Skip to main content
Erschienen in: Prevention Science 7/2017

17.11.2016

Improving Mental Health Outcomes of Burmese Migrant and Displaced Children in Thailand: a Community-Based Randomized Controlled Trial of a Parenting and Family Skills Intervention

verfasst von: Jeannie Annan, Amanda Sim, Eve S. Puffer, Carmel Salhi, Theresa S. Betancourt

Erschienen in: Prevention Science | Ausgabe 7/2017

Einloggen, um Zugang zu erhalten

Abstract

The negative effects of displacement and poverty on child mental health are well-known, yet research on prevention interventions in low- and middle-income countries, especially fragile states, remains limited. We examined the effectiveness of a parenting skills intervention on mental health outcomes among Burmese migrant and displaced children living in 20 communities in Thailand. Participants were primary caregivers and children aged 7 to 15 years (n = 479 families). Families were randomly assigned to receive an adapted version of the Strengthening Families Program (n = 240) or a wait-list control condition (n = 239). Assessments were conducted at baseline and 1-month post-intervention for both conditions and at 6 months for treatment group only. One month after the program, children in the treatment condition showed significant reductions in externalizing problems (caregiver effect size (ES) −0.22, p = 0.02; child report ES −0.11, p = 0.02) and child attention problems compared with controls (caregiver report ES −0.23, p = 0.03). There was no significant treatment effect on children’s internalizing problems (ES −0.06; p = 0.31). Children reported a significant increase in prosocial protective factors relative to controls (ES 0.20, p < 0.01). Results suggest that an evidence-based parenting skills intervention adapted for a displaced and migrant Burmese population facing high levels of adversity can have positive effects on children’s externalizing symptoms and protective psychosocial factors.
Trial Registration. Clinicaltrials.gov: https://​clinicaltrials.​gov/​show/​NCT01829815
Literatur
Zurück zum Zitat Achenbach, T. M., & Rescorla, L. A. (2001). Child behavior checklist. Youth self-report for ages 11–18 (YSR 11–18). In Manual for the ASEBA school-age forms and profiles. Research Center for Children, Youth, and Families in Burlington, VT. Achenbach, T. M., & Rescorla, L. A. (2001). Child behavior checklist. Youth self-report for ages 11–18 (YSR 11–18). In Manual for the ASEBA school-age forms and profiles. Research Center for Children, Youth, and Families in Burlington, VT.
Zurück zum Zitat Attanayake, V., McKay, R., Joffres, M., Singh, S., Burkle, F., & Mills, E. (2009). Prevalence of mental disorders among children exposed to war: a systematic review of 7,920 children. Medicine, Conflict, and Survival, 25, 4–19. doi:10.1080/13623690802568913.CrossRefPubMed Attanayake, V., McKay, R., Joffres, M., Singh, S., Burkle, F., & Mills, E. (2009). Prevalence of mental disorders among children exposed to war: a systematic review of 7,920 children. Medicine, Conflict, and Survival, 25, 4–19. doi:10.​1080/​1362369080256891​3.CrossRefPubMed
Zurück zum Zitat Barlow, J., McMillan, A. S., Kirkpatrick, S., Ghate, D., Barnes, J., & Smith, M. (2010). Health-led interventions in the early years to enhance infant and maternal mental health: A review of reviews. Child Adolescent Mental Health, 15, 178–185. doi:10.1111/j.1475-3588.2010.00570.x.CrossRef Barlow, J., McMillan, A. S., Kirkpatrick, S., Ghate, D., Barnes, J., & Smith, M. (2010). Health-led interventions in the early years to enhance infant and maternal mental health: A review of reviews. Child Adolescent Mental Health, 15, 178–185. doi:10.​1111/​j.​1475-3588.​2010.​00570.​x.CrossRef
