Engaging local communities in parent-based programs: lessons learnt from an Intimate Partner Violence and substance misuse intervention in Sri Lankan pre-schools.

Abstract

I undertook this doctoral research, based in Sri Lanka, to work with local communities to develop and implement a community-based intervention, and to document learnings along the way. The intervention was a community-based advocacy program that aimed to be affordable, adaptable, effective, sustainable, and community driven. It addressed complex issues of intimate partner violence (IPV) and substance misuse in a complex social setting (vulnerable communities of poor families/parents with children attending government preschools in two urban locations). My research focus was the process and insights gained from the community engagement undertaken during this intervention study, rather than the intervention study itself. My research aims were: to work with community to design and implement a community led training program that addresses a complex issue (IPV and substance misuse); and to review the process of engaging community in designing and implementing the program to understand how to maximise its effectiveness in the target population. This thesis documents the processes and lessons learnt. The research approach I used was iterative, joint, participatory and co-operative, and fostered co-learning between community and researchers. Community partners (including preschool teachers and service providers) were included early in the design of our intervention through meetings and workshops. Engaging partners in this way ensured they were empowered to contribute and guide each phase of the research to suit the needs of the community. I used a mixed methods approach to collect data, guided by the community-based participatory fundamentals as outlined by Israel et al (1998). With community participation, I developed and implemented a cross-sectional survey to collect the following data: quantitative data (demographic, IPV experience, substance misuse, help seeking behaviour); and qualitative data (attitudes and beliefs about IPV, drug misuse and help seeking behaviour). In addition, I documented observations and discussions during all field activities such as community meetings, training sessions for the survey delivery team, and workshops to develop the intervention. Analysis of the cross-sectional surveys found that IPV was present in the communities targeted, as was drug and alcohol misuse by fathers, and that use of available government services to address these issues was low. The reasons mothers experiencing IPV did not seek help included cultural or religious beliefs. The political settings in our study locations of Colombo and Galle influenced our data collection process, as did the long-term effects of living with trauma exhibited by members of our communities. Participation by fathers in the initial survey was low. To explore the reasons for this, and to inform future engagement of fathers, I undertook a literature review that aimed to: investigate how to successfully engage fathers in volunteer parenting interventions in low and lower-middle income countries; and to examine how to effectively retain fathers in such programs. Overall, this research found that improving the processes of designing, testing, and implementing the data collection and intervention by engaging the community early and at every phase using a community based participatory approach will support a better outcome. By engaging the community in this way, they are empowered through the process to increase control over their lives. The community should guide and lead projects that directly impact them, and delivery should be flexible in order to meet community needs. This research adds to the extremely limited evidence base for engaging fathers in voluntary well-being programs within complex social settings. Furthermore, the findings will be of practical use to field workers in the implementation of community-based programs in Sri Lanka and in similar settings internationally. Show more