Editorial Perspective: How can we help the children of Ukraine and others affected by military conflict?

Parents and caregivers play a key role in protecting children from the stresses of war. Their own experiences, changes they see in children in their care and the nature of the parenting they provide can have a profound effect on childrens' reactions. The adoption of a pyramid of resources from universally available psychoeducational materials to specialised forms of trauma-informed interventions allows for screening and provision of appropriate levels of assistance. The importance of consideration of the family's context, the evidence base and the capacity of informal and professional networks to support caregiving is discussed. Resources available through the United Nations Office on Drugs and Crime are provided to share experiences of building a pyramid of interlinked, evidence-based, trauma-informed interventions which have been developed in collaboration with families and practitioners experiencing life through the contexts of military conflict, displacement and resettlement.

The United Nations Office on Drugs and Crime's Efforts to Strengthen a Culture of Prevention in Low- and Middle-Income Countries.

This article discusses how decision-makers can be supported to strengthen a culture of prevention. This article presents an example of the United Nations Office on Drugs and Crime's (UNODC) work to engage with decision-makers to create readiness, demand, and capacity for evidence-based prevention programming among them, particularly in low- and middle-income countries. First, we utilized two of the UNODC's data sources to describe the context where the UNODC's prevention efforts take place. Analysis of the first dataset on prevention activities implemented globally revealed a gap in translating evidence into practice on a global scale. The second dataset consisted of UNODC policy documents mandating and guiding global action to address substance use. The analysis showed that at the level of political frameworks, prevention is gradually gaining more attention but is still frequently left in the shadow of health- and law enforcement-related issues. In addition, these guiding documents did not reflect fully the current scientific understanding of what constitutes an effective prevention response. Against this background, the feasibility of the UNODC's efforts to bridge the science-practice gap in the field of prevention was discussed by presenting the results from the UNODC's regional capacity-building seminars focused on the role of monitoring and evaluation in prevention programming. The results showed potential of this capacity building to affect the attitudes and knowledge of targeted decision-makers. Such efforts to increase decision-makers' readiness and ultimately their endorsement, adoption, and ongoing support of evidence-based preventive interventions should be continued and intensified.

Strong families: a new family skills training programme for challenged and humanitarian settings: a single-arm intervention tested in Afghanistan.

BACKGROUND: Children living in challenged humanitarian settings (including those in rural/underserved areas, the displaced, refugees, in conflict/post conflict situations) are at greater risk of mental health difficulties or behavioural problems, with caregivers acting as their main protective factors. While many family skills programmes exist, very few were developed for, or piloted in, low resource settings (settings with limited infrastructure, typical of humanitarian settings). We therefore designed a brief and light programme; the Strong Families (SF) programme, consisting of 5 h contact time over 3 weeks. We conducted a pilot study with the aim to test the feasibility of implementation, and a preliminary look at the effectiveness of SF, in improving child behaviour and family functioning in families living in Afghanistan. METHODS: We recruited female caregivers and children aged 8-12 years through schools and drug treatment centres in Afghanistan and enrolled them in the SF programme. Demographic data, emotional and behavioural difficulties of children and parental skills and family adjustment measures were collected from caregivers before, 2 and 6 weeks after the intervention. Outcome was assessed through the SDQ (Strengths and Difficulties Questionnaire), assessing children's behavioural, emotional, and social issues, and PAFAS (Parenting and Family Adjustment Scales), measuring parenting practices and family functioning. RESULTS: We enrolled 72 families in the programme with a 93.1% retention rate (n = 67) for data collection 6 weeks post intervention. Mean age of caregivers was 36.1 years, they had 3.8 children on average and 91.7% of them had experienced war/armed conflict in their past. The average total difficulty score of the SDQ (ranging from 0 to 40, with scores above 16 being indicative of high problems) of the 72 children reduced significantly, from 17.8 at pre-test to 12.9 at post-test and 10.6 at second follow-up, with no difference in gender and most noticeably amongst those with the highest scores at baseline. Likewise, PAFAS scores decreased significantly after the programme, again with caregivers with the highest scores at baseline improving most. CONCLUSIONS: The implementation of a brief family skills programme was seemingly effective and feasible in a resource-limited setting and positively improved child mental health and parenting practices and family adjustment skills. These results suggest the value of such a programme and call for further validation through other methods of impact assessment and outcome evaluation. TRIAL REGISTRATION: ISRCTN76509384. Retrospectively registered on March 9, 2020.

