A qualitative pilot study of the virtual implementation of the WHO caregiver skills training program in Brazil

Introduction Caregiver Skills Training (CST) is an evidence-based program developed by the World Health Organization (WHO) which aims to equip caregivers with skills to support children with neurodevelopmental disorders and enhance their wellbeing, particularly in low-resource settings. The COVID-19 pandemic affected CST implementation in Brazil, necessitating adaptations for remote delivery. Methods This qualitative study evaluated the acceptability, feasibility, and perceived effectiveness of a remote CST pilot implementation in Brazil. Focus groups were conducted with four master trainers (MTs), 11 facilitators, and 26 caregivers. The data were analyzed using Content Analysis and Descending Hierarchical Classification (IraMuTeQ®). Results Six thematic categories emerged from MTs, five from facilitators, and six from caregivers. Remote CST was well-received, enhancing caregiver learning, improving perceptions of children’s challenges, and facilitating modifications in family routines. Discussion Challenges identified included technological barriers, caregiver overload, lack of bonds between caregivers, and the need for practical training for facilitators. Engagement varied according to profile, affected by psychosocial and economic vulnerabilities. Participants valued the content and resources of the training, suggesting few adjustments. The importance of exchanges between families and the support of professionals was highlighted. A change in understanding the child’s difficulties, learning strategies and empowerment of caregivers was observed. Conclusion CST implementation in Brazil highlights the crucial role of caregiver training and the importance of cultural adaptation, demonstrating the program’s potential to expand access to structured interventions for families of children with neurodevelopmental disorders.