Zurück zum Zitat Bernal, G., Jiménez-Chafey, M. I., & Domenech Rodríguez, M. M. (2009). Cultural adaptation of treatments: A resource for considering culture in evidence-based practice. Prof Psychology: Research Practice, 40, 361–368. doi:10.1037/a0016401.CrossRef Bernal, G., Jiménez-Chafey, M. I., & Domenech Rodríguez, M. M. (2009). Cultural adaptation of treatments: A resource for considering culture in evidence-based practice. Prof Psychology: Research Practice, 40, 361–368. doi:10.​1037/​a0016401.CrossRef
Zurück zum Zitat Betancourt, T., Scorza, P., Meyers-Ohki, S., Mushashi, C., Kayiteshonga, Y., Binagwaho, A., … Beardslee, W. R. (2012). Validating the center for epidemiological studies depression scale for children in Rwanda. Journal of the American Academy of Child and Adolescent Psychiatry, 51(12), 1284–1292. doi:10.1016/j.jaac.2012.09.003 Betancourt, T., Scorza, P., Meyers-Ohki, S., Mushashi, C., Kayiteshonga, Y., Binagwaho, A., … Beardslee, W. R. (2012). Validating the center for epidemiological studies depression scale for children in Rwanda. Journal of the American Academy of Child and Adolescent Psychiatry, 51(12), 1284–1292. doi:10.​1016/​j.​jaac.​2012.​09.​003
Zurück zum Zitat Betancourt, T., Ng, L. C., Kirk, C. M., Munyanah, M., Mushashi, C., Ingabire, C., … Sezibera, V. (2014). Family-based prevention of mental health problems in children affected by HIV and AIDS: an open trial. AIDS (London, England), 28(0 3), S359–S368. doi:10.1097/QAD.0000000000000336 Betancourt, T., Ng, L. C., Kirk, C. M., Munyanah, M., Mushashi, C., Ingabire, C., … Sezibera, V. (2014). Family-based prevention of mental health problems in children affected by HIV and AIDS: an open trial. AIDS (London, England), 28(0 3), S359–S368. doi:10.​1097/​QAD.​0000000000000336​
Zurück zum Zitat Chorpita, B. F., Daleiden, E. L., Ebesutani, C., Young, J., Becker, K. D., Nakamura, B. J., … Starace, N. (2011). Evidence-based treatments for children and adolescents: An updated review of indicators of efficacy and effectiveness. Clinical Psychology: Science and Practice, 18, 154-172. Chorpita, B. F., Daleiden, E. L., Ebesutani, C., Young, J., Becker, K. D., Nakamura, B. J., … Starace, N. (2011). Evidence-based treatments for children and adolescents: An updated review of indicators of efficacy and effectiveness. Clinical Psychology: Science and Practice, 18, 154-172.
Zurück zum Zitat Gardner, F., Montgomery, P., & Knerr, W. (2015). Transporting evidence-based parenting programs for child problem behavior (age 3–10) between countries: Systematic review and meta-analysis. Journal of Clinical Child & Adolescent Psychology, 0, 1–14. doi:10.1080/15374416.2015.1015134 Gardner, F., Montgomery, P., & Knerr, W. (2015). Transporting evidence-based parenting programs for child problem behavior (age 3–10) between countries: Systematic review and meta-analysis. Journal of Clinical Child & Adolescent Psychology, 0, 1–14. doi:10.​1080/​15374416.​2015.​1015134
Zurück zum Zitat Green, M., Jacobsen, K., & Pyne, S. (2008). Invisible in Thailand: Documenting the need for protection. Forced Migration Review, 30, 31–33. Green, M., Jacobsen, K., & Pyne, S. (2008). Invisible in Thailand: Documenting the need for protection. Forced Migration Review, 30, 31–33.
