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Impact of a mid-pandemic phone-delivered early stimulation parenting program targeting Syrian refugee and host community caregivers in Jordan

Sat, March 25, 8:15 to 9:45am, Salt Palace Convention Center, Floor: 2, Meeting Room 255 F

Abstract

Parenting can be both a joy and a burden for most parents, making parents’ mental health an important resource to consider when encouraging parents to increase the quantity and quality of caregiver-child interactions and early stimulation activities. Given the everyday challenges faced by refugee parents (as well as the communities in which they are most often hosted) and the possible trauma they have undergone from war and displacement, such parents may particularly benefit from psycho-social support or parenting programs (Sim et al., 2018). Specifically, such programs have been shown to decrease parenting stress along with decreased harsh parenting among two refugee communities and another marginalized community in Beirut, Lebanon (Ponguta et al., 2020); increased parental warmth and responsiveness among Syrian refugees in Lebanon (Miller et al., 2020). More generally, a metanalysis of parenting interventions in 33 countries revealed the effectiveness of parenting interventions, in the first 3 years of a child’s life, in improving early childhood development outcomes (Jeong et al., 2021).

Given these benefits, our program partners translated and adapted an evidence-based home-visiting program (Reach Up and Learn) that has been used in a wide range of low- and middle-income contexts (Grantham-McGregor et al., 2020; Walker et al., 2018) for use with Syrian refugee and Jordanian host community caregivers of young children. At the onset of the COVID-19 pandemic, this program was further adapted to be delivered through 30-minute phone calls three times per month for six months. This paper presents findings from our impact evaluation of this program, as delivered in Irbid and Ramtha, Jordan from March to September 2021 to evaluate the impact of six months of the phone-based Reach up and Learn program on caregiver-reported parenting behaviors, child learning and development, and parental well-being, relative to basic health and nutrition support.

Community Health Volunteers (CHVs) recruited families from their social networks at baseline (N=2,298) who responded to a household survey that was administered by phone at baseline and endline. The survey assessed caregiver-reported mental health (depression and anxiety), parenting (parenting stress scale, parent self-efficacy, parent-child learning activities, caregiver responsiveness and discipline), and exploratory child outcomes (child’s social-emotional behavior and developmental milestones).

Following baseline data collection, CHVs -along with their caseloads- were randomly assigned to a control or treatment group. Caregivers in the treatment group received health, nutrition, early child stimulation messages, and well-being check-ins; while caregivers in the control group received only the health and nutrition messages. Following the intervention, endline data was collected from 1,714 of families recruited at baseline.

We find that caregivers in the group that received the early childhood messages report significantly fewer depressive symptoms after six months and that these findings are mediated by the comfort and lack of judgment exhibited in the relationship between the CHV and the caregiver. To the best of our knowledge, this study is the first evaluation of a phone-delivered parenting intervention implemented among Arabic-speaking population. We believe that this study will contribute significantly to the field, especially for populations that are hard to reach.

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