Caregiving for children through conflict and displacement: a pilot study testing the feasibility of delivering and evaluating a light touch parenting intervention for caregivers in the West Bank.

A child's adjustment to wartime stress is reliant not only on individual responses and qualities, but very significantly on the availability of support that they may receive from their parent or caregivers and quality of relationships. Strengthening parental support has the potential to be valuable. A pilot two-arm randomised controlled trial investigated the feasibility of delivering and evaluating the "Caring for Children Through Conflict and Displacement" intervention with caregivers in the West Bank. Feasibility to recruit and train non-specialist staff on-the-ground to screen families for eligibility, collect outcome data, deliver the intervention and to recruit and retain families in the study were examined. Research staff and intervention facilitators were successfully appointed in the field, screened participants and delivered the intervention to 120 caregivers, collecting outcome measures pre-and post-delivery. All families completed the outcome measures, with very little missing data. This indicated that the intervention can be delivered feasibly and evaluated with families in this humanitarian context. Preliminary outcome data showed promise that the intervention may have the potential to both improve family functioning and reduce children's problem behaviour. Implications of family-focused initiatives, particularly within a conflict/post-conflict context for the prevention of several negative health and social outcomes directions, are discussed.

Lions Quest Skills for Adolescence Program as a School Intervention to Prevent Substance Use-a Pilot Study Across Three South East European Countries.

Development of personal and social skills in a classroom prevents later drug use and alcohol abuse, and influence-related risk factors. However, clinical trials on the potential impact of such programs from low- or middle-income countries remain limited. Lions Quest Skills for Adolescence (LQSFA), a school-based prevention intervention supporting life skills, was implemented in three South East European countries. This was a collaboration between the United Nations Office on Drugs and Crime, the Lions Clubs International Foundation, and the Ministries of Education of Serbia, the Former Yugoslav Republic of Macedonia and Montenegro. The pilot was a multisite non-randomized trial. A total of 2964 elementary school students received the intervention through 232 instructors trained by the same internationally certified trainer. These were compared to 2232 students following the regular curriculum, which does not include LQFSA, in the same elementary schools. The assessment was done at the beginning and at the end of the same academic year (period of 10 months). Despite limited fluctuations, the overall results indicated an encouraging outcome on the current use of substances (alcohol, cigarettes, and marijuana) as well as intention to using these substances in the next 3 months among current users. This study attempts to address this aforementioned gap in literature and contributes to the body of research demonstrating the value, feasibility, and transferability of life skills programs in achieving prevention outcomes in South East Europe. Moreover, it paves the way to a future randomized clinical trial to further corroborate the results, overcoming limitation in current study design.

Report on the International Workshop on Drug Prevention and Treatment in Rural Settings Organized by United Nation Office on Drugs and Crime (UNODC) and World Health Organization (WHO).

Very little evidence has been reported in literature regarding the misuse of substances in rural areas. Despite the common perception of rural communities as a protective and risk-mitigating environment, the scientific literature demonstrated the existence of many risk factors in rural communities. The Drug Prevention and Health Branch (DHB) of the United Nations Office on Drugs and Crime (UNODC), and the World Health Organization (WHO), in June 2016, organized a meeting of experts in treatment and prevention of SUDs in rural settings. The content presented during the meeting and the related discussion have provided materials for the preparation of an outline document, which is the basis to create a technical tool on SUDs prevention and treatment in rural settings. The UNODC framework for interventions in rural settings is a technical tool aimed to assist policy makers and managers at the national level. This paper is a report on UNODC/WHO efforts to improve the clinical conditions of people affected by SUDs and living in rural areas. The purpose of this article is to draw attention on a severe clinical and social problem in a reality forgotten by everyone.

