Evaluating the 3Cs Program for Caregivers of Young Children Affected by the Armed Conflict in Colombia

Abstract

Colombia has endured one of the world's longest internal displacement crises in recent history. Programs that address the practices and psychosocial wellbeing of the community of caregivers of young children in protracted crises are urgently needed. We developed and implemented a program aimed at strengthening the resilience and wellbeing of caregivers (parents, grandparents, and educators) of children enrolled in home-based and institutional centers for early childhood development in Colombia. The program, Conmigo, Contigo, Con Todos, or 3Cs, used purposive sampling across 14 municipalities disproportionately impacted by the armed conflict in Colombia. It consisted of two modules, a skills-building program (SBP) module and a psychotherapy intervention (PTI). The program content drew from cognitive behavioral therapy and mindfulness, and from inputs from local stakeholders. By applying a pragmatic evaluation strategy, we explored the pre-post intervention changes in parental resilience (the primary outcome of interest) through self-reports on the Connor-Davidson Resilience Scale (CD-RISC). The analysis of the pre-post intervention outcomes showed statistically significant improvements in CD-RISC in both intervention arms (SBP and PTI). Caregivers in the PTI group started with lower CD-RISC scores than caregivers who did not receive the PTI, and they showed the most improvement over time. Caregivers who had lower than average participation in the SBP (M=1-3 sessions out of a total of 6) did not show significant changes in CD-RISC. Additionally, caregivers who had higher than average participation in the SBP showed significantly more improvement in CD-RISC scores than caregivers who did not attend any sessions. We discuss the implications of these findings for future applications of the program and substantiate the measurable impact of interventions for caregivers in conflict settings.