Ladnaan : evaluation of a culturally tailored parenting support program to Somali-born parents

Background: Research shows that immigrant families encounter different complexities and challenges in a new host country, such as acculturation, isolation and lack of social support. These challenges have been shown to have negative impacts on immigrant families’ mental and emotional health, family function, parenting practices and parents’ sense of competence. Parental support programmes have been shown to positively affect parental skills, strengthen the parent-child relationship, and promote the mental health of parents and children. However, universal parenting support programmes face challenges in reaching and retaining immigrant parents. In addition, there is limited knowledge on the effectiveness of parenting support programmes among immigrant Somali-born parents and their children. Aim: The overall aim of this thesis was to develop and evaluate the effectiveness of a culturally tailored parenting support programme (Ladnaan intervention) on the mental health of Somali-born parents and their children. A further aim was to explore the parents’ experience of such a support programme on their parenting practises. Methods: The thesis involved two explorative qualitative studies and one randomised controlled trial (RCT). Study I employed qualitative focus group discussions (FGDs) to explore Somali-born parents’ need for parenting support. Study II involved an RCT study in which 120 parents with children aged 11–16 years, and parents with self-perceived stress relating to their parenting were randomised to an intervention group or a wait-list control group. The Ladnaan intervention consisted of three components: societal information (two sessions), the Connect parenting programme (10 sessions), and a cultural sensitivity component. The Ladnaan intervention was delivered in the participants’ native language by group leaders of similar background and experience, and modifying the examples and role plays in the Connect programme. The primary outcome was a reduction in children’s emotional and behavioural problems as measured by the Child Behaviour Checklist 8-16. The secondary outcomes were improved mental health among parents, as assessed by the General Health Questionnaire (GHQ12); and greater sense ofparenting competence, as measured by the Parent Sense of Competence (PSOC) scale. Study III comprises a qualitative study using individual semi-structured interviews (conducted two months after the Ladnaan intervention) to explore parents’ experiences of participating in a culturally tailored parenting support programme. Results: The results in study I, shows that Somali-born parents encountered challenges in the host country, which impacted their confidence in parenting and the parent-child relationship. These challenges included insufficient knowledge of the parenting system and social obligations as a parent in the new host country. Other parental challenges in the host country included a stressful society, isolation, role changes, and parent-child power conflict. The Somali parents experienced opportunities to rethink and modify their parenting and strengthen their relationship with their children in the new country, but needed support from the local authority and others in these endeavours. In study II, the Ladnaan intervention showed that, according to the parents’ self-reports, children in the intervention group showed significantly decreased aggressive behaviour, social problems, attention problems, externalising ofbehavioural problems, and in total problems at the two-month follow-up. Moreover, parents in the intervention group showed significantly and clinically improved mental health and sense of competence in parenting at the two-month follow-up. The improved mental health of the parents could, in part, be explained by their satisfaction in parenting. In study III, parents who participated in the culturally tailored intervention programme reported that it enhanced their confidence in parenting and contributed to their ability to become emotionally aware and available for their children. The parents attributed this to the combination of societal information, the Connect programme, and the cultural sensitivity ofthe Ladnaan intervention, which were most supportive for their parenting. The culturally sensitive approach ofthe parenting programme (i.e., conducted in their native language by bicultural and bilingual group leaders) was viewed by the parents as valuable for their participation in the programme, as well as for modifying their parenting practices. Conclusion: The culturally tailored parenting support programme helped parents overcome transition challenges related to social obligation as parents in the host country, and to modify their parenting orientation and styles in the new country. Furthermore, it improved the parents’ mental health and sense of competence in parenting, as well as reduced their children’s behavioural problems. When tailoring and delivering a parenting support programme to immigrant parents it is crucial to consider their specific needs and preferences and to ensure that the programme is culturally sensitive. Such an approach is more likely to contribute to participants’ engagement, retention, and acceptance of the parenting programme; and also improve their parenting practices and strengthen parent-child relationship, leading to improvements in children’s behaviour and parents’ mental health

Social Determinants of the Mental Health of Young Migrants

Background: Young migrants face particular risks to develop mental health problems. Discrimination and social support impact mental health, yet little is known about the differential impact thereof on mental health in newcomers, non-newcomer migrants, and nonmigrants. Aim: This study sheds light on mental health (posttraumatic stress, behavioral problems, hyperactivity, emotional distress, peer relationship problems, prosocial behavior) and the overall well-being of newcomers, non-newcomer migrants, and non-migrants. Furthermore, the impact of social support and discrimination on mental health is investigated. Method: Descriptive analysis and Structural Equation Modelling (SEM) were applied to analyze responses of 2,320 adolescents through self-report questionnaires in Finland, Sweden, and the UK. Results: Newcomers, non-newcomer migrants, and non-migrants have different psychological profiles. While newcomers suffer more from posttraumatic stress disorder (PTSD) and peer problems, non-newcomers and non-migrants report more hyperactivity. Discrimination strongly threatens all mental health dimensions, while support from family serves as a protective factor. Support from friends has a positive impact on PTSD among newcomers. Limitations: As this study has a cross-sectional design, conclusions about causality cannot be drawn. In addition, history of traumatic life events or migration trajectory was lacking, while it may impact mental health. Conclusion: Different mental health profiles of newcomers, non-newcomer migrants, and non-migrants point to the need for a tailored and diversified approach. Discrimination remains a risk factor for mental health, while family support is a protective factor for adolescents. Interventions that foster social support from friends would be especially beneficial for newcomers.acceptedVersionPeer reviewe