Why do we Need to go Digital? Process of Developing an Online Facilitator Training Platform for a Global Family Skills Programme for Drug Use Prevention.

Strong Families is a programme developed for families living in challenged or stressful settings to prevent poor mental health and developmental outcomes, violence, and substance use. Facilitators are conventionally trained in person over two full days, by experienced international trainers. During the COVID-19 pandemic and due to travel restrictions, we developed an online course to deliver the content of the training manual electronically, with videos explaining the most difficult exercises, note taking functions and click and reveal activities to check their understanding. We further blended synchronous and asynchronous course formats to accommodate facilitators' different time zones and work schedules. We tied two educational theories (Malcom Knowles theory of andragogy and Blooms taxonomy) into the Strong Families online course, to ensure learners are easily able to understand content, remember it and implement the gained skills within their communities. The aim of this paper is to discuss the process of the development of the Learning Management System and the Strong Families online course, as well as its benefits, key tools and essential considerations for replication through the UNODC multi-country and inter-disciplinary experience in digitalizing the Strong Family skills prevention tool to support other institutions interested in such a process, including in anticipation of future similar circumstances. To date, our online course has been made available in 10 languages, benefitting facilitators from 11 countries and the respective beneficiary families. Further impact evaluation, fidelity of implementation during national scale up and return on investment of integration of blended-learning concepts still need to be assessed.

Assessing the efficacy of a brief universal family skills programme on child behaviour and family functioning in Gilgit-Baltistan, Pakistan: protocol for a feasibility randomised controlled trial of the Strong Families programme.

PURPOSE: The global burden of mental health difficulties among children underscores the importance of early prevention. This study aims to assess the efficacy, feasibility and acceptability of the Strong Families programme in enhancing child behaviour and family functioning in low-resource settings in Gilgit-Baltistan, Pakistan. METHODS AND ANALYSIS: This is a two-arm, multisite feasibility randomised controlled trial with an embedded process evaluation in three districts of Gilgit-Baltistan, namely Gilgit, Hunza and Skardu. 90 families living in these challenged settings, comprising a female primary caregiver aged 18 or above, and at least one child aged 8-15 years, will participate. Participants will be randomly assigned to either receive the Strong Families programme or to the waitlist group. Strong Families is a 7-hour family skills group intervention programme attended by children and their primary caregivers over 3 weeks. The waitlist group will be offered the intervention after their outcome assessment. Three raters will conduct blind assessments at baseline, 2 and 6 weeks postintervention. The primary outcome measures include the feasibility of Strong Families, as determined by families' recruitment and attendance rates, and programme completeness (mean number of sessions attended, attrition rates). The secondary outcomes include assessment of child behaviour, parenting practices, parental adjustment and child resilience. Purposefully selected participants, including up to five caregivers from each site, researchers and facilitators delivering the intervention, will be interviewed. Descriptive statistics will be used to analyse primary and secondary outcomes. The process evaluation will be conducted in terms of programme context, reach, fidelity, dose delivered and received, implementation, and recruitment. ETHICS AND DISSEMINATION: This study has been approved by the UNODC Drug Prevention and Health Branch in the Headquarters office of Vienna and the National Bioethics Committee of Pakistan. Findings will be disseminated through publication in reputable journals, newsletters and presentations at conferences. TRIAL REGISTRATION NUMBER: NCT05933850.

The role of faith in parenting; considerations when implementing family skills interventions with families affected by armed conflict or displacement.

