The Apapacho Violence Prevention Parenting Program: Conceptual Foundations and Pathways to Scale

• In Event: Using Qualitative Research to Optimize the Design of Parenting Interventions in the Global South

Abstract

Violence against children (VAC) is a global issue that can lead to long-lasting negative consequences on children’s neural and skill development, physical and mental health, and well-being (McLaughlin et al., 2019; Nelson & Gabard-Durnam, 2020; Norman et al., 2012). Globally, violent punishment inflicted by main caregivers in the home is the most common form of violence against children younger than five (Cuartas et al., 2019). Colombia, specifically, is one of the countries where children have suffered the most due to contextual violence in the world (Save the Children, 2017) and has one of the highest rates of violent punishment in Latin America (Cuartas, 2018). In response, the National Government of Colombia recently implemented a ban on physical punishment, launched a national strategy to end VAC, and made a call for “[…] designing services, programs, and strategies aimed at preventing physical punishment […] in all settings” (author's translation; Gobierno de Colombia, 2021, p. 51). In this study, we responded to policy calls on the need for VAC prevention programs in Colombia by conducting a participatory, evidence-based design of the Apapacho (i.e., “to hug the soul” in the Nahuatl language) violence prevention parenting program. We conducted a systematic mapping of existing local services, the policy ecosystem, and the core components (i.e., content and delivery approaches) of evidence-based violence prevention parenting programs. Furthermore, we conducted semi-structured interviews and focus groups with policymakers (N=10), parents (N=38), and facilitators from existing parenting programs (N=20). We used the qualitative data to understand (1) existing services in Colombia, (2) what has worked well, current challenges, and potential opportunities in the prevention of VAC in Colombia, and (3) content and delivery approaches that could potentially maximize effectiveness and implementation outcomes (i.e., acceptability, adoption, appropriateness, feasibility, fidelity, integration, and sustainability) of Apapacho. We integrated methodological approaches, evidence (e.g., core components of existing programs), and context (e.g., qualitative evidence on the needs of key stakeholders), to inform the theory of change of Apapacho. Apapacho will be a parenting program based on ecological, developmental, and neuroscience-informed perspectives to prevent and/or reduce violence against children younger than five by promoting caregivers’ core capabilities for parenting and children’s executive function and self-regulation skills. Based on findings from the qualitative work and core components of existing programs, Apapacho will encompass content and delivery strategies such as building knowledge of child development and developmentally appropriate discipline techniques, promoting play and learning activities, strengthening communication skills, improving caregivers’ emotion knowledge and regulation, and delivering content using interactive and participatory strategies, among others. These components will be adapted in future stages of this work using rapid-piloting and optimization to improve implementation outcomes and embed Apapacho into existing services to ensure scalability.

Author

• Jorge Cuartas, Harvard University
  Presenting Author