Dr Amanda Sim (McMaster University, Canada), Dr Eve Puffer (Duke University, USA), Dr Tawanchai Jirapramukpitak (Mahidol University, Thailand), Dr Sureeporn Punpueng (Mahidol University, Thailand)
Research Team
Dr Pattraporn Chuenglertsiri (Mahidol University), Nway Nway Oo (Mae Tao Clinic), Dr Catherine Lee (Johns Hopkins Bloomberg School of Public Health), Khaing Zar Lwin (IPSR-Mahidol University), Stephanie Eagling-Peche (University of Oxford) and Dr Andrea Gonzalez (McMaster University)
A two-arm cluster randomised trial to evaluate the effectiveness of a population-level media campaign to promote playful parenting among families displaced by armed conflict as well as an individual randomised trial for non-responders to evaluate a trauma-informed adaptation of Parenting for Lifelong Health, as well as a co-design process to collaboratively develop, implement and evaluate a trauma-informed adaptation of Parenting for Lifelong Health.
Beneficiaries include parents and caregivers as well as their children.
Context
Families displaced by armed conflict, poverty, and insecurity face multiple challenges to accessing parenting and mental health support despite compelling evidence of the intergenerational impacts of trauma and adversity on child development and well-being. There is an urgent need for evidence on effective, cost-effective, and scalable interventions that are locally led and sustained through formal and informal service delivery systems in displacement settings.
Objectives
The study will test a wraparound approach to improving systems, population, and individual caregiver and child level outcomes among migrant and displaced families on the Thai- Myanmar border.
Evaluate the effectiveness and cost-effectiveness of a population-level media campaign adapted from PLH to increase knowledge and skills around positive and playful parenting, reduce acceptance of violence against children, decrease harsh parenting, and promote caregiver and child wellbeing
Co-design and evaluate implementation of a trauma-informed adaptation of PLH for higher-need caregivers
Design, implement, and evaluate strategies to strengthen formal and informal systems for service delivery and sustainability in a volatile displacement context
Study Setting
An estimated 3 million people from Myanmar live in Thailand, the vast majority outside of refugee camps along the Thai-Myanmar border. Migrants and displaced families from Myanmar are exposed to multiple adversities including poverty, discrimination, and lack of access to quality education and healthcare that threaten the development and wellbeing of young children. Prospects of safe return to Myanmar have been dashed by the military coup in February 2021, which may trigger new displacements across the border. The research team has longstanding research experience and partnerships on the border, including 2 previous randomised controlled trials of parenting and mental health interventions.
Study Significance and Impact
This will be the first rigorous evaluation of a population-level media campaign to increase positive and playful parenting, reduce violence against children, and promote caregiver and child mental wellbeing in a displacement setting. If effective, this intervention approach could be easily replicated and scalable across Thailand and other LMICs to achieve population-level impacts at low cost. The study will also enable developing and testing of a trauma-informed adaptation of PLH for higher-need families, thereby informing strategies to effectively target and allocate resources for maximum impact.