Religious beliefs and practices are fundamental to shaping family functioning in many countries and cultures around the world. They are often associated with a strong influence on parenting, and a potential resource for parents. While nurturing caregiving can act as a protective shield, buffering against the negative effects on children's well-being, armed conflict and displacement often compromises parental well-being and positive parenting practices. Making interventions available to families affected by conflict and displacement that help to develop the quality of parenting is now seen as an important component in the care of war-affected children, causing a rise in family skills interventions for humanitarian contexts. Accordingly, there are certain considerations that need to be taken to achieve cultural sensitivity and acceptability, that account for the influence of religion. Here we share our United Nations Office on Drugs and Crime (UNODC) experience in the case of implementing "Strong Families," a UNODC family skills programme implemented in over 30 countries, providing key recommendations. (1) Appreciate and account for common religious beliefs and practices in your target populations; (2) ensure programme material acceptability and sensitivity; (3) avoid initiation of direct discussions, on religious beliefs or practices; and (4) facilitator need to be trained and prepared to respond to questions about faith. Though these considerations are presented considering the implementation of family skills programmes, they are also relevant to a range of other programming in which direct social (or other) contact is made with families in challenged contexts, aiming to reduce any perceived gaps between trainers and the families they are working with, and give families a sense that their religious beliefs, values, and priorities are understood.

Protocol for a Trial Assessing the Efficacy of a Universal School-Based Prevention Program for Addictive Behaviors.

BACKGROUND: "Juego de Llaves" [ Set of Keys ] is a universal school-based prevention program for adolescents aged 12-15. It is aimed at reducing drug use and other addictive behaviors. This paper describes the full protocol for the evaluation design, instruments, randomization procedure, follow-ups, and primary outcomes. METHOD: Non-Randomized Control Cluster Trial in a set of Spanish secondary schools, with follow-ups at 12-, 24- and 36-months. Participants will be allocated to an experimental or control group. Using a digital application designed for the study, a battery of instruments will be used to assess addictive behaviors, sociodemographic variables, school climate and other transdiagnostic psychological variables. RESULTS: A pilot test will be carried out to test the implementation protocol and to calculate the sample size needed for outcome evaluation. After implementing the program, longitudinal statistical approaches will be used to report intervention efficacy and potential moderators and mediators. CONCLUSIONS: There is a lack of assessments on the effectiveness of school prevention programs, and this paper is expected to improve monitoring and ongoing evaluation in prevention.

Assessing the Efficacy of a Brief Universal Family Skills Programme on Violence and Substance-Use Indicators in Youth in Trentino and Parma, Italy: Study Protocol for a Multi-Centre, Non-Blinded, Cluster-Randomised Controlled Trial (cRCT) of Family UNited.

Homes in which families are experiencing stressful and challenging circumstances can foster a social space that engenders violent behaviours in parents, inadequate childcare, and the exposure of children to criminal and antisocial behaviours at an early age in addition to many other negative social and health consequences throughout their development. Family Skills Training offers a combination of parenting knowledge, skill building, competency enhancement, and support to strengthen family protective factors, such as communication, trust, problem-solving skills, and conflict resolution. Through over a decade-long experience piloting evidence-based family skills packages globally, we developed a universal open-source family skills package, "Family UNited" (FU), designed for families with children aged 8 to 15 years living in low- and middle-income countries (LMIC). The current study aims to explore the efficacy, fidelity, and acceptability of FU in Trentino and Parma, Italy. We plan to conduct a multi-site, non-blinded, two-armed, cluster-randomised controlled trial to assess efficacy in 160 families: the intervention group receiving FU and the waitlist/control group only receiving FU after the completion of all data collection points. We will prospectively collect outcome data, assessing changes in parenting skills and family adjustment in caregivers, children's behaviour, resilience capacities, and attitudes towards peer violence. To assess programme delivery, fidelity, feasibility, and acceptability we will include an embedded process evaluation. This study aims to evaluate the improvement in parenting skills, child well-being, and family mental health after participation in FU, compared to no intervention. Even though this trial is to be conducted in a high-income country, such results complement the existing piloting experience in LMIC. with impact-related measures encouraging the adoption of such approaches globally and beyond the EU borders.

