Clarkston SafeCare is adaptation of a parenting program for refugees in order to advance child health. It seeks to evaluate the adaptation and implementation of SafeCare-PCI, an evidence-based parenting curriculum for migrant and refugee families in Clarkston, GA.
Clarkston SafeCare is PRC’s core research project that evaluates SafeCare. The project works to assess the effectiveness and efficacy of the program in the target community. The goal is to ensure that the families are receiving quality evidence-based programming that promotes healthy relationships between children and parents.
Why is positive parenting important for migrant and refugee families?
- Young migrant or refugee children are particular vulnerable to chronic early adversity, or toxic stress, leading to a myriad of short and long-term physical and mental problems. A key protective factor is the presence of safe, stable and nurturing care by parents or other caregivers.
- Parenting programs can reduce children’s biological risk and lead to more positive social, emotional, and behavioral development, and disseminating those programs to the most vulnerable populations is key to reducing health disparities. The implementation of evidence-based parenting programs to address early toxic stress has been recommended broadly and specifically for refugee populations.
- Significant barriers to implementation exist, including the linguistic and cultural appropriateness of the intervention and the workforce needed for program delivery.
This study seeks to adapt and evaluate methods to implement the SafeCare model, an evidence-based parenting program.
What is SafeCare’s Parent-Child Interaction Module?
SafeCare is a behavioral parenting program that addresses three parenting skills critical for the prevention of child maltreatment among parents of children ages 0-5: parent-child interactions, home safety, and child health.
The PCI module includes two protocols, one for parents of infants 0-12 months, and a second for parents of children 1 to 5 years old. Both protocols promote positive parent-child relationships by teaching parents to attend to their children and interact with them through language, stimulating play activities, and positive verbalizations and touch..
Parents of toddlers and older children are also taught to structure activities using planned activities training, in which parents are taught to talk with their child about activities, engage them in making choices, explain rules, provide positive reinforcers while ignoring minor misbehaviors, and give positive consequences for the child’s success
Our study will focus on the parent-child interaction module (PCI) of SafeCare because it most directly addresses the type of positive, nurturing behaviors that have been demonstrated to promote positive parenting and improved children’s development outcomes.
How will SafeCare be adapted for migrant and refugee families?
- An adaptation team consisting of model experts, community members, and service providers will create modifications to the SafeCare-PCI curriculum that are both culturally and linguistically appropriate for use among Burmese, Congolese, Ethiopian, Eritrean, and Afghan communities in the Clarkston, GA refugee resettlement zone.
- We will also examine two methods of implementing SafeCare: the usual method of delivery by service-providers and a ‘task shifting’ approach in which services are delivered by community members with less formal training and fewer qualifications.
- Task shifting may be a particularly important approach to employ in refugee resettlement communities, where a range of barriers exist for obtaining services including language barriers, cultural beliefs about mental health, lack of familiarity with the health care system, expectations about health professionals, and a lack of trust. Shifting service delivery to trusted community members can eliminate some of these barriers (language, culture, lack of trust).
What data is being collected from families?
- 240 families will be enrolled to receive SafeCare-PCI by either a service provider or a community worker that is fluent in the native language the family.
- SafeCare providers will collect data on caregiver’s demonstration of parenting skills during regular visits with the families.
- A native-speaking data-collector will administer a computer survey with each participant in their home to assess family outcomes including parenting behavior, parent-child relationship, parenting stress, and child social and emotional health.
- We will also collect interviews from a subset of families receiving SafeCare as well as families that refused SafeCare services regarding intervention barriers and effectiveness.
What can we learn from this study?
- We hope to determine whether cultural adaptations to SafeCare-PCI and a ‘task shifting’ approach to delivery is effective in increasing positive parent-child relationships among refugee communities.
- If successful, these approaches will serve as a model for transporting effective interventions to refugee resettlement zones, non-US countries, and even domestic settings in which a great deal of diversity exists in the community.
Research Team Members
- Daniel Whitaker
- Shannon Self-Brown
- Mary Helen O’Connor
- Kathleen Baggetto
- Erin Weeks
- Courtney Jones
- Lacell Joseph
- Jessica Koreis
- Violaine Muhemedi
- Tambwe Safalani
- Marwa Alkozai
- Sarah Nini
- Naw Wah
- International Rescue Committee
- New American Pathways
Community Health Workers
- Sharifa Adde
- Shaista Amani
- Kpor Shee
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