Design, implementation and evaluation of a program to strengthen resilience-building skills among caregivers of young children impacted by the armed conflict in Colombia

• In Event: Exploration of caregiver experiences and community-based interventions among refugee, internally-displaced, and war-impacted communities

Abstract

Background and Purpose: Colombia has endured one of the world’s longest internal displacement crises in recent history. Programs that address the practices and psychosocial wellbeing of caregivers of young children in protracted crises are urgently needed. We developed and implemented a program aimed at strengthening the resilience and wellbeing of caregivers (parents, grandparents, and educators) of children enrolled in home-based and institutional centers for early childhood development in Colombia. The program, Conmigo, Contigo, Con Todos, or 3Cs, consists of two modules, a skills-building program (SBP) module and a psychotherapy intervention (PTI). The program content draws from cognitive behavioral therapy and mindfulness, and from inputs from local community members.

Method: The program has been implemented in multiple waves. The first wave used purposive sampling across 14 municipalities disproportionately impacted by the armed conflict in Colombia. By applying a pragmatic evaluation strategy, we explored the pre-post intervention changes in parental resilience (the primary outcome of interest) through self-reports on the Connor-Davidson Resilience Scale (CD-RISC). The following waves included purposive recruitment and sampling among fragile contexts.

Results: The analysis of the pre-post intervention outcomes showed statistically significant improvements in CD-RISC in both intervention arms (SBP and PTI). Caregivers in the PTI group started with lower CD-RISC scores than caregivers who did not receive the PTI, and they showed the most improvement over time. Caregivers who had lower than average participation in the SBP (M=1-3 sessions out of a total of 6) did not show significant changes in CD-RISC. Additionally, caregivers who had higher than average participation in the SBP showed significantly more improvement in CD-RISC scores than caregivers who did not attend any sessions. Group-level impacts were also detected in CD-RISC scores in other waves of implementation, among specific subgroups.

Discussion: We discuss the implications of these findings for future applications of the program and substantiate the measurable impact of interventions for caregivers in conflict settings. We will also discuss the challenges and enablers to the implementation and design of the program, and key research gaps that need to be addressed to strengthen practice and policy.

Authors

• Lina María González Ballesteros, Fundacion Saldarriaga Concha
  Presenting Author

• Camila Andrea Castellanos-Rocancio, Fundación Saldarriaga Concha

• Sascha Hein, Freie Universität Berlin

• Ana María Ortiz Hoyos, Fundacion Saldarriaga Concha

• Oscar Gómez, Fundacion Saldarriaga Concha

• José M. Flores, University of California los Angeles

• Amalia Londoño Tobón, Yale University

• Felipe Bolívar Rincon, Fundacion Saldarriaga Concha

• Liliana Angelica Ponguta, Yale University