Family UNited: piloting of a new universal UNODC family skills programme to improve child mental health, resilience and parenting skills in Indonesia and Bangladesh.

BACKGROUND: Family is one of the most influential social institutions and caregivers act as the main protective factors for children's mental health and resilience skills. Family skills programmes support caregivers to be better parents and strengthen positive age-specific and age-appropriate family functioning and interactions. We developed a universal, brief and light programme for implementation in low-resource settings, the Family UNited (FU) programme, and conducted a pilot study to show feasibility of implementation, replicability and effectiveness in improving family functioning, child behaviour and resilience. METHODS: We recruited caregivers with children aged 8-14 years through schools in East Java, Indonesia and Dhaka, Bangladesh to the FU programme. Demographic data, emotional and behavioural difficulties of children, child resilience and parental skills and family adjustment measures were collected from children and caregivers before, 2 and 6 weeks after the intervention. Outcome was assessed through the SDQ (Strengths and Difficulties Questionnaire), PAFAS (Parenting and Family Adjustment Scales) and CYRM-R (Child and Youth Resilience Measure). RESULTS: We enrolled 29 families in Bangladesh and allocated 37 families to the intervention and 33 to the control group in Indonesia. Overall, there was no effect over time in the control group on any of the PAFAS subscales, whereas significant reductions in scores were found on six of the seven subscales in either country in the intervention group, most prominently in caregivers with higher scores at baseline. We found highly significant reductions in total SDQ scores in the intervention group in both countries, whereas there was no effect over time in the control group in Indonesia. Boys in the intervention group in Indonesia and in Bangladesh seemed to have benefitted significantly on the SDQ as well as the total resilience scale. Overall, on the CYRM-R, particularly children below the 33rd percentile at pre-test benefitted substantially from the programme. CONCLUSIONS: The implementation of a brief family skills programme was seemingly effective and feasible in resource-limited settings and positively improved child mental health, resilience and parenting practices and family adjustment skills. These results suggest the value of such a programme and call for further validation through other methods of impact assessment and outcome evaluation. TRIAL REGISTRATION: Clinical Trial Registration: ISRCTN99645405, retrospectively registered, 22 September, 2022.

Bridging the Gap between the Pressing Need for Family Skills Programmes in Humanitarian Settings and Implementation.

A supportive environment with nurturing caregivers is essential for the healthy development of children. For children who have been exposed to extreme stress, such as humanitarian contexts, the need for strong, healthy, nurturing caregiver relationships may assume even greater importance. Much research has been building to position family skills interventions as a key tool in encouraging safe and supporting relationships between caregivers and children, thus preventing many problem behaviours and poor mental health. While there is substantial evidence of the effectiveness of family skills interventions in high-income and stable contexts, evidence of interventions that have been tested in humanitarian and challenging settings, such as contexts of refugee and displacement, are far fewer. Despite the role that family skills interventions can play in protecting children from current and future challenges, there is a significant lack of such interventions being utilised in humanitarian settings. We put forward seven likely reasons for this lack of uptake. Furthermore, the Strong Families programme, a UNODC family skills intervention, is presented as an example of an intervention that aims to bridge this gap of interventions that meet the need for humanitarian and contexts of extreme stress. More research is needed to unpack the content, delivery mechanisms and reach of family skills programmes to further aid programme developers in investing in efforts that might provide significant sustained impact for families in humanitarian contexts.

Caring for Your Child during COVID-19-Utilizing a Light-Touch Parenting Resource during Lockdown in Indonesia.

