial role in fostering and ensuring sustained behavioral changes.

Resilience in Multicultural Families of Children With Disabilities in Korea: A Path Analysis Using National Data

PURPOSE

The number of multicultural families has increased globally, and Korea has also witnessed a surge. Along with the various challenges experienced by these families, a child with a disability can pose additional challenges. In-depth knowledge about resilience factors among multicultural families of children with disabilities is important. The aim of this study was to examine relationships between family demands, family appraisals, family problem solving and coping, family resources, and family adaptation in multicultural families of children with disabilities in Korea as perceived by married immigrants.

DESIGN

This study was based on a secondary analysis of national survey data in 2015 and 2018 in Korea.

METHODS

A total of 256 multicultural families who have children with disabilities participated. Family demands were identified by examining marital conflict, cultural differences, marital status, and public assistance recipient households. Family appraisal was assessed by how the family perceived the married immigrant's culture. Family problem solving and coping were examined by how actively a married immigrant participated in social activities. Family resources were assessed by examining Korean language competency and the health status of immigrants. Family adaptation was identified by how immigrants perceived their life satisfaction. Path analysis was used to assess the factors.

FINDINGS

Family demands had a direct impact on family resources and family adaptation. Family appraisal had a direct impact on family adaptation. Family resources mediated the effect of family demands on family adaptation.

CONCLUSIONS

This study demonstrated that although a multicultural family of a child with a disability struggles with family demands, if the family receives positive resources from family members, they can adapt well. Current findings can be used to develop interventions that can foster greater resilience among families.

CLINICAL RELEVANCE

This study provides evidence that nurses can target modifiable family aspects, including immigrants' health and family perceptions of immigrants' cultures identified in this study to enhance the immigrant and family adaptation.

Immigrant Vietnamese women's adaptation to culture and society in rural areas of Korea

BACKGROUND

International marriages between Vietnamese women and Korean men have increased rapidly in Korea. Successful adaptation of these women is challenging, and concerns on the issue have been raised. Most existing studies have surveyed Vietnamese immigrant women in urban Korea; less is known about women residing in rural areas of Korea. Uncovering the experiences and perspectives of these women can inform the design of community support resources. The purpose of this study was to identify a typology to effectively describe the subjective perspectives of Vietnamese women residing in rural Korea on adaptation to Korean culture and society.

METHODS AND RESULTS

A Q-methodological study was conducted with five steps: construction of the concourse, Q sample, selection of participants, Q-sorting, and data analysis. Twenty-six Vietnamese women married to Korean men who attended local public health centers were surveyed and asked to rank-order 39 Q-statements using a 9-point scale. Principal component factor analysis using a pc-QUANL program was performed to identify adaptation sub-types. Four types of adaptation were identified and labeled: positive adaptation (35.54%), passive adaptation with reservations (8.33%), adaptation with frustration (6.20%), and adaptation and involvement (5.33%). These four types explained 55.40% of the total variance in the women's experience of adaptation to Korean culture and society.

CONCLUSIONS

This study provides data that may be helpful in understanding the challenges immigrant women in rural areas of Korea face, and in planning family-sensitive adaptation support programs for these women and their families.

Developing Parenting Stress Scale for International Marriage Immigrant Women in South Korea: Focused on Vietnamese and Filipino Marriage Immigrant Women

PURPOSE

The purpose of this study was to develop a scale to evaluate parenting stress of international marriage immigrant women from Vietnam and the Philippines.

METHODS

The concept of parenting stress of international marriage immigrant women was analysed with a hybrid model. Data were collected from 273 international marriage immigrant women from Vietnam and the Philippines who were raising their children aged 1 to 6 years. These collected data were subjected to exploratory factor analysis, multitrait/multi-item matrix assessment, Pearson correlation coefficient analysis, and Cronbach's alpha internal consistency measurement.

RESULTS

The final instrument consisted of 28 items. The following six factors were extracted by exploratory factor analysis: 'insufficiency of parenting support system', 'role burden of mothers', 'maladjustment of children', 'confusion of parenting methods due to cultural differences', 'unskilled Korean communication', and 'ordinary difficulties'. Construct validity (factor analysis, convergent validity, and discriminant validity) and criterion-related validity were confirmed. Cronbach's α value of total items was .92(95% CI .91-.94). Cronbach's α of values for these factors ranged from .76 to .85.

CONCLUSION

The parenting stress scale for international marriage immigrant women is a valid and reliable tool.

Factors Influencing Depression in Married Immigrant Women in Korea

PURPOSE

The purpose of this study was to identify the factors influencing depression of married immigrant women in Korea.

METHODS

Participants included 127 married immigrant women who met eligibility criteria and agreed to participate in the study. Participants were evaluated for subjective assessment of married immigrant-related constructs using a self-report questionnaire, for depression, acculturation stress, and social support. The analysis was done using SPSS for Windows, version 18.0, and included stepwise regression.

RESULTS

The major findings were as follows; 1) Depression significantly differed according to native country, length of residence in Korea, education, family monthly income, household and primary support. 2) There were significant relationships between marital life satisfaction (r=-.80, p<.001), acculturative stress (r=.78, p<.001), and social support (r=-.20, p = .025). 3) Marital life satisfaction, family monthly income, acculturative stress, primary support and social support were significant factors, which explained 84.6% of the variance in depression (F=138.04, p<.001). Multiple regression analysis revealed that a powerful predictor of depression for married immigrant women was marital life satisfaction.

CONCLUSION

Based upon the findings, this study provides useful information that could assist in reducing depression among married immigrant women, and indicates that nursing interventions are needed.

[Effects of Korean proficiency and parent-child cohesion on self-esteem and acculturation among children from multicultural families]

PURPOSE

There is evidence that parent-child cohesion is a potentially influential factor in children's self-esteem and acculturation. However, no research to date has examined cohesion with parents as a potential pathway between Korean proficiency and self-esteem or acculturation among children from multicultural families. This study was done to address these limitations by examining whether and to what extent cohesion with parents mediated the effect of Korean proficiency on self-esteem and acculturation among children from multicultural families.

METHODS

Data were collected from a sample of 138 mothers and their children living in Seoul, Daegu, Kyungi province, and Kyungpook province. Multiple regression analysis was used to examine the relationships between the variables of interest. Mediation effects of cohesion with parents were tested by following the procedure recommended by Baron and Kenny (1986).

RESULTS

Cohesion with parents partially mediated the relationship between Korean proficiency and self-esteem. For children's acculturation, the effect of Korean proficiency was partially mediated through father-child cohesion. Mother-child cohesion completely mediated the relationship between Korean proficiency and acculturation.

CONCLUSION

These findings suggest that to help children from multicultural families experiencing difficulties with self-esteem or acculturation, it might be useful to develop programs that are aimed at strengthen cohesion with parents.