The overall findings showed that the programme was implemented and delivered as intended; however, the implementation strategy was adapted during the course of delivering the four rounds of the programme to meet the needs of the target group. Results are presented according to the Moore et al. [22] framework.
Contextual Conditions For The Implementation
Some group leaders lacked support from their manager, while group leaders who worked at schools reported that they did not have enough preparation time for the sessions. The group leaders suggested that the managers should be involved in the planning phase so that they could set aside time for group leaders to prepare and deliver the sessions. The group leaders estimated a need for 8–10 hours per week for preparation and delivery.
According to the internal facilitators, parents were unsure about the involvement of social services in their parenting and the delivery of the intervention. Therefore, it was important to start with the societal information sessions as one of the lecturers who later led the Connect programme stated:
It was crucial that we began by talking about social services work with children and youth. This gave parents an understanding of the true purpose of social services and also helped relieve them of some of their worries. It also facilitated the engagement of parents in other topics in the parenting programme. I think we should always start with what is important for parents or what concerns them.
According to the group leaders and the field notes, one factor that supported the implementation was the involvement at the programme start of key individuals who were well-known Somalis and respected within the community. These key individuals arranged and participated in the initial informal meetings and reassured parents about the benefits of participating in the parenting programme. The group leaders and external facilitators were also crucial in terms of the cultural competence that the programme required. One lecturer stated, “It was the right person behind each post/work that we are very grateful for”.
The group leaders emphasised that programmes become sustainable when funded from the municipality or civil society. They believed that if the Somali associations [and not social services] had implemented the parenting programme, it might have been easier to recruit parents; on the other hand, this might have been difficult in terms of sustainability or quality assurance.
The internal facilitators stressed the fact that the venue was unsuitable for more than three children and lacked toys: this may have prevented couples from bringing their children and thereby being able to participate in the programme together. They suggested a more suitable and child-friendly venue where both young and older children can play during the sessions.
Implementation Process
Reach of the target group
Sixty parents were invited to participate in the programme. Of these, 58 did in fact participate, and nearly one third were fathers (n = 17). Of the 58, 40 attended more than eight sessions while 17 attended fewer than eight sessions.
Adaptations to the implementation strategy and perceptions of the strategy
In addition to the components in the strategy to reach and retain parents, peer information [i.e. parents who completed the programme informing other presumptive participants about their experience] was added after the first two groups in the programme had completed their sessions. Peer information was felt to contribute to information about the programme reaching more parents.
Parents appreciated receiving a diploma upon successful completion of the programme, which was a strategy to retain their involvement.
An implementation strategy used in the programme was the sending of reminders to participants. However, it was soon realised that this strategy needed reinforcement and subsequently internal facilitators offered parents not living within the neighbourhood free transportation, which contributed to high attendance. One internal facilitator said:
In the beginning, when we saw that they [parents] hadn’t arrived 30 minutes before the session, we phoned them. If they told us that they had difficulties coming due to a lack of transportation, we offered them a lift. However, we later came to give all parents who lived outside the neighbourhood a lift.
Many participants took advantage of the group leaders’ and facilitators’ willingness to read and write their letters at most of the sessions. One group leader described his experiences supporting participants: It was positive supporting parents with reading or writing letters for them because parents were stressed about all the letters they received. In addition, this kind of support was helpful to engage and retain the participants in the sessions.
Fidelity to the Ladnaan Programme and perceptions of delivering the intervention
The interviews with the group leaders showed that the training with other group leaders before and during the programme, along with the supervision, enhanced their competence and self-confidence in delivering the parenting programme.
Connect instructors reported that the group leaders were knowledgeable both during the Connect training course and during delivery of the sessions. According to the Connect instructors, group leaders delivered the programme according to the manual. The Connect instructors felt that the group leaders delivered the sessions sensibly, and that they listened to the parents and sought to explain information in different ways. They also encouraged group leaders to use metaphors and proverbs, as well as verses from religion, one Connect instructors explained:
I had encouraged them to use metaphors, proverbs and religious verses because we had noticed that parents became engaged in the topic and had a lot to discuss when the group leaders used a proverb, something from the Quran or sometimes their own experiences.
Connect instructors pointed out that the supervision sessions were very important to ensure that the programme was delivered as intended. The lectures on parenting style and the work of social services were held in one session and took longer than planned. As a result of the FGD with the group leaders and the lecturer’s reflection notes, a suggestion was made to divide the two topics (societal information and parenting styles) into two sessions and to deliver the Parenting Styles lecture in Somali.
Mechanism Of Impact
The importance of parental engagement: the perspective of the group leaders
Group leaders reported that it took two to three sessions to build trust with parents and for parents to accept the programme. Some group leaders stated that most of the parents and group leaders knew each other and that this facilitated the building of trust with parents. Another crucial factor that contributed to the retention of participants was the Ladnaan Programme with its societal information component because most parents were eager to receive this information.
The group leaders agreed that the fact Somali was both their mother tongue and that of the parents served to increase parental involvement, which in turn contributed to their completing the programme. Further, the group leaders felt that the fact that they and the parents shared the same cultural background was a contributing factor for success. As one group leader stated:
I would say that the biggest success factor was that the group leaders and the parents shared the same country, culture and language and understood each other… for instance, a Swedish group leader would present the message and I would add examples from the culture or examples that they could identify with. (Female group leader 3)
The use of poetry, proverbs and metaphors served to make the programme culturally sensitive; this seemed to help the parents understand, recognise and realise the universality of parenting. Group leaders noted that the adaptation of role-play exercises and examples was crucial for parents to understand and view parental-child interaction from different perspectives, which led to further reflections and discussions on the part of the parents.
Parent satisfaction with the Ladnaan Programme
Parents were asked about their satisfaction with the Ladnaan Programme. The CSQ showed that 96% [n = 55] of participants were very satisfied. Most (70%) reported increased knowledge about social services and increased confidence to seek support from social services when facing difficulties with their children. All participants (n = 57) stated that their relationships with their children had improved. They reported a better post-programme understanding of themselves as parents, and of their children’s needs and behaviour; they also reported feeling more secure in their parenting role in Sweden. The total satisfaction (n = 39) ranged from 24 to 43 (M = 26.38, SD = 4.13). Overall, these findings demonstrate families’ high satisfaction with the programme.