To tackle the spread of COVID-19 globally, countries around the world have responded by implementing measures such as lockdowns, social distance maintenance, temporary school closures, and remote working and learning. COVID-19 social isolation has been found to increase stress, and potentially have long term harmful effects on both mental and physical health. Stress and compromised parenting often place children at risk of violence and abuse. In parallel, times of hardship might also provide an opportunity to build stronger relationships with our children. The United Nations Office on Drugs and Crime (UNODC) joined many other agencies and international organizations in recognizing the threat the pandemic might have on individual and family wellbeing, and has thus availed a number of light-touch parenting resources. One such tool is the 'Caring for your child in response to the COVID-19 lockdown' booklet, developed to enhance parenting skills, and to build family harmony as challenged by the COVID-19 context. This short communication reflects on a feasibility study that took place in Indonesia during the implementation of this booklet with 30 parents in five cities. Thematic analysis identified challenges in parenting during COVID-19, as well as reported positive experiences of engaging in the parenting resource. The findings are discussed with regard to the usefulness of light-touch parenting information, adding to the context of the feasibility and global scalability of reaching families. The implications pave the way to the engagement and implication of more intensive parenting information interventions in high-stress contexts. Despite the challenge, there is promising news for families globally, as agencies and policy-makers begin to recognize the importance of supporting families with the appropriate skills to navigate extreme stress contexts with effective strategies.

"Because This Is an Evidence-Based Program": The Learning Experience of Croatia with the Lions Quest Skills for Adolescence, Implemented In-Person and Online.

Background: The Lions Quest Skills for Adolescence (LQSFA) is an evidence-based social and emotional learning program for school students. It is implemented as a teacher-led extracurricular activity for children aged 10-15 years. From 2019 to 2022, the United Nations Office on Drugs and Crime, in collaboration with Lions Clubs International Foundation, implemented the LQSFA in 41 schools in Croatia. Due to the COVID-19 lockdown measures, the intervention was adjusted into a hybrid modality (in-class and online). We evaluated the experience that the teachers had with the LQSFA in a hybrid modality. Methods: We used a focus-group discussion approach to evaluate the experience of five LQSFA teachers. Results: Three themes emerged: (1) the appreciation of evidence-based programs by the teachers, (2) the benefit of the LQSFA on the parents, and (3) the length of the online version of the questionnaire tool that was used to assess pre- and post-LQSFA experiences among students was too long. These results indicate that the LQSFA is undergoing a scaling on a national level in Croatia, even when implemented in a hybrid setting. Conclusions: Using an evidence-based program such as the LQSFA was rewarding for teachers, despite the challenges in the administrative adjustments regarding the online and in-person class teaching. LQSFA filled an important gap during COVID19-related stress.

Scaling the Children Immunization App (CIMA) to Support Child Refugees and Parents in the Time of the COVID-19 Pandemic: A Social Capital Approach to Scale a Smartphone Application in Zaatari Camp, Jordan.

BACKGROUND: Children vaccination is a key intervention for their survival, especially among refugees. Yet, children vaccination registration is done manually in refugees camps and there is no possibility to send reminders to parents to come back on time. We aimed to boost the parental registration of children's vaccination records on a Children Immunization app (CIMA) while also availing the parents with useful parenting skills under COVID-19-related stress. METHODS: We incorporated United Nations Office on Drugs and Crime (UNODC) Parenting Skills under COVID-19 information material, through CIMA in Arabic and English languages. We recruited 1100 children in February-March 2021, through a community health promotion dissemination approach. A team of two nurses from the local population and two volunteers (one trained nurse and one trained social worker), from the camp, was formed. They promoted the CIMA app at two clinics and through households visits in Zaatari refugee camp. Qualitative data on impressions and observations of the interactions with the Zaatari camp community were also collected. RESULTS: A total of 1100 children, up to 15 months of age, eligible for vaccination were enrolled in CIMA, whereby the staff explained the content of the app in terms of vaccination schedule, health promotion materials for vaccination and parenting skills to their caregivers. During the household visits, the volunteers identified a total of 70 children that have incomplete history of vaccination records (n = 42/70 girls, 60%). Also, opportunities and challenges for scaling the app were documented. CONCLUSION: The scaling of CIMA as an innovative means of dissemination of risk and health information in challenging context such as refugee camps was feasible. In the context of vaccination needs for children, in refugee settings, such a need is more eminent, particularly in the context of COVID-19.

