1. The bread wrapper study
Evaluating a mechanism for dissemination and evaluation of psychological “first aid” for families affected by the conflict in Syria
Aala El-Khani
Kim Cartwright
Rachel Calam
School of Psychological Sciences
The University of Manchester

2. The role of the family during displacement
Primary caregiver- ‘protective shield’ or further complicate war stress? (Elbedour et al, 1993)
Family cohesion is a significant predictor of refugee children’s mental health (Fazel et al 2012, Lancet)
Family violence is a strong predictor of change in a child’s mental health; improved family life working to protect and increased conflict associated with intrafamilial violence
THEY THEYB WILL BE GOING AND COMING

3. Using family skills approaches
Family and parenting skills have a key role in improving children’s wellbeing now and in the future
Prevention of emotional and behavioural difficulties, drug misuse, violence and crime
Adapting to needs, cultures and contexts

4. Can this approach help displaced families?

5. Exploring refugee parenting needs
8 one to one Interviews with refugee parents
4 focus groups with parents
2 Interviews with professional aid workers
Data collection was carried out inside refugee tents and refugee camp schools

6. Parenting challenges in refugee situations
Environmental specific challenges
Child specific challenges
Parent specific challenges

7. How can we reach large numbers of families in such challenging contexts?

8. Caregiver leaflet Questionnaire
What caregivers might be experiencing
What children might be experiencing
How caregivers can help themselves
How caregivers can help their children
Sample characteristics
Demographics
Usefulness ratings of leaflet
Open comment section

14. Results 3000 bread wrappers distributed over 5 days
1784 returned 59.5% return rate!
400 comments left

15. Sample Characteristics
Frequency
Percentage
Gender
Male
1307
73∙3
Female
452
26∙7
Missing 24
1∙3
Number of children 5
0∙3
1-4
1010
56∙6
5-8
714 40
9-12 32
1∙8 22
1∙2
Internally displaced
Yes
1271
71∙3 No
492
27∙6 20
1∙1
Length of time in current location (for displaced families)
<3 months
373
29∙3
3-6 months
404
31∙8
6-12 months
199
15∙7
>12 months
278
21∙9 17

16. Perceived overall usefulness of parenting leaflet

17. Content analysis Frequency of comments coded in themes (n=400)
Frequency
Percentage
Theme 1: Positive comments
289
68∙97
Theme 2: Modifications suggested 67
15∙99
Theme 3: Needs 36
8∙59
Theme 4: Faith 16
3∙82
Excluded 11
2∙63

19. Collaboration with an NGO

20. Key messages
Using existing humanitarian aid chains can be a very effective mechanism to reach families
There is a crucial need for family skills training and support for parents/caregivers who are affected by war and conflict
Despite all the traumas of displacement, parents are motivated to be the best parents they can be
We need to identify cost-effective ways of delivering such programs to these displaced families