Miller 2020.
| Study characteristics | |
| Methods |
Study design: RCT Duration of study: the study was conducted between 2019‐2020. Country: Lebanon Income classification: upper‐middle‐income country from 2018 Geographical scope: urban—city of Tripoli in North Lebanon Healthcare setting: offices of three community‐based organizations (CBOs) with which War Child Holland collaborates in the target communities |
| Participants | 1. Age: children 3 to 12; parents not specified 2. Gender: both 3. Socioeconomic background: most caregivers were not working. 4. Educational background: most parents had at least primary education. Inclusion criteria: a. Syrian refugee or vulnerable host community families with at least one child between the ages of 3 to 12 years; b. both primary caregivers willing to participate in the study and willing to commit to attending all nine sessions of the Caregiver Skills Intervention if randomized to the Caregiver Skills Intervention arm of the study; c. participating caregivers are Arabic speaking. Exclusion criteria: a. prior or current participation by either caregiver in a parenting or stress management intervention; b. family does not have a child aged 3 to 12 years; c. anyone who is unable, even with assistance, to complete the assessment questionnaires; d. unwillingness of either caregiver to give informed consent. Note: at baseline, the intervention and control group scores for Kessler Psychological Distress (K10) were, respectively, 30.27 (9.74) and 29.69 (8.12); for the Warwick‐Edinburgh Mental Wellbeing Scale (WEMWBS), 49.52 (7.27) and 49.21 (6.75). Stated purpose: to test the feasibility of our study methodology prior to conducting a definitive RCT on the Caregiver Skills Intervention |
| Interventions |
Name: Caregiver Support Intervention (CSI) Title/name of PW and number: facilitators (number not specified) 1. Selection: non‐mental health specialist, 24 years or older, with at least 2 years of experience implementing psychosocial interventions, preferably with adults, even more preferably with parents/caregivers, emotionally mature 2. Educational background: high school education required, university education desirable 3. Training: CSI facilitators participate in a 6‐day (42‐hour) training which combines didactic and experiential components and includes extensive practice implementing the intervention within the training group. In addition to covering the specific content of the sessions (e.g. parental stress and well‐being, relaxation exercises, coping with anger and frustration, child development, positive parenting), trainees also learn group facilitation skills through extensive role‐playing and continuous feedback. 4. Supervision: weekly supervision by a trained social worker (supervised by PI and local psychologist) 5. Incentives/remuneration: not specified Prevention type: selective—participants were included based upon the presence of a risk factor (parents with a refugee background) and presented with some level of distress. The WEMWBS scores were not indicative of low mental well‐being. Intervention details: the CSI is a nine‐session weekly group intervention, offered separately to women and men. Sessions one through four focus exclusively on caregiver well‐being (covering topics such as stress and relaxation, lowering stress, and coping with frustration and anger). Sessions five through eight focus on strengthening parenting under conditions of adversity and draw heavily on social learning theory and commonly used methods of training in positive parenting (i.e. increasing awareness of the impact of stress on parenting, increasing positive parent‐child interactions and the use of non‐violent discipline methods, and reducing harsh parenting). Session 9 entails a review and closing of the intervention. In addition, in each session, participants are introduced to a new relaxation or stress management technique. These techniques are also provided to participants in Arabic on mp3 files, which they can either play on their smartphones or on mp3 players provided at the start of the programme. Participants are encouraged to practice any relaxation or stress management activity at least three times each week. Control: waiting list – receiving intervention upon completion of the study |
| Outcomes |
Participants’outcomes of interest for this review
Note: the primary focus of the intervention is promoting caregiver mental health. Carers’ outcomes of interest for this review Nil Economic outcomes Nil Time points: baseline, post‐intervention (< 1 month) |
| Notes |
Source of funding: funding by grants from the Bernard van Leer Foundation and Open Society Foundations Notes on validation of instruments (screening and outcomes): the adopted measures were tested for their psychometric properties in the study. Additional information: not applicable Handling the data: not applicable Prospective trial registration number: not reported |