Speakers
Description
Authors: Joshua Patras (The Regional Centre for Child and Youth Mental Health), June T. Forsberg (UiT – The Arctic University of Norway), Mer Saus (UiT – The Arctic University of Norway), Pål Wessel (UiT – The Arctic University of Norway), Ragnhild Bjørknes (The Norwegian Center for Child Behavioral Development, Oslo, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE, Bergen, Norway), Therese B. Halvorsen (UiT – The Arctic University of Norway), Lene-Mari Potulski Rasmussen (UiT - The arctic university of Norway), Marcela Douglas (UiT The Arctic University of Norway)
Chair: Lene-Mari, P. Rasmussen
Discussant: Ragnhild Bjørknes
Presenter/Corresponding author: Lene-Mari. P. Rasmussen
Description of the symposium:
This symposium focuses on different aspects that arise when refugee and immigrant families are being resettled in a new country, especially in relation to parenting interventions. In the Supported Parenting Interventions for Refugee Minorities study (the PIRM-study), we have investigated the effectiveness of two parenting interventions, together with a measurement feedback system (MFS) in a full 2x2 factorial design with nearly 300 parents. In addition to answering questionnaires, both parents and children have been interviewed to provide a more in-depth understanding of the family’s experiences when coming to a new country and being obliged to participate in a preventive parenting intervention.
Through the different presentations, the current state of the field based on a recent meta-analysis will be presented together with the preliminary results from the effectiveness trial. Results from the effectiveness trial are based on reports from over 200 families and nearly 300 parents altogether. Initial findings from the parenting interventions and the MFS will be presented, along with qualitative results focusing on how the parents and children experience the parents’ participation in the intervention. Lastly, the implications of the study results for practice and implementation will be discussed.
Abstract 1
Parenting interventions for refugee and immigrant families: The current state of the field
Ragnhild Bjørknes (The Norwegian Center for Child Behavioral Development, Oslo, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE, Bergen, Norway)
Background: Migration stressors can significantly impact parental care, placing immigrant and refugee families in vulnerable situations due to challenges like acculturation, poverty, and reduced family functioning. These contextual risk factors detrimentally affect parenting practices and children's development. Strengthening positive parenting practices through parental programs could be essential in improving life for families. However, implementing parental programs also calls for evidence-based research. This review analyzes randomized controlled studies on parenting interventions for refugee and immigrant families in Europe, focusing on those based on social learning theory.
Methods: This study includes a systematic review and a meta-analysis. Studies included in the analysis had to employ parenting programs based on social learning theory, including immigrant families, and conducted in Europe. We followed PRISMA guidelines and pre-registered the review with PROSPERO. A search through nine databases identified 8,286 publications.
Results: Seven studies met the inclusion criteria, and they were published between 2010 and 2017. The meta-analysis showed a small but significant effect of parent training on child behavior and parenting styles, with effect sizes of 0.26, 0.24, and 0.20, respectively. However, the systematic review highlighted that few studies have addressed migration or cultural factors in family life, hindering future program development.
Discussion: This systematic review highlights the lack of studies addressing migration and cultural factors in family life, which hinders program development for immigrant families. The meta-analysis found a small but significant overall effect on child problem behaviors and parenting favoring parent training compared to control conditions. Key topics like cultural adaptation and intersectionality are emphasized to improve evaluators and planners’ practices in prevention research. Further evidence on the effects of parental programs for immigrant and refugee families in Europe is necessary.
Abstract 2
Characteristics of parents and children coming to Norway as refugees
Pål Wessel (UiT – The Arctic University of Norway)
Background: Resettlement in a new country can be experienced as challenging, and some may need support to navigate and adapt to new surroundings. Parental stress and child problem behavior are potential risk factors for newly resettled families. On the other hand, protective factors, such as resilience, are also valuable to focus on during a resettlement process. Acquiring more knowledge about the characteristics of the families is important to tailor and support their needs when they are rebuilding their lives in a new country.
