From lived experience to intervention design: engaging adolescents and parents living in conflict affected Democratic Republic of Congo to inform content of a parenting intervention guided by the Medical Research Council framework

BackgroundBy the end of 2023, it was estimated that over 473 million children were living in areas affected by armed conflict globally. In these settings, adolescents are at heightened risk of experiencing multiple forms of violence. While parenting interventions are a promising strategy that can equip parents with skills and practices to prevent violence against children, little is known about desired content of parenting interventions for caregivers of adolescents in conflict settings. This qualitative study aims to address this gap through participatory methods with adolescents and parents in a setting of co-occurring conflict and displacement. The study is situated in the development phase of the Medical Research Council (MRC) framework for developing and evaluating complex intervention.MethodsSame-sex participatory workshops were conducted with n = 73 participants: n = 37 parents, n = 16 adolescent boys and n = 20 adolescent girls living in Ituri province of the Democratic Republic of Congo. Workshops explored perception of the burden of violence among adolescents, the experience of parents living in a conflict setting, associated changes in parenting practices, and proposals on content for parenting interventions to reduce violence against adolescents. The study applied reflexive data analysis and grouped themes corresponding to the research question.ResultsParents and adolescents perceive parenting interventions as a strategy that may contribute to reducing different forms of violence experienced by adolescents. Majority of content in existing parenting interventions were nominated by adolescents and by caregivers. Nine components/themes were identified by participants as important for inclusion in a parenting intervention. Three themes related to experiences of violence, three themes related to healthy relationships and three themes related to strategies for parents to manage their conduct, skills, and their mental health. While the parenting content proposed as relevant for participants in a conflict setting mirrors content from non-conflict settings, the findings illustrate the necessity to tailor interventions to strengthen the adolescent-parent relationship and address family violence.ConclusionThe findings can inform researchers, policy makers and practitioners working with adolescents and parents in conflict settings on what content to adapt, newly develop or replicate to evaluate and implement evidence-based parenting interventions.