Zurück zum Zitat Jordans, M. J. D., Tol, W. A., Ndayisaba, A., & Komproe, I. H. (2012). A controlled evaluation of a brief parenting psychoeducation intervention in Burundi. Social Psychiatry and Psychiatric Epidemiology, 48, 1851–1859. doi:10.1007/s00127-012-0630-6.CrossRefPubMed Jordans, M. J. D., Tol, W. A., Ndayisaba, A., & Komproe, I. H. (2012). A controlled evaluation of a brief parenting psychoeducation intervention in Burundi. Social Psychiatry and Psychiatric Epidemiology, 48, 1851–1859. doi:10.​1007/​s00127-012-0630-6.CrossRefPubMed
Zurück zum Zitat Kieling, C., Baker-Henningham, H., Belfer, M., Conti, G., Ertem, I., Omigbodun, O., … Rahman, A. (2011). Child and adolescent mental health worldwide: evidence for action. The Lancet, 378, 1515–1525. doi:10.1016/S0140-6736(11)60827-1 Kieling, C., Baker-Henningham, H., Belfer, M., Conti, G., Ertem, I., Omigbodun, O., … Rahman, A. (2011). Child and adolescent mental health worldwide: evidence for action. The Lancet, 378, 1515–1525. doi:10.​1016/​S0140-6736(11)60827-1
Zurück zum Zitat Knerr, W., Gardner, F., & Cluver, L. (2013). Improving positive parenting skills and reducing harsh and abusive parenting in low- and middle-income countries: A systematic review. Prevention Science, 14, 352–363. doi:10.1007/s11121-012-0314-1.CrossRefPubMed Knerr, W., Gardner, F., & Cluver, L. (2013). Improving positive parenting skills and reducing harsh and abusive parenting in low- and middle-income countries: A systematic review. Prevention Science, 14, 352–363. doi:10.​1007/​s11121-012-0314-1.CrossRefPubMed
Zurück zum Zitat Kohrt, B. A., Jordans, M. J. D., Rai, S., Shrestha, P., Luitel, N. P., Ramaiya, M. K., … Patel, V. (2015). Therapist competence in global mental health: Development of the ENhancing Assessment of Common Therapeutic factors (ENACT) rating scale. Behaviour Research and Therapy, 69, 11–21. doi:10.1016/j.brat.2015.03.009. Kohrt, B. A., Jordans, M. J. D., Rai, S., Shrestha, P., Luitel, N. P., Ramaiya, M. K., … Patel, V. (2015). Therapist competence in global mental health: Development of the ENhancing Assessment of Common Therapeutic factors (ENACT) rating scale. Behaviour Research and Therapy, 69, 11–21. doi:10.​1016/​j.​brat.​2015.​03.​009.
Zurück zum Zitat Kumpfer, K. L., & Bluth, B. (2004). Parent/child transactional processes predictive of resilience or vulnerability to “Substance Abuse Disorders.”. Substance Use & Misuse, 39, 671–698. doi:10.1081/JA-120034011.CrossRef Kumpfer, K. L., & Bluth, B. (2004). Parent/child transactional processes predictive of resilience or vulnerability to “Substance Abuse Disorders.”. Substance Use & Misuse, 39, 671–698. doi:10.​1081/​JA-120034011.CrossRef
Zurück zum Zitat Kumpfer, K. L., Alvarado, R., Tait, C., & Whiteside, H. O. (2007). The Strengthening Families Program: An evidence-based, multicultural family skills training program. In P. Tolan, J. Szapocznik, & S. Sambrano (Eds.), Preventing youth substance abuse: Science-based programs for children and adolescents (pp. 159–181). Washington, DC: APA.CrossRef Kumpfer, K. L., Alvarado, R., Tait, C., & Whiteside, H. O. (2007). The Strengthening Families Program: An evidence-based, multicultural family skills training program. In P. Tolan, J. Szapocznik, & S. Sambrano (Eds.), Preventing youth substance abuse: Science-based programs for children and adolescents (pp. 159–181). Washington, DC: APA.CrossRef
Zurück zum Zitat Kumpfer, K. L., Pinyuchon, M., de Melo, A. T., & Whiteside, H. O. (2008). Cultural adaptation process for international dissemination of the Strengthening Families Program. Evaluation & the Health Professions, 31, 226–239. doi:10.1177/0163278708315926.CrossRef Kumpfer, K. L., Pinyuchon, M., de Melo, A. T., & Whiteside, H. O. (2008). Cultural adaptation process for international dissemination of the Strengthening Families Program. Evaluation & the Health Professions, 31, 226–239. doi:10.​1177/​0163278708315926​.CrossRef
Zurück zum Zitat Kumpfer, K. L., Whiteside, H. O., Greene, J. A., & Allen, K. C. (2010). Effectiveness outcomes of four age versions of the Strengthening Families Program in statewide field sites. Group Dynamics: Theory Research Practice, 14, 211–229. doi:10.1037/a0020602.CrossRef Kumpfer, K. L., Whiteside, H. O., Greene, J. A., & Allen, K. C. (2010). Effectiveness outcomes of four age versions of the Strengthening Families Program in statewide field sites. Group Dynamics: Theory Research Practice, 14, 211–229. doi:10.​1037/​a0020602.CrossRef
