Mothering from the Inside Out: Adapting an evidence-based intervention for high-risk mothers in the Western Cape of South Africa
| Autor: | Toni Abrahams, Nasera Cader-Mokoa, Astrid Berg, Amy Adams, Waseem Hawa, Cindy DeCoste, Bulelwa Mpinda, Lameze Abrahams, Nancy E. Suchman, Brenda Cowley, Nosisana Nama, Anusha Lachman, Juané Voges |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Community-Based Participatory Research Evidence-based practice Psychological intervention Community-based participatory research Participatory action research Mothers Article 03 medical and health sciences South Africa Young Adult 0302 clinical medicine Nursing Developmental and Educational Psychology Humans 0501 psychology and cognitive sciences Child Poverty Extreme poverty Evidence-Based Medicine Parenting business.industry 05 social sciences Public sector Mother-Child Relations 030227 psychiatry Psychiatry and Mental health Female Implementation research Psychology business 050104 developmental & child psychology Qualitative research |
| Zdroj: | Dev Psychopathol |
| ISSN: | 1469-2198 |
| Popis: | During South Africa’s first two decades as a democracy, the Western Cape Province has undergone radical changes to its healthcare system in an effort to address the extensive socioeconomic inequities that remain in the aftermath of the apartheid era. Although progress has been made, there is a clear need for interventions that support parents and children receiving health services in the public sector who are vulnerable to multiple psychosocial risks associated with extreme poverty. In this mixed method study, we examined the feasibility and acceptability of adapting an evidence-based parenting intervention called Mothering from the Inside Out that was developed for mothers who are vulnerable to similar risks in the U.S. Using qualitative methods, we documented the collaborative process that was guided by principles of Community-Based Participatory Research and examined themes in the Western Cape collaborators’ perspectives about the feasibility and acceptability of the intervention. Using quantitative methods, we tested the preliminary efficacy of the adapted version of MIO for improving maternal reflective functioning and mother-child interactions. Although findings from both study components indicated preliminary promise, a number of obstacles and challenges at multiple levels underscore the need for (a) flexibility and contextual support for intervention research conducted in under-resourced communities, (b) clinical sensitivity to the unique experiences of parents rearing children in highly stressful, under-resourced environments, and (c) equal partnerships that allow the expertise of local providers to inform the design proposals of consulting investigators. During South Africa’s first two decades as a democracy, the Western Cape Province has undergone radical changes to its healthcare system in an effort to address the extensive socioeconomic inequities that remain in the aftermath of the apartheid era. Although progress has been made, there is a clear need for interventions that support parents and children receiving health services in the public sector who are vulnerable to multiple psychosocial risks (e.g., mental illness, substance abuse, physical injury) associated with extreme poverty. In this mixed method study, we examined the feasibility and acceptability of adapting an evidence-based parenting intervention called Mothering from the Inside Out that was developed for mothers who are vulnerable to similar risks in the U.S. MIO is a time-limited therapeutic intervention designed to enhance maternal reflective functioning (the mother’s capacity to make sense of her own emotions and to understand her child’s emotional needs within an attachment framework). Using qualitative methods, we documented the collaborative process within the sociocultural context of the Western Cape and examined themes in the Western Cape collaborators’ perspectives about the feasibility and acceptability of the intervention. Using quantitative methods, we tested the preliminary efficacy of the adapted version of MIO for improving maternal mentalizing capacity and mother-child interaction quality. In the introduction that follows, the rationale for this collaboration is first grounded within the context of the Western Cape’s recent history of health service reform. Next we explain the need for interventions that broadly target psychosocial risks in the context of poverty. An overview of the MIO intervention and its evidence base follows. Finally, the approach for adapting the intervention is described. In the next section, the qualitative study is presented, beginning with a timeline and description of the collaborative process followed by results of a thematic analysis of participating treatment providers’ perspectives about the feasibility and acceptability of the intervention within the local cultural context. In the following section, the quantitative study is presented in a conventional format (i.e., hypotheses, recruitment procedures, sample characteristics, measures, and results). Finally, in the Discussion we explore the implications of the qualitative and quantitative findings combined for future intervention and research development. |
| Databáze: | OpenAIRE |
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