Mental Health of Refugee and Non-refugee Migrant Young People in European Secondary Education : The Role of Family Separation, Daily Material Stress and Perceived Discrimination in Resettlement

While scholarly literature indicates that both refugee and non-refugee migrant young people display increased levels of psychosocial vulnerability, studies comparing the mental health of the two groups remain scarce. This study aims to further the existing evidence by examining refugee and non-refugee migrants’ mental health, in relation to their migration history and resettlement conditions. The mental health of 883 refugee and 483 non-refugee migrants (mean age 15.41, range 11-24, 45.9% girls, average length of stay in the host country 3.75 years) in five European countries was studied in their relation to family separation, daily material stress and perceived discrimination in resettlement. All participants reported high levels of post-traumatic stress symptoms. Family separation predicted post-trauma and internalizing behavioral difficulties only in refugees. Daily material stress related to lower levels of overall well-being in all participants, and higher levels of internalizing and externalizing behavioral difficulties in refugees. Perceived discrimination was associated with increased levels of mental health problems for refugees and non-refugee migrants. The relationship between perceived discrimination and post-traumatic stress symptoms in non-refugee migrants, together with the high levels of post-traumatic stress symptoms in this subsample, raises important questions on the nature of trauma exposure in non-refugee migrants, as well as the ways in which experiences of discrimination may interact with other traumatic stressors in predicting mental health.acceptedVersionPeer reviewe

Migrant Students’ Sense of Belonging and the Covid‐19 Pandemic: Implications for Educational Inclusion

This article investigates school belonging among migrant students and how this changed during the Covid‐19 pandemic. Drawing on quantitative data gathered from 751 migrant students in secondary schools in six European countries (Belgium, Denmark, Finland, Norway, Sweden, and the UK), we examined the impact of Covid‐19 school closures, social support, and post‐traumatic stress symptoms on changes in school belonging. Linear regression showed a non‐significant decrease in school belonging, and none of the studied variables had a significant effect on this change in our whole sample. However, sensitivity analysis on a subsample from three countries (Denmark, Finland, and the UK) showed a small but significant negative effect of increasing post‐traumatic stress symptoms on school belonging during Covid‐19 school closures. Given that scholarship on school belonging during Covid‐19 is emergent, this study delineates some key areas for future research on the relationship between wellbeing, school belonging, and inclusion.</p

Profiles of Parental Burnout Around the Globe: Similarities and Differences Across 36 Countries

Parental burnout (PB) is a pervasive phenomenon. Parenting is embedded in cultural values, and previous research has shown the role of individualism in PB. In this paper, we reanalyze previously collected data to identify profiles based on the four dimensions of PB, and explore whether these profiles vary across countries’ levels of collectivistic-individualistic (COL-IND) values. Our sample comprised 16,885 individuals from 36 countries (73% women; 27% men), and we used a latent profile approach to uncover PB profiles. The findings showed five profiles: Fulfilled, Not in PB, Low risk of PB, High risk of PB and Burned out. The profiles pointed to climbing levels of PB in the total sample and in each of the three country groups (High COL/Low IND, Medium COL-IND, Low COL/High IND). Exploratory analyses revealed that distinct dimensions of PB had the most prominent roles in the climbing pattern, depending on the countries’ levels of COL/IND. In particular, we found contrast to be a hallmark dimension and an indicator of severe burnout for individualistic countries. Contrary to our predictions, emotional distance and saturation did not allow a clear differentiation across collectivistic countries. Our findings support several research avenues regarding PB measurement and intervention

Uppfattningar om att använda kat bland somaliska kvinnor och män boende i Sverige