Zurück zum Zitat Lustig, S. L., Kia-Keating, M., Knight, W. G., Geltman, P., Ellis, H., Kinzie, J. D., … Saxe, G. N. (2004). Review of child and adolescent refugee mental health. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 24–36. doi:10.1097/00004583-200401000-00012 Lustig, S. L., Kia-Keating, M., Knight, W. G., Geltman, P., Ellis, H., Kinzie, J. D., … Saxe, G. N. (2004). Review of child and adolescent refugee mental health. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 24–36. doi:10.​1097/​00004583-200401000-00012
Zurück zum Zitat Manassis, K., Lee, T. C., Bennett, K., Zhao, X. Y., Mendlowitz, S., Duda, S., … Wood, J. J. (2014). Types of parental involvement in CBT with anxious youth: A preliminary meta-analysis. Journal of Consulting and Clinical Psychology, 82, 1163–1172. doi:10.1037/a0036969. Manassis, K., Lee, T. C., Bennett, K., Zhao, X. Y., Mendlowitz, S., Duda, S., … Wood, J. J. (2014). Types of parental involvement in CBT with anxious youth: A preliminary meta-analysis. Journal of Consulting and Clinical Psychology, 82, 1163–1172. doi:10.​1037/​a0036969.
Zurück zum Zitat Mejia, A., Calam, R., & Sanders, M. R. (2012). A review of parenting programs in developing countries: opportunities and challenges for preventing emotional and behavioral difficulties in children. Clinical Child and Family Psychology Review, 15, 163–175.CrossRefPubMed Mejia, A., Calam, R., & Sanders, M. R. (2012). A review of parenting programs in developing countries: opportunities and challenges for preventing emotional and behavioral difficulties in children. Clinical Child and Family Psychology Review, 15, 163–175.CrossRefPubMed
Zurück zum Zitat Meyer, S. R., Robinson, W. C., Abshir, N., Mar, A. A., & Decker, M. R. (2015). Trafficking, exploitation and migration on the Thailand-Burma Border: A qualitative study. International Migration, 53, 37–50. doi:10.1111/imig.12177.CrossRef Meyer, S. R., Robinson, W. C., Abshir, N., Mar, A. A., & Decker, M. R. (2015). Trafficking, exploitation and migration on the Thailand-Burma Border: A qualitative study. International Migration, 53, 37–50. doi:10.​1111/​imig.​12177.CrossRef
Zurück zum Zitat Mullany, L. C., Richards, A. K., Lee, C. I., Suwanvanichkij, V., Maung, C., Mahn, M., … Lee, T. J. (2007). Population-based survey methods to quantify associations between human rights violations and health outcomes among internally displaced persons in eastern Burma. Journal of Epidemiology and Community Health, 61, 908–914. doi:10.1136/jech.2006.055087. Mullany, L. C., Richards, A. K., Lee, C. I., Suwanvanichkij, V., Maung, C., Mahn, M., … Lee, T. J. (2007). Population-based survey methods to quantify associations between human rights violations and health outcomes among internally displaced persons in eastern Burma. Journal of Epidemiology and Community Health, 61, 908–914. doi:10.​1136/​jech.​2006.​055087.
Zurück zum Zitat Panter-Brick, C., Burgess, A., Eggerman, M., McAllister, F., Pruett, K., & Leckman, J. F. (2014). Practitioner review: Engaging fathers—recommendations for a game change in parenting interventions based on a systematic review of the global evidence. Journal of Child Psychology and Psychiatry, 55, 1187–1212. doi:10.1111/jcpp.12280.CrossRefPubMedPubMedCentral Panter-Brick, C., Burgess, A., Eggerman, M., McAllister, F., Pruett, K., & Leckman, J. F. (2014). Practitioner review: Engaging fathers—recommendations for a game change in parenting interventions based on a systematic review of the global evidence. Journal of Child Psychology and Psychiatry, 55, 1187–1212. doi:10.​1111/​jcpp.​12280.CrossRefPubMedPubMedCentral
Zurück zum Zitat Pinyuchon, M. (2010, June). Effectiveness of implementing the Strengthening Families Program for Families of school children in Songkhla Province, Thailand. In Karol L. Kumpfer (Chair), Cultural Adaptations of Family-Based Interventions to Strengthen Families and Prevent Substance Abuse. Presented at NIDA International Conference, Scottsdale, AZ. Pinyuchon, M. (2010, June). Effectiveness of implementing the Strengthening Families Program for Families of school children in Songkhla Province, Thailand. In Karol L. Kumpfer (Chair), Cultural Adaptations of Family-Based Interventions to Strengthen Families and Prevent Substance Abuse. Presented at NIDA International Conference, Scottsdale, AZ.
