Parenting on the Thailand/Myanmar Border Updates

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. Beneficiaries include parents and caregivers as well as their children.

2024

Following the successful delivery of the Being Family film intervention, we are delighted to report that the United Nations High Commissioner for Refugees (UNHCR) will support funding to expand access to other communities on the Thailand/ Myanmar border. Training for facilitators on leading audience discussions will take place in early September. Following training, 113 screenings are planned in three refugee border communities. In addition, a manuscript for the study is also under review for submission to the Lancet Regional Health.

The work of GPI Future Leaders in the Parenting on the Border team is also progressing well. Nway Nway Oo (Co-Investigator) and Stephanie (Research Manager and Co-Investigator) presented on the team’s fieldwork safety experiences from the Thailand/Myanmar Border at a GPI Fieldwork Safety and Wellbeing workshop on 30 July.  In September, Khaing Zar Lwin (Research Manager and Co-Investigator) will defend her thesis. Stephanie will also present on the team’s trauma informed mental health PLH adaptation at the European Society for Prevention Research Conference (11-13 September, Italy). Finally, a Masters student Playful Parenting Scholar, based in Myanmar will join the team in August.

Preparations are ongoing for the Parenting on the Border team’s delivery of a caregiver focused trauma informed mental health intervention, which builds upon the positive results of the ‘Being Family’ film intervention.  An intervention manual has been drafted and the team are finalising film clips and video content. Dr Amanda Sim (Co-Principal Investigator) will conduct training with intervention facilitators in July. A trial intervention with parents will also take place, prior to commencing a randomised controlled trial in August (n=480). The team is liaising with colleagues in the GPI core research team to complete additional pre-trial activities, with recruitment of a Research Support Assistant in progress to support data cleaning and troubleshooting during fieldwork. In addition, the team is engaged in local fundraising for grants to expand access of the film intervention to other communities on the Thailand/ Myanmar border.

Following the delivery of a film intervention to 2,250 parents/caregivers of children aged 4-17 across 44 communities on the Thailand/Myanmar Border, analysis of findings are in progress. Once finalised, preliminary findings will be reviewed with senior members of the GPI management team in May to determine a strategy for wider dissemination. The intervention consisted of a one hour long narrative film that depicted parenting challenges and scaffolded positive parenting strategies. The film, entitled ‘Being Family’, formed a crucial part of the intervention’s ability to connect with families and provide a model for positive parenting strategies. In addition to the community screening format to disseminate the film, the study team hopes to identify ways to make the film more widely accessible in different modalities.

The Parenting on the Border team’s development of a caregiver focused trauma informed mental health intervention also continues to progress well. Discussions concerning the design of the planned five session programme structure have resulted in the first draft of content for each day of the intervention. Co-creation work has supported integration of feedback into the programme, with technical working group sessions now completed and a stakeholder workshop also held on 9 April. Finally, Stephanie Eagling-Peche (study Research Manager) conducted a visit to Thailand/Myanmar during April. Activities included visiting refugee camps on the border with the Being Family film intervention partner The Sermpanya Foundation.

The Parenting on the Border team continues to make great progress with their research activities. Following the completion of data cleaning for the film intervention that was delivered in 2023, data analysis is ongoing with preliminary results expected in the first quarter of 2024. In preparation for the implementation of a trauma informed mental health intervention, the team are drafting a manual based on co-creation work conducted by Dr Amanda Sim (Co-Principal Investigator) and Stephanie Eagling-Peche (Research Manager) in late 2023. In order to implement the intervention, the team will identify communities and community mobilisers and facilitators to support a randomised controlled trial. A 5 session programme is planned, with each session lasting 3 hours. Each session is to focus on a key parenting skill - based on PLH’s instructional content, with adaptations from the team’s formative work - and another element concerning adult mental health. The intervention aims to layer these components, to help parents apply coping skills to difficult parenting situations. Another key feature of the intervention is the integration of elements of the Parenting on the Border films, which aim to show participants coping skills and stressors in practice. Supported by the GPI Advocacy team, arrangements are also progressing for a May film screening of the Parenting on the Border film in Oxford.

2023

The Parenting on the Border team has collected implementation-level monitoring data such as film screening attendance and conducted qualitative focus group post-intervention discussions focused primarily on implementation outcomes. A four month follow-up for data collection is due to be completed in January 2024 and a detailed statistical analysis plan is also in place to measure the film intervention’s impact. To raise the profile of issues on the Thailand/Myanmar border the team is liaising with the GPI Communications team to develop an output based on the project’s baseline findings. This work will be a particularly valuable resource in government and funder discussions for project partners in Thailand. A local screening of the Parenting on the Border film is anticipated for spring/summer 2024. The team’s film partner, Sermpanya Foundation has also received interest from UNHCR and UNICEF to arrange screenings in migrant communities, including those outside refugee camps. 