The Role of Law Enforcement Officers/Police in Drug Prevention within Educational Settings-Study Protocol for the Development of a Guiding Document Based on Experts' Opinions.

The United Nations Office on Drugs and Crime-World Health Organization International Standards on Drug Use Prevention-reflects the value of safe, nurturing and supportive social institutions around the lives of youths to benefit from the prevention of risky behavior extending beyond individually-developed resilience for healthy adolescent development. Schools are valuable social institutions to this effect and school safety and adolescent health outcomes can be threatened by drug use and violence. As such, collaborative, multi-level, evidence-based, developmentally sensitive, substance use prevention programs are imperative. The International Standards, in their latest version, did not reflect specific evidence of law enforcement officer-based programs with effect on drug use prevention, including in school settings. Nevertheless, the collaboration between law enforcement agencies and school-based substance use prevention programs continue to be the focus of research and policy. In this project, we aim to explore in more detail the role of law enforcement in preventing substance use in schools. We use mixed methods, including three phases: (i) scoping review on the best practices for effective law enforcement in school-based drug and crime prevention; (ii) interviews with experts, using the Delphi method, in substance use prevention and training law enforcement in school-based drug prevention; and iii) developing guidelines for law enforcement based on the findings. Initially, we identified a total of 17 papers that were categorized in four categories based on their results (negative or null effect n = 11 studies, positive effect n = 1 study, mixed effects n = 4 studies and indefinite conclusion n = 1 study). However, the authors of the studies with negative or null effect did recommend being cautious about these results due to the respective studies' methodological limitations. The actual and perceived roles of police are largely unclear and/or variable. Therefore, clear outlines regarding law enforcement's role within schools are crucial as one study showed that an officer's role influences how they respond to student conduct. A secondary emergent theme from this review indicates that there is potential for positively impacting a youth's perceptions of police through collaborative and engaging school-based programs. Currently the project is gradually moving to Phase II, where we are identifying the key experts based on scientifically published peer reviewed and grey literature/guidelines to investigate elements that make the role of law enforcement officers in school-based prevention more effective. Given the frequency with which policy makers around the world request information about the role of law enforcement in effective prevention efforts, guidelines on their roles within schools is a gap that needs to be filled. Such efforts would improve drug prevention in schools and better orient law enforcement's role in drug prevention within educational settings.

Assessing the Feasibility of Providing a Family Skills Intervention, "Strong Families", for Refugee Families Residing in Reception Centers in Serbia.

War exposure and forced displacement threatens the wellbeing of caregivers and their children, leaving them at risk of negative outcomes, such as elevated rates of anxiety, depression and post-traumatic stress disorder. The importance of engaged, responsive and stable parenting for positive child wellbeing has been documented across diverse cultural and economic backgrounds. Despite the higher need for caregivers to be nurturing in challenging settings, they struggle to provide adequate support for their children due to lack of resources or their inability to deal with their own emotional challenges. A feasibility study was conducted of a new, open-access and light-touch family skills intervention, Strong Families (for families in humanitarian and challenged settings) on refugee families residing in Reception Centers in Serbia. Questionnaires and interviews were completed by participating caregivers and facilitators. Qualitative results indicated that the intervention was feasible to run in this humanitarian context, that caregivers viewed the intervention as culturally acceptable and complemented the quantitative results that showed promise for enhancing child behavior and family functioning tested indicators. Despite being a light intervention, Strong Families indicated improvement on child mental health, parenting practices and parent and family adjustment skills. Prioritizing family mental health and functioning as a primary need that parallels that of accessing physical medical care, sanitation and clean water must be the definitive next step in humanitarian aid.

