Currently submitted to: JMIR Pediatrics and Parenting
Date Submitted: Apr 16, 2026
Open Peer Review Period: Apr 20, 2026 - Jun 15, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Family experiences of the Strong Families Program in Thailand: A Mixed-Methods Study
ABSTRACT
Background:
The Strong Families (SF) Program, developed by the United Nations Office on Drugs and Crime, is an evidence-informed family skills intervention designed to support caregivers and children in low-resourced, high-stress circumstances. Following a pilot phase, we revised the program materials according to the expert trainers’ suggestions to best reflect the needs of the target population.
Objective:
To evaluate the feasibility, effectiveness, and cultural adaptability of the second phase of the Strong Families (SF) program expansion in Northern Thailand.
Methods:
This mixed methods, pre-post feasibility study involved 68 families (caregivers and children as 1:1) from Chiang Mai, Lamphun, and Chiang Rai – three providences in Northern Thailand. The applied intervention consisted of a three-week program with both separate and joint sessions for caregivers and children. Quantitative data were collected using the Parent and Family Adjustment Scale (PAFAS), Strengths and Difficulties Questionnaire (SDQ), and Child and Youth Resilience Measure-Revised (PMK-CYRM-R). Data were analyzed using linear mixed-effects regression. Qualitative data were gathered through semi-structured interviews with 19 families and analyzed using content analysis to identify key themes.
Results:
Quantitative analysis using linear mixed-effects regression revealed significant improvements in Coercive Parenting (β -0.10, p = 0.003), child Conduct Problems (β -0.04, p = 0.002), and Peer relationship (β -0.04, p = 0.048) for parents, and Emotional behavior (β -0.05, p = 0.011), and Conduct behavior (β -0.04, p = 0.023) for children. However, scores for Positive Encouragement and Parent-Child Relationships significantly declined, a discrepancy that may be due to response shift bias where participants adopted stricter self-evaluation standards post-intervention. Qualitative findings, showed five themes that highlighted improved family atmosphere, better emotional regulation, and successful translation of knowledge into practice to better develop protective factors for young people. Participants viewed the program as feasible and culturally appropriate but recommended extending the duration and increasing paternal involvement for more significant, sustainable outcomes.
Conclusions:
The SF program is a culturally adaptable and effective intervention for improving family dynamics in low-resource settings.
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