DEVELOPMENT, IMPLEMENTATION AND EVALUATION OF A PARENTING INTERVENTION TO PROMOTE MOTHER-CHILD INTERACTION IN UNDERPRIVILEGED FAMILIES IN BANGLADESH

Abstract

Bangladesh is a developing country with approximately 165 million inhabitants (Bangladesh Bureau of Statistics [BBS], 2018). Among this huge population, nearly 14.8% are living below the international poverty line (The World Bank, 2019) and 71.2% of women are literate (BBS, 2018). Research indicates that the quality of mother-child interactions has an immense impact on children‟s development and educational outcomes (Mihelic et al., 2017; UNICEF Bangladesh, 2010). The main objective of the research was to investigate the effectiveness of the International Child Development Program (ICDP) in order to enhance the quality of mother-child interaction for disadvantaged families in Bangladesh. More specifically, this study addressed five research questions; these were as follows: (i) Does engagement in an 8 week parenting intervention increase mothers‟ feelings of competence as a parent? (ii) Does participation in the intervention produce significant improvements in parenting practices? (iii) Does engagement in the intervention show significant improvements in mother-child positive interaction? (iv)What changes are found in the mothers‟ conception of their children due to attend the intervention? (v) What characteristics distinguishes mothers who benefitted the most from the intervention from those who benefitted the least? The ICDP is non-instructive, designed to identify and reactivate local cultural parenting practices and to improve positive parent-child interaction (Hundeide, 2010). A mixed method design was used combining a single-blinded, randomised wait-listed control group trial with qualitative observations and interviews. One conveniently selected slum area was used where five intervention and five wait-listed control groups were formed. A total of 100 mothers participated in the intervention with random assignment to intervention (n=50) and wait-listed control groups (n=50). The inclusion criteria were that (i) participating families had a child aged one to three years; (ii) the PARENTING INTERVENTION IN UNDERPRIVILEGED FAMILIES Page iv mothers would be primary caregivers; and (iii) mothers had no prior experience of attending any parenting intervention programs. Intervention and wait-listed control groups had received the ICDP‟s 8-week two hourly centre-based group sessions. Along with a demographic questionnaire, measures were included the parenting sense of competence scale (PSOC), the parenting subscale of the parenting and family adjustment scale (PAFAS), the infant-toddler version of the home observation for the measurement of the environment (IT-HOME), the 6-item observation rating scale (ORS) of positive interaction, the observational guide for identifying mothers‟ caregiving qualities, and the semi-structured interview guides. All participants were assessed at two points of time: Pre-test and post-test. In addition, intervention experience related interviews were completed at post-intervention. A log book was used to keep all the records during intervention implementation. Daily session of the intervention was measured by an observational measure and a semi-structured feedback interview. Ethical issues were cautiously considered for data collection phases. Quantitative data were analysed through SPSS software using chi-square and MANOVAs whereas qualitative data were analysed through thematic analysis. This study findings indicated the effectiveness of the intervention in terms of both quantitative and qualitative data. Preliminary analyses of the study found that some of the sub-scales of three widely used measures, that is PSOC, PAFAS, and IT-HOME, were discarded from the main analyses due to their low reliability scores. The findings of main analyses identified that mothers‟ parental efficacy, parent-child relationship, and emotional and verbal responsivity were more important in promoting mother-child positive interaction for disadvantaged families of Bangladesh. Findings also showed a noticeable changes in mothers‟ parental satisfaction, coercive practices, maternal invlovement, and mediated interaction after receiving ICDP intervention. In consistent with quantitative findings, the qualitative observational analyses identified that all eight ICDP themes of positive mother-child interaction were more practiced in the intervention group mothers than in the wait-listed control mothers. A remarkable change was reported in the mothers‟ conception towards children measure between intervention and wait-listed control group. Findings revealed that children‟s motor abilities, socio-emotional relationship, and cognitive functioning were more exploring positive conceptions of the child to the intervention mothers. In contrast, control group mothers PARENTING INTERVENTION IN UNDERPRIVILEGED FAMILIES Page v more focused on negative conceptions of the child in terms of aggressive and non-compliant behaviour and less emphasised on children‟s abilities. Mothers‟ experience of the intervention also found ICDP‟s main concepts of positive interaction that categorised as maternal sensitivity to the child, positive attitude towards child, talk to the child, maternal mediation, and self-regulation. Overall, intervention experience of the mothers highlighted the caregiving qualities of mothers, learning aspects from the intervention, and parenting practices that changed after attending the ICDP intervention. This research also presented individual case studies to demonstrate the changes that occurred for the mothers in terms of their parenting practices. The mothers were selected as case studies from the intervention groups based on their responses on the quantitative and qualitative measures. By critically scrutinising data, the researcher found 12 cases who improved, 18 cases who did not change substantially, and 7 cases who did not improve from the intervention. Finally, the researcher selected six mothers who benefitted most and another five mothers who did not appear to benefit from the intervention. The individual case study analysis highlighted a comparative and deeper understanding of the mothers‟ perceived benefits from the intervention in terms of their living condition, family income, family type, and performance in the intervention. In summary, the broader view of the findings indicated the partial effectiveness of the intervention from which some mothers were benefitted whereas some were not benefitted from the intervention due to the mothers‟ poor educational background, disadvantaged living conditions, self-reported measures, and lower cognitive functioning while answering the questionnaires. The strengths and weaknesses of this study were included along with its future implications in policy making and capacity building of promising practitioners. Disseminating the knowledge of positive mother-child inteaction on a larger scale would be helpful for underprivileged as well as privileged mothers and other caregivers to promote advanced parenting practices and developmental outcomes of the children.