Kat är en buske vars blad tuggas och saliven som bildas sväljs, för att uppnå stimulans. Den växer i Yemen, Etiopien och Kenya och smugglas till Sverige från Storbritannien via flyg samt bil. Kat-användandet är utbrett bland somalier i västvärlden och har medfört både hälsomässiga och socioekonomiska konsekvenser. För att förstå hur somalier i Sverige har anpassat sina uppfattningar gällande kat-bruk är syftet i denna uppsats att beskriva varierande uppfattningar om användande av kat hos några somaliska män och kvinnor boende i Sverige. Information samlades och analyserades utifrån en fenomenografisk studie design. Data samlades genom intervjuer.   Resultatet visar att kat-tuggande uppfattas både som en föda och som en drog. Största skälet till att kat brukas uppfattas som att den skapar gemenskap och sysselsättning. Den kat som används i Sverige smugglas vilket uppfattas problematiskt för somalier. Som implikation ska hälsofrämjande arbete genomföras utifrån det ekologiska perspektivet. Hälsofrämjande aktiviteter ska riktas på både individ- och familjnivå genom att ge information om kat, skapa sysselsättning samt stödja familjen. På samhälls- och organisations/policynivå är det viktigt att öka samarbetet mellan de somaliska föreningar och myndigheten samt att problemet kring kat sätts på agendan och diskuteras på nationell- och internationellnivå.  Kat is a plant whose leaves are chewed to produce juice and to be swallowed for its stimulating effect. Kat plant grows in Yemen, Ethiopia and Kenya. It is smuggled from Great Britain to Sweden by plane or car. The use of kat is widely spread among Somalis in western countries. This has led to both health and socioeconomic consequences for the users and their families. In order to understand Somalis’ attitudes regarding kat - the aim of this study was to describe variations of perceptions of the use of kat among Somalian men and women living in Sweden. A phenomenographic design was used to collect and analyze data. Data collected through interviews.   The findings show that chewing kat is perceived both as food and as a drug. The biggest reason for chewing kat is to create a feeling of belonging to a social group and to create activity. Kat being chewed in Sweden is smuggled here, which creates problems for Somalis. As an implication of this study health promotion activities, based on the theory of the ecological system, should focus on individual and family level for example by supporting and giving information to families on the issues of kat. Health promoting activities should also focus on community and organization/policy level to increase the cooperation between the Somali society and the public authority. Finally, the problem regarding kat should be on the agenda to be discussed both on national and international level.Har redan gått upp med min uppsats. Vill bara att den blir tillgänglig för de som vill läsa

Living in the Shadow of Political Decisions : Former Refugees’ Experiences of Supporting Newly Arrived Refugee Minors

Intending to support the cultural integration of unaccompanied refugee minors into the Swedish society, the Save the Children charity organization arranged meeting places in 2018 in four municipalities in Sweden. The mentors for the activities at these meeting places were recruited among former refugees who themselves had arrived in Sweden as unaccompanied minors. The study aimed to explore the experiences of being a mentor offering peer support to unaccompanied minor refugees at the meeting places. In this study, four semi-structured group interviews were conducted at the meeting places with 14 mentors, also former refugees. Data were analysed using thematic network analysis. Although the respondents expressed frustration concerning the Swedish migration politics, they all perceived the helping role as of utmost importance and connected this to positive emotions. The study highlights the unique contributions of peer support to the integration process of refugee minors by mentors providing social support, sharing experience-based knowledge and helping minors to navigate an often confusing and complex welfare system

Living in the Shadow of Political Decisions : Former Refugees' Experiences of Supporting Newly Arrived Refugee Minors

Intending to support the cultural integration of unaccompanied refugee minors into the Swedish society, the Save the Children charity organization arranged meeting places in 2018 in four municipalities in Sweden. The mentors for the activities at these meeting places were recruited among former refugees who themselves had arrived in Sweden as unaccompanied minors. The study aimed to explore the experiences of being a mentor offering peer support to unaccompanied minor refugees at the meeting places. In this study, four semi-structured group interviews were conducted at the meeting places with 14 mentors, also former refugees. Data were analysed using thematic network analysis. Although the respondents expressed frustration concerning the Swedish migration politics, they all perceived the helping role as of utmost importance and connected this to positive emotions. The study highlights the unique contributions of peer support to the integration process of refugee minors by mentors providing social support, sharing experience-based knowledge and helping minors to navigate an often confusing and complex welfare system

The views of Somali religious leaders on birth spacing : A qualitative study

Background Birth spacing is an important health intervention for women to attain good physical and mental health. In Somalia, religious leaders play a decisive role in approving or rejecting the use of family planning. Objective The study aimed to investigate Somali Islamic religious leaders’ views on birth spacing. Method Qualitative individual interviews were conducted with 17 Somali Islamic religious leaders aged 28–59 years and analysed through content analysis. Results The main category that emerged from the analysis was that the concept “birth spacing should be used and nor family planning to be in accordance with the Islamic religion. Two perspectives of views of birth spacing were identified: accepted ways and unaccepted ways. The accepted ways include breastfeeding, use of contraceptives causing no harm to the women’s health, and coitus interruptus. The preferred method should be determined by a joint agreement between the husband and wife, and that Muslim doctors should play a key role while the couples investigate their preferred method. Using contraceptives with the intention to limit the number of children was against Islamic values and practice. In addition, it was believed that using condoms promoted the temptation to engage in sex outside the marriage and was therefore prohibited. Conclusion According to the religious Islamic leaders, selected practice recommendations for contraceptive use is permitted in relation to birth spacing to promote the health of the mother and child. When providing professional contraceptive counselling to Muslim women, the word “birth spacing” is recommended to be used instead of “family planning”.Open Access APC beslut 6/2019</p