Zurück zum Zitat Price, M., Yuen, E. K., Goetter, E. M., Herbert, J. D., Forman, E. M., Acierno, R., & Ruggiero, K. J. (2014). mHealth: A mechanism to deliver more accessible, more effective mental health care. Clinical Psychology & Psychotherapy, 21, 427–436. doi:10.1002/cpp.1855.CrossRef Price, M., Yuen, E. K., Goetter, E. M., Herbert, J. D., Forman, E. M., Acierno, R., & Ruggiero, K. J. (2014). mHealth: A mechanism to deliver more accessible, more effective mental health care. Clinical Psychology & Psychotherapy, 21, 427–436. doi:10.​1002/​cpp.​1855.CrossRef
Zurück zum Zitat Puffer, E., Green, E. P., Chase, R. M., Sim, A. L., Zayzay, J., Friis, E., … Boone, L. (2015). Parents make the difference: a randomized-controlled trial of a parenting intervention in Liberia. Global Mental Health, 2. doi:10.1017/gmh.2015.12 Puffer, E., Green, E. P., Chase, R. M., Sim, A. L., Zayzay, J., Friis, E., … Boone, L. (2015). Parents make the difference: a randomized-controlled trial of a parenting intervention in Liberia. Global Mental Health, 2. doi:10.​1017/​gmh.​2015.​12
Zurück zum Zitat Puffer, E., Green, E., Sikkema, K., Broverman, S., Ogwang-Odhiambo, R., & Pian, J. (2016). A church-based intervention for families to promote mental health and prevent HIV among adolescents in rural Kenya: Results of a randomized trial. Journal of Consulting and Clinical Psychology, 84, 511–525. doi:10.1037/ccp0000076. Puffer, E., Green, E., Sikkema, K., Broverman, S., Ogwang-Odhiambo, R., & Pian, J. (2016). A church-based intervention for families to promote mental health and prevent HIV among adolescents in rural Kenya: Results of a randomized trial. Journal of Consulting and Clinical Psychology, 84, 511–525. doi:10.​1037/​ccp0000076.
Zurück zum Zitat Reed, R. V., Fazel, M., Jones, L., Panter-Brick, C., & Stein, A. (2012). Mental health of displaced and refugee children resettled in low-income and middle-income countries: Risk and protective factors. Lancet, 379, 250–265. doi:10.1016/S0140-6736(11)60050-0.CrossRefPubMed Reed, R. V., Fazel, M., Jones, L., Panter-Brick, C., & Stein, A. (2012). Mental health of displaced and refugee children resettled in low-income and middle-income countries: Risk and protective factors. Lancet, 379, 250–265. doi:10.​1016/​S0140-6736(11)60050-0.CrossRefPubMed
Zurück zum Zitat Rubin, D. B. (2004). Multiple imputation for nonresponse in surveys. Hoboken, NJ: John Wiley & Sons. Rubin, D. B. (2004). Multiple imputation for nonresponse in surveys. Hoboken, NJ: John Wiley & Sons.
Zurück zum Zitat Ryzin, M. J. V., Kumpfer, K. L., Fosco, G. M., & Greenberg, M. T. (2015). Family-based prevention programs for children and adolescents: Theory, research, and large-scale dissemination. Psychology Press. Ryzin, M. J. V., Kumpfer, K. L., Fosco, G. M., & Greenberg, M. T. (2015). Family-based prevention programs for children and adolescents: Theory, research, and large-scale dissemination. Psychology Press.
