Mothering from the Inside Out: Adapting an evidence-based intervention for high-risk mothers in the Western Cape of South Africa
Mothering from the Inside Out: Adapting an evidence-based intervention for high-risk mothers in the Western Cape of South Africa
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DOI：
10.1017/s0954579418001451
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发表时间：
2020-02-01
影响因子：
3.3
通讯作者：
Voges, Juane
中科院分区：
文献类型：
--
作者：
Suchman, Nancy;Berg, Astrid;Voges, Juane
在南非作为民主国家的头二十年里，西开普省对其医疗保健系统进行了彻底的改革，以解决种族隔离时代遗留下来的广泛的社会经济不平等。虽然取得了进展，但显然需要采取干预措施，支持在公共部门接受保健服务的父母和儿童，他们容易受到与赤贫有关的多种心理社会风险的影响。在这项混合方法研究中，我们研究了适应循证育儿干预的可行性和可接受性，这种干预被称为“由内而外的母亲”，是为美国容易受到类似风险的母亲开发的。使用定性的方法，我们记录的协作过程，是以社区为基础的参与性研究的原则为指导，并在西开普省的合作者的观点的可行性和可接受性的干预检查的主题。采用定量方法，我们测试了改编版的母亲从内到外，改善母亲的反思功能和母子互动的初步疗效。虽然两个研究部分的结果表明了初步的希望，但多个层面的一些障碍和挑战强调了以下需要：（a）在资源不足的社区进行干预研究的灵活性和背景支持，（B）对父母在高度紧张，资源不足的环境中抚养孩子的独特经历的临床敏感性，以及（c）平等的伙伴关系，使当地供应商的专门知识能够为咨询调查人员的设计提案提供信息。
During South Africa's first two decades as a democracy, the Western Cape Province has undergone radical changes to its healthcare system in an effort to address the extensive socioeconomic inequities that remain in the aftermath of the apartheid era. Although progress has been made, there is a clear need for interventions that support parents and children receiving health services in the public sector who are vulnerable to multiple psychosocial risks associated with extreme poverty. In this mixed-method study, we examined the feasibility and acceptability of adapting an evidence-based parenting intervention called Mothering from the Inside Out that was developed for mothers who are vulnerable to similar risks in the United States. Using qualitative methods, we documented the collaborative process that was guided by principles of community-based participatory research and examined themes in the Western Cape collaborators' perspectives about the feasibility and acceptability of the intervention. Using quantitative methods, we tested the preliminary efficacy of the adapted version of Mothering from the Inside Out for improving maternal reflective functioning and mother-child interactions. Although findings from both study components indicated preliminary promise, a number of obstacles and challenges at multiple levels underscore the need for (a) flexibility and contextual support for intervention research conducted in under-resourced communities, (b) clinical sensitivity to the unique experiences of parents rearing children in highly stressful, under-resourced environments, and (c) equal partnerships that allow the expertise of local providers to inform the design proposals of consulting investigators.