Adaptation and implementation of a parenting curriculum in a refugee/immigrant community using a task-shifting approach: a study protocol.
Adaptation and implementation of a parenting curriculum in a refugee/immigrant community using a task-shifting approach: a study protocol.
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使用任务转换方法在难民/移民社区中适应和实施育儿课程：研究方案。
DOI：
10.1186/s12889-021-11148-2
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发表时间：
2021-06-06
影响因子：
4.5
通讯作者：
Rao N
中科院分区：
文献类型：
--
作者：
Whitaker DJ;Self-Brown S;Weeks EA;O'Connor MH;Lyons M;Willging C;Lee NH;Kumar JL;Joseph H;Reidy DE;Rivers D;Rao N
为难民和移民家庭提供循证干预措施存在诸多困难，原因包括语言和文化问题，以及接触和信任方面的问题，这些问题可能导致他们不愿与典型的干预实施系统合作。对循证干预措施及其实施系统进行调整，能够使这些干预措施更适合目标人群且更易被接受，从而提高采用率和效果。本研究聚焦于对 “安全育儿”（SafeCare©）育儿模式的调整，以及通过基于社区的组织（CBO）采用标准实施方法，和采用任务转移实施方式（即培训阿富汗、缅甸、刚果社区成员来实施 “安全育儿” 模式）来推行该模式。
一个由社区成员、CBO成员以及 “安全育儿” 专家组成的调整团队，将采用结构化流程，针对每个目标社区调整 “安全育儿” 课程。调整将同时关注模式本身及其实施方式。调整过程的数据收集将着重记录调整内容，以及团队成员对该过程的参与度和满意度。“安全育儿” 模式将以两种方式在每个社区实施：标准实施和任务转移实施。标准实施将由CBO（120个）负责，任务转移实施将由社区成员（120人）负责。所有干预人员都将接受标准化培训，并在培训后获得支持。同时将对实施指标和家庭成果进行评估。实施指标将包括持续的调整情况、服务提供情况、实施的忠实度、家庭对技能的掌握情况、参与度/完成情况以及对服务的满意度。家庭成果评估将包括在三个时间点（干预前、干预后和6个月后）对积极育儿方式、亲子关系、育儿压力以及儿童行为健康进行评估。
针对特定人群调整循证项目和实施方法的必要性，仍然是实施科学领域的一个重要研究问题。本研究的目标是更好地理解针对三个独特人群的调整过程和实施方法。我们希望该研究能为其他为难民社区提供健康干预的工作提供参考，最终改善难民的健康状况。
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. 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. 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.