Zurück zum Zitat Shonkoff, J. P., & Fisher, P. A. (2013). Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy. Development and Psychopathology, 25, 1635–1653. doi:10.1017/S0954579413000813 Shonkoff, J. P., & Fisher, P. A. (2013). Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy. Development and Psychopathology, 25, 1635–1653. doi:10.​1017/​S095457941300081​3
Zurück zum Zitat Sim, A., Annan, J., Puffer, E., Salhi, C., & Betancourt, T. (2014a). Building Happy Families: Impact evaluation of a parenting and family skills intervention for migrant and displaced Burmese families in Thailand. International Rescue Committee. Sim, A., Annan, J., Puffer, E., Salhi, C., & Betancourt, T. (2014a). Building Happy Families: Impact evaluation of a parenting and family skills intervention for migrant and displaced Burmese families in Thailand. International Rescue Committee.
Zurück zum Zitat Sim, A., Puffer, E., Green, E., Chase, R., Zayzay, J., Garcia-Rolland, E., & Boone, L. (2014b). Parents Make the Difference Findings from a randomized impact evaluation of a parenting program in rural Liberia. International Rescue Committee. Sim, A., Puffer, E., Green, E., Chase, R., Zayzay, J., Garcia-Rolland, E., & Boone, L. (2014b). Parents Make the Difference Findings from a randomized impact evaluation of a parenting program in rural Liberia. International Rescue Committee.
Zurück zum Zitat South, A. (2008). Ethnic politics in Burma: States of conflict. New York, NY: Routledge. South, A. (2008). Ethnic politics in Burma: States of conflict. New York, NY: Routledge.
Zurück zum Zitat Spoth, R., & Redmond, C. (2000). Research on family engagement in preventive interventions: Toward improved use of scientific findings in primary prevention practice. Journal Prim Prev, 21, 267–284. doi:10.1023/A:1007039421026.CrossRef Spoth, R., & Redmond, C. (2000). Research on family engagement in preventive interventions: Toward improved use of scientific findings in primary prevention practice. Journal Prim Prev, 21, 267–284. doi:10.​1023/​A:​1007039421026.CrossRef
Zurück zum Zitat StataCorp. (2011). Stata Statistical Software (Version 12). College Station, TX: StataCorp LP. StataCorp. (2011). Stata Statistical Software (Version 12). College Station, TX: StataCorp LP.
Zurück zum Zitat Sumargi, A., Sofronoff, K., & Morawska, A. (2014). A randomized-controlled trial of the Triple P-Positive Parenting Program Seminar Series with Indonesian parents. Child Psychiatry & Human Development, 46, 749–761. doi:10.1007/s10578-014-0517-8 Sumargi, A., Sofronoff, K., & Morawska, A. (2014). A randomized-controlled trial of the Triple P-Positive Parenting Program Seminar Series with Indonesian parents. Child Psychiatry & Human Development, 46, 749–761. doi:10.​1007/​s10578-014-0517-8
Zurück zum Zitat Tol, W. A., Song, S., & Jordans, M. J. D. (2013). Annual Research Review: Resilience and mental health in children and adolescents living in areas of armed conflict—a systematic review of findings in low- and middle-income countries. Journal of Child Psychology and Psychiatry, 54, 445–460. doi:10.1111/jcpp.12053.CrossRefPubMed Tol, W. A., Song, S., & Jordans, M. J. D. (2013). Annual Research Review: Resilience and mental health in children and adolescents living in areas of armed conflict—a systematic review of findings in low- and middle-income countries. Journal of Child Psychology and Psychiatry, 54, 445–460. doi:10.​1111/​jcpp.​12053.CrossRefPubMed
Metadaten
Titel
Improving Mental Health Outcomes of Burmese Migrant and Displaced Children in Thailand: a Community-Based Randomized Controlled Trial of a Parenting and Family Skills Intervention
verfasst von
Jeannie Annan
Amanda Sim
Eve S. Puffer
Carmel Salhi
Theresa S. Betancourt
Publikationsdatum
17.11.2016
Verlag
Springer US
Erschienen in
Prevention Science / Ausgabe 7/2017
Print ISSN: 1389-4986
Elektronische ISSN: 1573-6695
DOI
https://doi.org/10.1007/s11121-016-0728-2

Weitere Artikel der Ausgabe 7/2017

Prevention Science 7/2017 Zur Ausgabe