[Evaluation of a family-community workshop on birth and death: impact on parental attitudes]

To evaluate a community-based workshop on birth and death, delivered by midwives for children aged 6 to 12 accompanied by one or both parents. Specifically, to analyse the adults' evaluation of the workshop and whether it modifies their attitudes towards how to approach these processes with children.

Evaluative non-experimental pre-post intervention and qualitative study conducted in community settings across nine Spanish provinces, primarily in Cantabria. Mothers and fathers (n=185) accompanied by their children (aged 6-12, n=218) attended the workshop "To be born, to die, to love, to care". The intervention was grounded in the ecosystemic model of perinatal care and the attachment and meaning-reconstruction models in bereavement. Parents completed a questionnaire assessing adult attitudes toward children's involvement in grief processes immediately before and after the workshop (n=143), and again 15 days later (n=54). Post-intervention, participants also completed a workshop evaluation survey. Additionally, five focus groups were conducted.

Adults' attitudes shifted statistically significantly toward greater inclusion of children in collective grief processes (pre-post workshop comparison p <0.001, r=0,309, and pre-15 days p=0.010; δ=0.239). Participants emphasized the workshop's value in facilitating children's understanding of pregnancy, childbirth, family bonding, and death (including perinatal loss), breaking taboos and fostering family dialogue.

The workshop may constitute a community health promotion tool to address birth and death with children and their parents, fostering children's understanding and coping with both processes and reducing adults' avoidant attitudes towards childhood and death.