Methods: Using quantitative methods, we aimed to examine characteristics of the participating families before receiving parent intervention. Demographic characteristics were analyzed, and descriptive statistics were generated using the Parenting Stress Index-Short form (PSI-SF), Eyberg Child Behavior Inventory (ECBI), and Resilience Scale for Adolescents (READ).
Results: A total of 278 parents (68 % mothers) participated, and 196 children (57 % boys) were assessed by their parents using the ECBI. The results showed that most of the families had fled, in order of frequency (high to low), from Ukraine, Syria, Eritrea, and DR Congo. Most families reported having lived in Norway for two years or less and being full-time participants in the national Introduction Program that supports the integration process. The overall findings indicated that most of the parents reported scores within the normal range on the parenting stress outcome measure. Generally, a high level of resilience, and especially family cohesion, was found. When differentiated by child age and gender, about 10 percent of the children were assessed by their parents within the clinical range of disruptive behavior.
Discussion: The parents did not report elevated levels of parenting stress, which may indicate that, once settled, they potentially feel a sense of safety for being in a secure environment after experiencing war and flight. At the beginning of the resettlement process, it is possible that the family itself constitutes their primary social resources and source of support, which may explain the high level of family cohesion.
Abstract 3
Effect of parent interventions for families with refugee background in Norway
June T. Forsberg (UiT – The Arctic University of Norway)
Background: Parents with refugee background risk and may experience difficulties with e.g. integration, upbringing, parental stress and child problem behavior after resettling in a new country. In Norway, parents are obliged to attend a parent intervention or program, as a mandatory part of their integration process. The main goals are to provide the parents with information about upbringing in Norway and prevent family maladjustments. The aims of this study were to evaluate the effectiveness of two parent interventions that are widely used in Norway; the Incredible Years (IY) and the International Child Development Programme (ICDP). The focus was on assessing their impact on improving parenting skills and reducing parental stress and problem behavior in children. Additionally, this study aimed to evaluate the effectiveness of a measurement feedback system (MFS) to improve the primary outcomes.
Methods: This study employs a 2x2 factorial design and nearly 300 parents were recruited to participate. A total of N=135 parents were randomized to an IY group and N=139 parents to an ICDP group. Further, the groups were randomized to either MFS (N=141) or not MFS (N=133). The measures included child behavioral problems with Eyberg Child Behavior Inventory (ECBI), parental stress with Parent Stress Index –Short Form and parent practices using Parent Practices Interview (PPI).
Results: Preliminary results showed no significant main or interaction effects of the main factors on either child or parent outcomes. This indicates that neither participating in one parent intervention over the other (ICDP vs. IY) nor utilizing MFS or not had a significant influence on the measured outcome variables. Analyses comparing outcome variables at baseline and post-intervention showed a significant decrease in child problem behavior, as measured by the ECBI intensity scale. There was also a significant reduction in parenting stress from pre- to post-assessment, as measured by PSI-SF, specifically in the subscales of parental distress, parent child dysfunctional interaction and difficult child.
Discussion: Overall, participating in a parent intervention (either ICDP or IY) seems to have a positive impact on parenting stress and child problem behavior. It was hypothesized that the parents that were assigned to MFS would benefit more from the interventions. This was not confirmed. One possible explanation can be that the MFS was not implemented as intended. For optimal usage, the parents must provide feedback, and the group leaders must integrate this feedback to tailor the intervention to the participants’ specific needs. Further implications for practice will be discussed.
Abstract 4
Parents’ experiences of participating in parent interventions
Mer Saus (UiT – The Arctic University of Norway), Marcela Douglas (UiT The Arctic University of Norway)
Background: To bring up children in new countries is challenging for most parents. Raising children as refugees strains the usual stress. This is the background for implementing parenting interventions in the Norwegian integration program for refugees and immigrants. In this presentation, we will discuss the parent’s experiences from participating in parenting interventions.
Methods: We used qualitative methods and interviewed 45 parents, 26 mothers, and 19 fathers about their experiences and reflections concerning participation in parenting interventions. The informants are from eight municipalities in Norway, some small, rural communities and some cities. The recruitment of informants was done through the PIRM study.
