Abstract
BACKGROUND: The Strong Families program has been successfully implemented in multiple low- and middle-income countries. However, Thailand has only recently begun exploring the program's potential. OBJECTIVES: To assess the feasibility, indicative effects, and adaptability of the Strong Families program. METHODS: This pilot project was conducted between June and July 2024 in Chiang Mai, Chiang Rai, and Mae Hong Son provinces in Thailand. Project trainers and family caregivers participating in the Strong Families program were recruited. Qualitative data were gathered prospectively through semi-structured interviews guided by the RE-AIM framework for project evaluation. Quantitative data were collected retrospectively, including pre- and post-training assessments using validated tools for the Strong Families program: the Strengths and Difficulties Questionnaire (SDQ), Parent and Family Adjustment Scale (PAFAS), and Child & Youth Resilience Measure-Revised Person Most Knowledgeable version (PMK-CYRM-R). Paired t-tests were conducted to indicate effects. RESULTS: A total of 10 trainers from 8 sites participated, with a majority being female and a mean age of 35.20 ± 5.78 years. Additionally, 47 participants joined the Strong Families program and completed pre- and post-training assessments, most of whom were female, with a mean age of 39.17 ± 10.71 years. Preliminary findings from the pre- and post-training assessments revealed significant improvements in family dynamics and child resilience. Most trainers who participated in the Train-the-Trainer (ToT) program found the Strong Families program easy to implement in their areas by following the guidelines provided. Trainers reported that the program enhanced family relationships and improved mutual understanding among family members. However, challenges were identified, including language barriers and age group differences among participants. Some trainers noted that certain sentences in the materials were difficult to understand and translating them into local languages posed additional challenges. Furthermore, older children completed activities more quickly and experienced more boredom compared to younger children, leading to reduced cooperation. The words/activity adjustments were made to align behavior with cultural norms of the community, such as a pat on the shoulder instead of hugging. Each area plans to expand family and trainer networks, focusing on developing local volunteer trainers to ensure sustainability and continuity. Trainers need ongoing support and feedback from instructors to increase confidence, improve skills, and adapt effectively, especially when working with vulnerable families. CONCLUSION: The pilot project demonstrated the feasibility and preliminary effectiveness of the Strong Families program. It holds significant potential for scalability and expansion to other areas in the future. CLINICAL TRIAL: Not applicable.