Improving parenting skill through the strong families program in Thailand

Buawangpong et al. Archives of Public Health https://doi.org/10.1186/s13690-025-01743-9 (2025) 83:250 Archives of Public Health Open Access RESEARCH Improving parenting skill through the strong families program in Thailand Nida Buawangpong1,2, Aala El-Khani3,4, Apinun Aramrattana1, Chalermkwan Chutima5, Watjana Arunrangsi6, Chiraporn Tantihachai7, Chaisiri Angkurawaranon1,2, Amalee McCoy1,2, Kawinthip Rinpon2, Nopakoon Nantsupawat1,2, Karen Peters3, Zin Ko Ko Lynn6, Wadih Maalouf3 and Wichuda Jiraporncharoen1,2* 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. *Correspondence: Wichuda Jiraporncharoen Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Buawangpong et al. Archives of Public Health (2025) 83:250 Page 2 of 12 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. Keywords Parenting skills, Positive parenting, Family health, Program evaluation Text box 1. Contributions to the literature • This study is the first to evaluate the feasibility and preliminary effectiveness of the Strong Families program in Thailand using both qualitative and quantitative methods. • It provides insight into program adaptability across diverse community settings, including high-risk families and protective care centers. • The findings highlight key cultural and operational considerations necessary for localizing international parenting interventions in Southeast Asian contexts. • The study offers practical guidance for sustainable implementation through community-led trainer development and cost-effective strategies. Introduction Families worldwide face numerous challenges that affect their daily lives, including unemployment, difficulties with education, and environmental struggles [1]. These hardships are often compounded by additional factors such as migration, residing in refugee camps, or living in conflict or post-conflict zones [2]. In such high-stress environments, developing appropriate parenting skills becomes critical, as these skills profoundly influence various aspects of children’s health and development. Early childhood interactions predominantly occur within the family, and children may develop vulnerabilities if their parents or caregivers lack nurturing abilities, effective parenting skills, or face challenges such as poor health or financial instability [3, 4]. Strengthening family skills and competencies can provide vital reciprocal support for both parents and children [5]. In Thailand, parenting practices reflect a blend of traditional cultural values, health-related challenges, and the pressures of globalization [6]. These interconnected factors create a unique parenting environment, requiring caregivers to adapt their approaches to effectively support their children [7]. Addressing communication barriers and socio-economic issues is also essential for fostering effective parenting practices [8]. However, Thailand’s rapidly changing social dynamics have introduced significant challenges, particularly in addressing youth behavior and domestic violence [9]. This is evidenced by rising rates of substance abuse and gaming addiction among adolescents [10, 11]. Moreover, over 10% of children aged 4 to 6 years are at risk of behavioral and emotional problems. Children exposed to physical, e (...truncated)