Results: The qualitative interviews show that the parents are, for the most part, pleased with the interventions. They do not interpret that they must participate because they do not cope as parents but because it is challenging to be parents in new contexts. Learning parent strategies is helpful, but they do not use all of them. Mostly, they like the techniques that help them to implement practice in their homes and help them adapt to Norway for the sake of the children. That can be how to deal with “nagging for sweets at the shops” or maintain an appropriate bedtime. The parents highlight that information about the Norwegian child welfare system is important. This is a system they are the least familiar with, don’t understand, and are afraid of.
Discussion: The context for parenting appears important. Support that helps them organize their family life, so it is aligned with the expectations of the Norway communities is valued. While the parenting programs are often designed to help parents with their roles or the child’s behaviour, it is more critical for refugee parents to stress how parents’ strategies can be customized to the current contexts. Also, information about systems and governmental roles, such as the child welfare system, seems desirable to parents.
Abstract 5
Refugee children`s experiences with parents participating in parent interventions
Therese B. Halvorsen (UiT – The Arctic University of Norway)
Background: The influence of parental participation in parenting interventions is rarely examined from the perspective of children, despite them being the primary beneficiaries of such initiatives. This study addresses this gap by exploring children’s experiences with these programs and the programs’ influence on their everyday lives.
Methods: Using a dialogue-based interview method, we interviewed twenty-three children with refugee backgrounds aged 7–13 years. The children originated from the Middle East and Africa and had lived in Norway for 9 months up to 7 years. Participants were recruited through the PIRM study which meant that at the time of the interviews, at least one of their parents had recently participated in the IY or ICDP parenting interventions. The data was analysed through a qualitative content analysis method.
Preliminary Results: Only a small number of children were aware of the parenting program that their parents had participated in, and a few others held misconceptions about what such programs entailed. However, the majority of children were unaware of their parents’ involvement in these initiatives. Despite this, some children noticed changes in their parents' behaviour. These changes were generally perceived positively, although certain strategies were regarded as less pleasant yet effective. Overall, much of the programs’ influence was reflected indirectly in the children’s everyday experiences.
Discussion: The study revealed that only a small number of children are aware that their parents participate in parenting support programs. This lack of awareness may stem from the programs being primarily designed with a focus on parents. Traditionally, the effectiveness of parenting interventions is evaluated based on adults' reports. This study highlights that changes are not always immediately evident to children. Many strategies and guidelines introduced in both programs were not clearly reflected in the children's everyday experiences, possibly because these strategies are more abstract and challenging for children to grasp.
Abstract 6
Conducting research in a preventive setting on refugee families: Implications for research and practice
Joshua Patras (The Regional Centre for Child and Youth Mental Health)
Background: Barriers and facilitators encountered during the implementation of support programs for families with refugee backgrounds are similar to those found in other implementation efforts. Characteristics of interventions such as the feasibility, utility, acceptability, and adherence all play roles in successful implementation. Additional key challenges in the work with refugees such as language barriers, cultural differences, and limited access to resources can affect implementation efforts for this group in particular.
Two parenting interventions and a measurement feedback system (MFS) designed to support these interventions were implemented in Norwegian services for families with refugee backgrounds. The parenting programs, including The Incredible Years (IY) and The International Child Development Programme (ICDP), aim to improve parenting practices and child development outcomes through structured group sessions (Patras et al, 2021). The MFS was designed to provide regular feedback to interventionists about parents' progress and experiences via a smartphone app, with the aim of enhancing the effectiveness of the parenting interventions.
Methods: We used a mixed methods approach to assess the users’ experiences with the parenting interventions and measurement feedback system.
Results: The primary challenges for the use of the parenting interventions included cultural adaptation and language barriers. The main challenge for using the measurement and feedback system involved the level of adoption by the intervention group leaders.
Discussion: We will discuss the implications based on the successful use of the interventions in this population and potential ways the MFS could be adapted to improve implementation and uptake in group-based interventions such as these.
| Conflict of interest | No conflict of interest. |
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