A Randomized Clinical Trial Testing a Parenting Intervention Among Afghan and Rohingya Refugee Communities in Malaysia

Background and Purpose: Refugee parents undergo unique experiences when migrating to a new country and may benefit from interventions that target parent-child relationships, discipline strategies, and adaptation to new parental norms. Parenting interventions have demonstrated promise in improving relationships and wellbeing among diverse communities, with limited literature available regarding parenting strategies among forced migrants. The purpose of this study was to examine the effects of an 8-week parenting intervention on a number of parenting outcomes, among Afghan and Rohingya refugee communities residing in Malaysia.

Methods: The parenting intervention was developed in consultation with a local research team and drew from resources utilized with refugees in other contexts. Content focused on positive parenting, building family relationships, and coping with challenges in Malaysia. Participants were recruited in the greater Kuala Lumpur area through community centers, community leaders, community online chat groups, and word of mouth. Eligibility criteria included being age 18 or older, having at least one child under the age of 18, being a refugee or asylum seeker in Malaysia, and willingness to participate in a parenting intervention. Outcome measures included the Child Adjustment & Parent Efficacy Scale (CAPES), which had child intensity (α=.90) and parenting self-efficacy (α=.96) subscales; the Alabama Parenting Questionnaire-Short Form (APQ-9), which had positive parenting (α=.79), inconsistent discipline (α=.72), and poor supervision (α=.59) subscales; and the Family Functioning Scale (FFS), which had family intimacy (α=.92) and family conflict (α=.82) subscales. We used weighted scores to account for the underlying latent constructs in the outcomes. Linear piecewise models were run in Mplus using Bayesian estimation.

Results: The sample of 79 female participants were approximately 32 years old (SD = 7.95) and had been in Malaysia an average of 3.5 years (SD = 3.76). Participants were randomized into a treatment (n = 47) or waitlist control group (n = 32). The treatment group reported a decrease in child intensity (b = -0.37, p < .001), a decrease in family conflict (b = -0.45, p < .05), an increase in family intimacy (b = 0.29, p < .05), and an increase in parenting self-efficacy (b = 1.81, p < .001); these gains were maintained at the 3-month follow-up.

Conclusions and Implications: This parenting intervention may be most effective for child intensity, family intimacy, family conflict, and parenting self-efficacy. Significant effects observed across a number of parenting outcomes demonstrates the utility of such approaches in helping refugee families cope and adapt within stressful forced migration contexts. In resource-limited settings such as Malaysia, additional services that respond to social and economic needs of refugee families are needed. Policies that support family reunification, access to education for children, and permanent solutions for refugees and asylum seekers are also essential.