Impact of a Brief Family Skills Training Programme ("Strong Families") on Parenting Skills, Child Psychosocial Functioning, and Resilience in Iran: A Multisite Controlled Trial.

Caregivers have a key role in protecting children's wellbeing, and, with appropriate skills, can prevent a multitude of negative social outcomes, particularly in challenged or humanitarian settings. Accordingly, the Strong Families programme was designed as a light touch family skills programme, with a focus of supporting caregiving during stressful situations. To evaluate the short-term impact of the Strong Families programme, we performed a time-convenience, randomized, controlled trial in Iran. A total of 292 families (63% from Iranian decent, 39% from Afghan decent, and 1% other), with children aged eight to twelve years, were recruited through ten centers in Iran and allocated to an intervention (n = 199) or waitlist/control group (n = 93). The two groups did not differ demographically at baseline. We assessed families prospectively, through three scales, PAFAS (parenting and family adjustment scales), SDQ (strengths and difficulties questionnaire), and CYRM-R (child and youth resilience measure). Caregivers in the intervention group improved (highly) statistically significantly on all but one PAFAS subscales (parental consistency, coercive parenting, positive encouragement, parental adjustment, family relationships, and parental teamwork), which was not noted in the waitlist group. On the SDQ, there were (highly) significant positive changes in scores in the intervention group on all sub-scales and the "total difficulty scale", whereas the waitlist/control group also improved on three (prosocial, conduct problems, and hyperactivity) of the five SDQ subscales. Children originating from Afghanistan improved significantly on the overall resilience scale of the CYRM-R in the intervention group, but not in the waitlist/control group. Overall, all our stratified results of the different scales reflect an accentuated improvement in families with higher levels of problems at baseline. Our comparative results indicated a strong alignment of the strong families programme with its intended short-term impact, per its logical frame on parenting practices and family management skills, children behaviour, caregivers and children mental health, and capacity to cope with stress. We postulate that the potential nudging or diffusion of knowledge (cross-contamination between intervention and waitlist/control group) at the community level could explain improvements in the waitlist/control group on some indicators, however, further research on this is recommend.

Enhancing Teaching Recovery Techniques (TRT) with Parenting Skills: RCT of TRT + Parenting with Trauma-Affected Syrian Refugees in Lebanon Utilising Remote Training with Implications for Insecure Contexts and COVID-19.

Child psychosocial recovery interventions in humanitarian contexts often overlook the significant effect that caregivers can have on improving children's future trajectory. We enhanced the well-established, evidenced-based child trauma recovery programme Teaching Recovery Techniques (TRT) intervention with parenting sessions, i.e., TRT + Parenting (TRT + P), which aims to improve parent mental health and their ability to support their children's mental health. We describe the findings of a three-arm randomised controlled trial comparing enhanced TRT + P vs. TRT and waitlist. The primary aim was to test if children in the enhanced arm of the programme show improved child and caregiver mental health. We recruited 119 Syrian refugee children and one of their caregivers in Beqaa Valley in Lebanon. They were randomised to the TRT, TRT + P, or waitlist control group. Data were collected at baseline and 2 weeks and 12 weeks post intervention. Training of facilitators was via remote training from the United Kingdom. Results showed a highly consistent pattern, with children in the enhanced TRT + P group showing the greatest levels of improvement in behavioural and emotional difficulties compared to children in the TRT or waitlist control groups. Caregivers in the TRT + P group also reported significant reductions in depression, anxiety, and stress. Findings indicate that the addition of the evidence-based parenting skills components has the potential to enhance the effects of interventions designed to improve children's mental health in contexts of trauma, conflict, and displacement. Implications for COVID-19 remote learning are also discussed.