Background There is robust evidence that compromised parenting, stemming from persistently high stress, mediates the impact of war and displacement on children's mental health and psychosocial wellbeing. Parenting interventions generally prioritize the acquisition of parenting knowledge and skills, while under-attending to parental stress and distress. This paper describes the development of the Caregiver Support Intervention (CSI), a nine-session group intervention for conflict-affected parents of children aged 3–13, that aims to strengthen parenting both indirectly, by lowering stress and improving psychosocial wellbeing among parents, and directly, by increasing knowledge and skill related to positive parenting. Methods We describe the multi-phase, iterative process by which we developed the CSI, and illustrate the essential role of community input in shaping the intervention and strengthening its cultural fit and perceived usefulness. We used focus group data from participants in successive cycles of implementation, feedback, and revision, as well as quantitative data and expert consultation to develop a culturally and empirically grounded intervention. Results This mixed-method, iterative approach to intervention development enabled us to develop a psychosocial intervention for conflict-affected caregivers that is feasible, acceptable, and perceived by participants as useful in addressing their own wellbeing and their parenting. Focus group data support the underlying model in which caregiver wellbeing powerfully influences parenting. Conclusions Programs aimed at strengthening parenting in conflict-affected communities should substantively address caregiver wellbeing. An iterative approach incorporating community feedback can help ensure intervention acceptability and feasibility. We also illustrate the feasibility of involving men in parenting interventions.

中文翻译：

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在受冲突影响的社区加强养育子女：制定照顾者支持干预措施

背景 有强有力的证据表明，由于持续的高压力而导致的养育方式受损，可以调节战争和流离失所对儿童心理健康和社会心理健康的影响。育儿干预通常优先考虑获得育儿知识和技能，而忽视父母的压力和痛苦。本文描述了看护者支持干预 (CSI) 的发展，这是一项针对 3-13 岁受冲突影响的父母的九次小组干预，旨在通过减轻压力和改善父母的心理健康来间接加强养育子女，直接地，通过增加与积极育儿相关的知识和技能。方法 我们描述了开发 CSI 的多阶段迭代过程，并说明社区投入在塑造干预和加强其文化契合度和感知有用性方面的重要作用。我们使用参与者在实施、反馈和修订的连续周期中的焦点小组数据，以及定量数据和专家咨询来制定基于文化和经验的干预措施。结果 这种干预开发的混合方法、迭代方法使我们能够为受冲突影响的照顾者开发一种可行的、可接受的并且被参与者认为对解决他们自己的幸福和养育子女有用的心理社会干预。焦点小组数据支持照顾者幸福感强烈影响育儿的基本模型。结论 旨在加强受冲突影响社区养育子女的计划应从实质上解决照顾者的福祉。结合社区反馈的迭代方法有助于确保干预的可接受性和可行性。我们还说明了让男性参与育儿干预的可行性。