Outcomes of a Culturally-Tailored Trauma Intervention in Zimbabwe: Results from Children's Drawings

Background

Drawings have increasingly been used as a qualitative data collection tool (De Lange et al., 2012; Mayaba & Wood, 2015) to understand children’s lived experience (Fabris et al., 2023). Drawings are highly relevant across cultures, can support marginalized and highly vulnerable children (Green & Denov, 2019), and can reveal changes in knowledge, attitudes, and self-appraisals (Kaplun, 2019). In Global South contexts, data collection via drawings can be a novel component of broader anti-oppressive research efforts to de-center Western knowledge systems and assessment approaches. Yet, while drawings have been used extensively in social work practice, their research utility for assessing intervention outcomes has been underexplored (Fabris et al., 2023). To advance the use of drawings for community-engaged global social work research, this presentation shares findings from a study in Zimbabwe that was co-designed with community partners and used drawings to evaluate intervention impacts with vulnerable youth.

Methods

A mixed-method cluster randomized controlled trial was conducted to evaluate a culturally-tailored biopsychosocial workshop (Singing to the Lions; Brakarsh et al., 2022) designed to enhance resilience among marginalized and trauma-affected youth (n=1,081) ages 13-17 in Zimbabwe. The qualitative study phase used a drawing activity with a sub-sample (n=51) of urban and rural participants to explore intervention impacts from children’s perspectives. Participants were provided with paper and colored pencils and asked to draw a picture of themselves along with people/things that help them to “sing to their lions” (i.e., conquer their fears). Facilitators then conducted a brief interview in Shona asking children to (a) name the people/objects, (b) describe how they help them sing to their lions, and (c) title their drawing. Drawings and interview responses were translated then analyzed by a bilingual team using in vivo coding to identify participant-driven program impacts.

Results

Drawing analysis yielded distinct themes of resilience from the rural sub-sample (n=16) versus urban sub-sample (n=35). Three themes emerged from drawings by rural children: (1) Safe People, (2) Safe Places, and (3) Safe Activities. Drawings included adults that children could trust to help them in times of fear or violence (e.g., parents, teachers, community elders) as well as the schools, churches, and police stations identified as places they could go in times of trouble. Rural children depicted themselves playing games, ignoring troublemakers, and running away from violence as methods for staying safe. Two themes emerged from drawings by the urban sub-sample: (1) Coping Tools, and (2) Cognitive Reframing. These drawings depicted children using tools they had learned in the intervention to calm fears (e.g., breathing techniques) and to reframe their fears in empowering ways (e.g., roots of their “tree of life”).

Conclusions

Findings illuminated children’s appraisals of intervention impact which offered a unique and geographically-tailored perspective compared to traditional intervention assessment approaches. Presenters will conclude with a discussion of how drawing results were shared with each community, including via local events, conversations with community leaders, and digitally, to illustrate one strategy for social work researchers to more deeply engage with communities and advance social justice for marginalized global populations.