Risk and Protective Factors Experienced by Fathers of Refugee Background during the Early Years of Parenting: A Qualitative Study.

Fathers of refugee background with young children can experience significant mental health difficulties, with the potential for intergenerational impacts. This study aimed to explore how fathers of refugee background experience risk and protective factors for their own health and wellbeing during the early years of parenting. Semi-structured interviews and one semi-structured focus group were conducted with fathers of refugee background, with young children (0-5 years), who had settled in Australia. Transcribed interviews were analysed using thematic analysis, informed by the socioecological model of health. A total of 21 fathers participated in the study. Risk factors experienced included: prior experiences of trauma, reduced access to family support in Australia, adjustments in parenting roles, and the challenges of learning a new language and securing employment. Fathers drew on a number of sources of strength, including a sense of joy from fatherhood and support from partners, families, and communities. While most fathers regularly accompanied their partners and children to healthcare appointments, they were rarely asked by healthcare professionals about their own needs. Our findings support the idea that there is a need for greater assistance for fathers, particularly for navigating issues arising from the settlement process. Healthcare services working with families of refugee background must adopt a father-inclusive, trauma-informed approach that is responsive to fathers' needs.

What factors are associated with resilient outcomes in children exposed to social adversity? A systematic review.

OBJECTIVES: Children exposed to social adversity-hardship as a result of social circumstances such as poverty or intergenerational trauma-are at increased risk of poor outcomes across the life course. Understanding what promotes resilient outcomes is essential for the development of evidence informed intervention strategies. We conducted a systematic review to identify how child resilience is measured and what factors are associated with resilient outcomes. DESIGN: Systematic search conducted in CINAHL, MEDLINE and PsychInfo from January 2004 to October 2018 using the keywords 'resilien* and child* in the title or abstract. Eligible studies: (1) described children aged 5-12 years; (2) identified exposure to social adversity; (3) identified resilience; and (4) investigated factors associated with resilience. OUTCOME MEASURES: (1) approaches to identifying resilience and (2) factors associated with resilient outcomes. RESULTS: From 1979 studies retrieved, 30 studies met the inclusion criteria. Most studies were moderate to high quality, with low cultural competency. Social adversity exposures included poverty, parent loss, maltreatment and war. Only two studies used a measure of child resilience; neither was psychometrically validated. Remaining studies classified children as resilient if they showed positive outcomes (eg, mental health or academic achievement) despite adversity. A range of child, family, school and community factors were associated with resilient outcomes, with individual factors most commonly investigated. The best available evidence was for cognitive skills, emotion regulation, relationships with caregivers and academic engagement. CONCLUSIONS: While there is huge variation in the type and severity of adversity that children experience, there is some evidence that specific individual, relational and school factors are associated with resilient outcomes across a range of contexts. Such factors provide an important starting point for effective public health interventions to promote resilience and to prevent or ameliorate the immediate and long-term impacts of social adversity on children.