Overview

The Parenting on the Border project seeks to test a multilevel approach to improving caregiver and child outcomes among migrant and displaced families on the Thailand- Myanmar border. In 2024, the team completed a cluster RCT to evaluate the effectiveness of a universal entertainment-education film intervention to promote playful parenting and reduce violence against children in this high-adversity context. Results showing a 9% reduction in physical violence against children and improvements in positive and playful parenting have been published in The Lancet Regional Health – Southeast Asia journal. Through the support of local implementation partner, The Sermpanya Foundation, and funding received from the United Nations High Commissioner for Refugees (UNHCR), the Being Family film intervention has been delivered in three refugee camps on the Thailand- Myanmar border. The team is currently conducting a RCT evaluation of a trauma-informed adaptation of PLH for higher-need families, with data collection due to be completed in mid-2025.

Context

Families displaced by armed conflict, poverty, and insecurity face multiple challenges to accessing parenting and mental health support despite compelling evidence of the intergenerational impacts of trauma and adversity on child development and well-being. There is an urgent need for evidence on effective, cost-effective, and scalable interventions that are locally led and sustained through formal and informal service delivery systems in displacement settings.

Objectives

The study will test a wraparound approach to improving systems, population, and individual caregiver and child level outcomes among migrant and displaced families on the Thai- Myanmar border.

• Evaluate the effectiveness and cost-effectiveness of a population-level media campaign adapted from PLH to increase knowledge and skills around positive and playful parenting, reduce acceptance of violence against children, decrease harsh parenting, and promote caregiver and child wellbeing
• Co-design and evaluate implementation of a trauma-informed adaptation of PLH for higher-need caregivers
  Design, implement, and evaluate strategies to strengthen formal and informal systems for service delivery and sustainability in a volatile displacement context

Study Setting

An estimated 3 million people from Myanmar live in Thailand, the vast majority outside of refugee camps along the Thai-Myanmar border. Migrants and displaced families from Myanmar are exposed to multiple adversities including poverty, discrimination, and lack of access to quality education and healthcare that threaten the development and wellbeing of young children. Prospects of safe return to Myanmar have been dashed by the military coup in February 2021, which may trigger new displacements across the border. The research team has longstanding research experience and partnerships on the border, including 2 previous randomised controlled trials of parenting and mental health interventions.

Study Significance and Impact

This will be the first rigorous evaluation of a population-level media campaign to increase positive and playful parenting, reduce violence against children, and promote caregiver and child mental wellbeing in a displacement setting. If effective, this intervention approach could be easily replicated and scalable across Thailand and other LMICs to achieve population-level impacts at low cost. The study will also enable developing and testing of a trauma-informed adaptation of PLH for higher-need families, thereby informing strategies to effectively target and allocate resources for maximum impact.