Parenting interventions for families with refugee backgrounds: a randomized factorial, mixed-methods design study protocol

Abstract

Background Raising children in new social and cultural contexts can be challenging for parents. In order to help parents address these challenges, the Norwegian government has instituted a policy of mandatory parent training for families who settle in Norway as refugees. The Incredible Years (IY) and The International Child Development Programme (ICDP) have been widely adopted throughout Norway. They have similar aims: to improve parenting through positive parenting practices and development of attachment behaviors. We will evaluate the use of these programs and a measurement feedback system (MFS) to give regular feedback to interventionists about parents’ progress during the course of the parenting intervention. Methods The study is a mixed method, randomized factorial design aimed at evaluating the effect of parenting interventions and the use of feedback to address parental stress, child behavior, resilience, and parents’ mental health. Factor 1 is based on random assignment to one of the parenting interventions IY or ICDP. The parenting interventions are delivered over 15 weeks (IY) or 12 weeks (ICDP) in group-based settings. Factor 2 is based on random assignment of the parenting groups to the (a) with MFS or (b) without MFS condition. The MFS is answered weekly via a phone app, MittEcho, and results are sent to group leaders in the MFS condition. Additionally, the study explores the experiences of families settling in a new cultural context and participating with parenting programs via qualitative interviews. Participants will be recruited from a population of parents with children between the age of 6 and 12 years who settled in Norway as refugees within the previous 9 years. The target sample size is N = 360; n (IY) = 180, n (ICDP) = 180 families. This study is a collaboration between first-line, municipal services; their national governing agencies; family representatives; and a national network of research organizations. Discussion This study endeavors to provide information about what helps families with refugee background integrate successfully into new cultural contexts with different laws, norms, and expectations. Whether or not these interventions can help to normalize this experience, reduce stress, and provide parents with new tools to improve their parenting and the lives of their children are important questions which we address. These findings can lead to the further establishment of evidence-based practices in Norway. Trial registration ISRCTN35008070. Registered on February 24, 2020

Knowledge of legal rights as a factor of refugee and asylum seekers’ health status: a qualitative study

“…This observation is consistent with other qualitative research studies with displaced persons 36 37 39 40. All participants were provided a gift card to remove any monetary barriers to participation related to missing work obligations and incurring expenses while travelling to the interview site 45–53. This compensation mechanism could have introduced participation bias.…”

“…Participants received a $60 USD gift card for their time and travel on completion of the interview, as has been done previously in our own studies and in multiple qualitative studies with refugees and asylum seekers in highincome countries. [45][46][47][48][49][50][51][52][53] The audio-recorded interviews were transcribed verbatim. Identifying information was removed from each transcript and then saved on a secure server.…”

“…Interviews lasted 45–75 min and were audio-recorded. Participants received a $60 USD gift card for their time and travel on completion of the interview, as has been done previously in our own studies and in multiple qualitative studies with refugees and asylum seekers in high-income countries 45–53. The audio-recorded interviews were transcribed verbatim.…”

“…36 37 39 40 All participants were provided a gift card to remove any monetary barriers to participation related to missing work obligations and incurring expenses while travelling to the interview site. [45][46][47][48][49][50][51][52][53] This compensation mechanism could have introduced participation bias. Thus, the characteristics of participants may differ from those who chose not to participate (e.g., age, employment).…”