Co-Designing a Culturally-Sensitive Parenting Support Program for Refugee and Asylum-Seeking Parents of Children Under 5 Living in Resource-Limited Settings (PSP-REFUGEE)

Background: The UK has the highest level of homelessness in the developed world putting the most underserved children at risk. There has been an increase in the number of asylum seekers being placed in TA, with 67,337 asylum applications being made in the UK in 2023. Refugee and Asylum seeking (RAS) families are experiencing homelessness in some of the most restricted environments impacting on the heath and development of their children, especially those under 5. RAS family circumstances in the UK are aggravated by poverty, limited resources, disrupted social support and networks, and culture shock. Parenting programmes have the potential to address these challenges, but existing programmes are based on western child nurturing norms with few being culturally adapted. The system around the families is also fragile with many pressure points across health, housing, and social care. The overarching aim of our Programme: Mediate the adverse effects of low-resource environments like temporary accommodation (TA) on RAS children by co designing a cross-sectoral, culturally sensitive, and tailored parenting programme and strengthening the system that is required for its successful delivery and implementation. Our interdisciplinary team including a parent co-applicant, has a successful track record of working with underserved communities using creative and innovative methodologies to represent their voices in meaningful way. The team and collaborators extend across England with support from higher education institutions, the NHS, local authority, housing and third sector partners. Programme Development Grant objectives: 1. To scope and learn from global early years parenting programmes for RAS families in TA to inform content and strategies for delivery in a UK context along the Healthy Child Programme (WP1, M1-6). 2. To conduct needs analysis of frontline health visiting services for delivering culturally sensitive parenting support (WP1, M1-6) 3. To fully map the cross-sectoral eco-system of services and policymakers (housing, education, healthcare, social care, legal) within which RAS families raise their children to understand where fragile and pressure points are to inform strategies for system strengthening and implementation (WP2, M4-8). 4. To work in partnership with RAS families to inform meaningful, feasible, and sustainable ways of engagement throughout the research cycle including implementation ensuring equitable voice and recognition of lived experiences (WP3, M3-17) 5. To work with creative artists to understand how the creative arts can be used throughout the research cycle as a research methodology when working with underserved communities and cross-sector professionals (WP4, M5-13). 6. To identify existing early years health, wellbeing, and developmental outcome measures in line with Healthy Child Programme and to review identified measures with cross-sector professionals and RAS families for cultural acceptability, appropriateness, and applicability (WP5, M2-15). 7. To review process evaluation measures for RAS families in TA context (WP5, M2-15). 8. To collate and synthesise the learning to inform the Programme Bid (WP6, M16-18). Impact: PSP-REFUGEE will transform support available for RAS families to improve safety, health, and development of children under 5. Development work will establish appropriate and sustainable pathways and resources for intervention development and implementation for and with RAS families.