A Randomized Clinical Trial Testing a Parenting Intervention Among Afghan and Rohingya Refugees in Malaysia

Abstract

Refugee families experience uncertainty and stress when residing in countries of first asylum, such as Malaysia, and may benefit from supportive parenting interventions. In the greater Kuala Lumpur, Malaysia area we piloted an eight‐week parenting program with 79 Rohingya and Afghan mothers in nine separate groups. Participants were randomized to an intervention group or a waitlist control group and those in each arm completed a 3‐month follow‐up assessment. Program content addressed positive discipline, strengthening family relationships, adapting to a new environment, and improving health and emotional well‐being. Measures assessed included child intensity and parenting self‐efficacy from the Child Adjustment and Parent Efficacy Scale; positive parenting, inconsistent discipline, and poor supervision from the Alabama Parenting Questionnaire‐Short Form; family intimacy and family conflict from the Family Functioning Scale, and emotional well‐being from the Refugee Health Screening‐15. Participating in the intervention led to beneficial changes in child intensity, parenting self‐efficacy, family intimacy, family conflict, and emotional distress for the treatment group, and all changes except for emotional distress were maintained over time. However, the intervention did not lead to changes in positive parenting, inconsistent discipline, or poor supervision in the treatment group. Findings point to the potential benefits of parenting programs for refugee communities in transitory settings and contribute to the limited body of literature examining such programs.

Transdiagnostic Psychosocial Interventions to Promote Mental Health in Forcibly Displaced Persons: A Systematic Review and Meta-Analysis

“…Looking at the studies with large effect size estimates (SMD ≥ .80) in adult samples, six studies emerged (Ali, 2020;De Graaff et al, 2020;Koch et al, 2020;Orang et al, 2022;Renner et al, 2011;Shaw et al, 2021). In a study with moderate risk of bias, De Graaff et al ( 2020 (2020) found constantly larger effect sizes for the same program in a population of adult Syrian refugees in the Netherlands, Spaaij ( 2022) -yet in a feasibility and acceptability trial -reported nonsignificant but inverse effect sizes for a sample of Syrian refugees and asylum seekers in Switzerland.…”

“…Furthermore, the remaining four studies with large effect sizes in adult samples was associated with at least 'some concerns' for risk of bias in three out of five domains (Ali, 2020;Orang et al, 2022;Renner et al, 2011;Shaw et al, 2021).…”

Strengthening parental self‐efficacy and resilience: A within‐subject experimental study with refugee parents of adolescents

“…For example, Morina et al ( 2018 ) used mastery experiences to strengthen self‐efficacy among a Turkish sample of refugees resettled in Switzerland. In addition, parenting interventions aimed at supporting refugee parents seem to contribute to strengthening parental self‐efficacy in Syrian, Karen, Rohingya, and Afghan refugee families (El‐Khani et al, 2018 ; Hoffman et al, 2020 ; Shaw et al, 2020 ). Until now, however, studies primarily focused on the feasibility and acceptability of programs in those populations, and the field is less developed in terms of the specific effects that these programs yield.…”

The family crisis migration stress framework: A framework to understand the mental health effects of crisis migration on children and families caused by disasters

“…For example, qualitative work with Afghani women who settled in Australia found that many faced violence, exclusion, and discrimination from other refugee groups and native peoples during their time in refugee camps in Pakistan (Kavian et al, 2020). Additionally, many Rohingya refugee families have made Bangladesh or Malaysia their country of "first asylum," but may continue on to other countries or return to Myanmar when it is safe to do so (Shaw et al, 2020). Importantly, wealthier migrants may be able to travel by air rather than embark on land or sea journeys, whereas migrants from lower socioeconomic brackets may not have this option.…”