The next phase of the Parenting on the Border project - to co-design, implement and evaluate a parenting and mental health intervention – is progressing well. Following workshops with key community-based service providers to shape the intervention's framework and content, there is substantial partner interest in the co-designed intervention. The project has worked extremely hard to identify interested and value-aligned partners in Thailand, and these partners are now actively engaged in the co-design process. The team is also exploring options to increase the size and power of the evaluation of its parenting and mental health intervention, firstly to engage a greater number of implementing partners in the delivery of the project, helping build engagement and prospects for sustainability, and secondly, to increase the sample size and power of the evaluation.

The Parenting on the Thailand/Myanmar Border team has completed baseline data collection in all communities recruited for their cluster randomised controlled trial of a film intervention aiming to reduce harsh punishment and promote positive parenting practices. Delivery of the film based intervention and endline data collection are ongoing. With support from the University of Oxford core research team, preliminary analysis of baseline trial data is due to take place in August 2023 and great progress has also been made to clean existing data and finalise participant lists. As data collected by the team will be the first of its type to exist for the population group at this scale, next steps will include engaging with the community advisory board to facilitate discussion on key interests and priorities for data analysis. Participant attrition has presented a key challenge for the team during the data collection period and will continue to be reviewed alongside planned recruitment targets and timelines. In addition, flooding temporarily impacted transportation and data collection but the team’s planned schedule has now resumed. 

In relation to advocacy, the team has plans to collaborate with fellow GPI partner, the Peace Culture Foundation and is also coordinating with the GPI advocacy team to organise a film screening in Oxford for spring 2024. Further activities have included a visit from study Co-Principal Investigators based at Mahidol University to Mae Sot, Thailand to attend a film screening and receive input from partners and advisory group members on priority questions for baseline data analysis. In November 2023, the team also plans to share the findings of baseline data collection with study partners and the advisory committee. In addition, Dr Amanda Sim will present at a research seminar in Mahidol and to the Committee for Coordination of Services to Displaced Persons in Thailand
 

Reported by Stephanie Eagling-Peche

In the next phase of their research, the Parenting in Displacement team will be conducting a cluster randomised-controlled trial of a film intervention aiming to reduce harsh punishment and promote positive parenting practices. The film, developed in collaboration with filmmakers from Sermpanya Foundation, is expected to be ready by the end of this month. Screening in communities is anticipated to begin in May.

In February the team of enumerators finished their training ready to begin baseline data collection in March. The team started data collection with a bang, and has already completed data collection across four communities.

The team held the first research team meeting of the year with the data collection team, academic collaborators from Mahidol University, McMaster University, Duke University and the University of Oxford as well as partner organisations Help Without Frontiers, Mae Tao Clinic, TeacherFocus and Sermpanya Foundation in attendance. The day provided an exciting opportunity to share their plan for the upcoming year of data collection and next phases of research. The workshop also resulted in the development of a Scientific Working Group, open to all interested members of the study and foster collaboration across all partners.

2022

Reporting by Stephanie Eagling Peche

September/October 2022

The Institute for Population and Social Research, Mahidol University hosted a webinar titled “The Global Parenting Initiative: Innovating delivery of parenting and psychosocial support to families living on the Thailand-Myanmar border” on 28 September. This seminar reviewed the literature on parenting and barriers to accessing parenting and psychosocial support in forced displacement settings, as well as presented the design of the project on the Thailand-Myanmar border.

You can view recording below

https://www.facebook.com/plugins/video.php?height=314&href=https%3A%2F%2Fwww.facebook.com%2FIPSRMAHIDOLUNIVERSITY%2Fvideos%2F611996220601103%2F&show_text=false&width=560&t=0

 

The team is also in the process of developing a script with Sermpanya Foundation for an evidence-based parenting film. The script will be presented to partners for community feedback.

November 2022

Family and Community-Based Approaches for Closing The Treatment Gap in Low-Resource Settings

Family and Community-Based Approaches for Closing The Treatment Gap in Low-Resource Settings Seminar

The Parenting on the Border research team was busy in November preparing for the next phase of research, a cluster-randomised controlled trial that will begin in 2023.  Sermpanya Foundation has begun production on the evidence-based film intervention, with casting finalised and filming beginning this month.  

Members of the research team have had the opportunity to collaborate in person, as Ajahn Sureeporn Punpueng, Ajahn Pattraporn Chuenglertsiri and Lwin Khine Zar welcomed Stephanie Eagling-Peche to the Annual Mahidol Migration Conference in Bangkok. The conference provided insight into the labour and migration policy context within Thailand and allowed for in-person research development sessions. This month, Principal Investigator Professor Eve Puffer also led a special seminar for the Institute for Population and Social Research, Mahidol University on Global Mental Health: Family and Community-Based Approaches for Closing The Treatment Gap in Low-Resource Settings.