ABSTRACT
BACKGROUND: Delivering evidence-based interventions to refugee and immigrant families is difficult for several reasons, including language and cultural issues, and access and trust issues that can lead to an unwillingness to engage with the typical intervention delivery systems. Adapting both the intervention and the delivery system for evidence-based interventions can make those interventions more appropriate and palatable for the targeted population, increasing uptake and effectiveness. This study focuses on the adaptation of the SafeCare© parenting model, and its delivery through either standard implementation methods via community-based organizations (CBO) and a task-shifted implementation in which members of the Afghans, Burmese, Congolese community will be trained to deliver SafeCare. METHOD: An adaptation team consisting of community members, members of CBO, and SafeCare experts will engage a structured process to adapt the SafeCare curriculum for each targeted community. Adaptations will focus on both the model and the delivery of it. Data collection of the adaptation process will focus on documenting adaptations and team member's engagement and satisfaction with the process. SafeCare will be implemented in each community in two ways: standard implementation and task-shifted implementation. Standard implementation will be delivered by CBOs (n = 120), and task-shifted implementation will be delivered by community members (n = 120). All interventionists will be trained in a standard format, and will receive post-training support. Both implementation metrics and family outcomes will be assessed. Implementation metrics will include ongoing adaptations, delivery of services, fidelity, skill uptake by families, engagement/completion, and satisfaction with services. Family outcomes will include assessments at three time points (pre, post, and 6 months) of positive parenting, parent-child relationship, parenting stress, and child behavioral health. DISCUSSION: The need for adapting of evidence-based programs and delivery methods for specific populations continues to be an important research question in implementation science. The goal of this study is to better understand an adaptation process and delivery method for three unique populations. We hope the study will inform other efforts to deliver health intervention to refugee communities and ultimately improve refugee health.
Subject(s)
Emigrants and Immigrants , Refugees , Child , Curriculum , Humans , Parent-Child Relations , ParentingABSTRACT
Research investigating associations between immigration policies and practices and indicators of mental health among Latina/o immigrant families has identified a number of risk factors for this population, such as family separation. The role of protective factors tied to the mental health of Latina/o immigrants, however, often has been neglected. This study explored internal and external sources of resilience that may protect Latina/o immigrant families against the potentially negative effects of restrictive immigration policies and practices on psychological well-being. Six focus groups (N = 50) were conducted with Latina/o immigrant parents of varying residency statuses (i.e., undocumented, permanent residents, Temporary Protected Status beneficiaries, and U.S. citizens). Data were analyzed using thematic analysis. Three themes were identified: Social Support, Faith, and Civic Commitment and Action. Across groups, Latina/o parents referenced family, peer, and community support, as well as their spiritual faith and involvement in advocacy efforts as coping mechanisms. Overall, results suggest that Latina/o immigrant parents of varying residency statuses rely on both internal and external sources of resilience to protect themselves and their families when navigating restrictive immigration policies and practices. This research is particularly timely in light of the increasingly restrictive nature of immigration policies in the U.S. and the growing literature on the influence these may have on immigrant wellbeing. Intervention efforts should build upon existing strengths, such as providing opportunities for Latina/o immigrant families to participate in political activism.
