Recent systematic reviews found limited rigorous research conducted to date of the effectiveness of parent training programs in reducing behavioral problems for autistic children in low- and ...middle-income countries. This study is aimed at evaluating the effectiveness of a short-term intensive parent training program for autistic children aged three to six in the context of routine service provision in China. A quasi-experiment was conducted involving the local implementing organization and using a waitlist control. Data were collected at baseline and immediate post-intervention. The primary outcome was child behavioral problems measured using the Child Behavior Checklist Externalizing scale. Between-group comparisons used a difference-in-differences design with propensity score weighting to reduce sources of bias. A process evaluation was undertaken in parallel to assess participant involvement, program acceptability, and delivery. The protocol was prospectively registered with ClinicalTrials.gov (NCT04257331). The final sample size was 111 (treatment: 63; comparison: 48). Results suggest that the program was associated with improvements in child externalizing behaviors (
= -2.71, 95% CI -5.23, -0.18), parental mental health symptoms (
= -5.96, 95% CI -11.74, -0.17), over-reactive parenting (
= -0.63, 95% CI -0.98, -0.27), and parental knowledge (
= 2.08, 95% CI 2.07, 2.17). Exploratory analysis of factors related to implementation indicated that baseline parental mental health was related to participant engagement, and that satisfaction and engagement levels were potentially linked to positive treatment effects. Findings suggest that short-term intensive parent training programs that are provided by trained non-specialists, could potentially be used as an alternative to traditional prohibitively costly services that are delivered intensively for consecutive years in low-resource contexts. Follow-ups are needed to investigate its long-term benefits.
Objective:
This mixed-methods process evaluation examined the feasibility of a parenting program delivered by community facilitators to reduce the risk of child maltreatment in low-income families ...with children aged 3–8 years in Cape Town, South Africa (N = 68).
Method:
Quantitative measures included attendance registers, fidelity checklists, satisfaction surveys, and engagement in home practice activities. Qualitative data included parent interviews, facilitator focus groups, and transcripts from parent groups and facilitator supervision sessions.
Results:
Quantitative results show high levels of participant involvement, implementation, and acceptability. Thematic analyses identified seven themes related to program feasibility: (a) supporting participant involvement, (b) engagement in collaborative learning, (c) strengthening facilitator competency, (d) delivering nonviolent discipline skills, (e) contextualizing content, (f) receptivity to existing practices, and (g) resistance to new skills.
Discussion:
Findings suggest that parenting programs derived from evidence-based principles may be feasible in South Africa when situated within a culturally relevant context.
•This is the first known study of a positive parenting program for street-connected parents in Kenya.•The adapted program is both feasible and acceptable with this population.•This program may reduce ...the use of corporal punishment among street-connected parents.•The program may increase positive parenting practices within this population.•The program may reduce parental stress.
Background: Children of street-connected women in Kenya are at risk of child maltreatment. There have been increasing calls for positive parenting programs for parents experiencing homelessness, however never has one been implemented with this population. We therefore adapted the evidence-based Parenting for Lifelong Health for Young Children program using participatory methods, and piloted the adapted program with street-connected mothers in Kenya. Objectives: To (a) determine if the adapted program was feasible and acceptable with street-connected mothers, and (b) assess indicative effects on child maltreatment, positive parenting, and parental stress. Participants and setting: Two groups of 15 mothers (ages 19+, and 20−) participated between June-July 2018 in Eldoret, Kenya. Participants were eligible if they (a) were the mother of at least one child and (b) self-identified as street-connected. Methods: Feasibility was measured via enrollment, attendance, drop-out rates, and engagement in take-away activities. Focus groups explored program acceptability and program outcomes. Self-report surveys assessed pre-post changes in child maltreatment, parental stress, parental sense of inefficacy, and positive parenting practices. Results: 70% of participants attended >3/4 of sessions, 10% dropped out, and >50% of take-away activities were completed. Participants reported high acceptability and requested its continuation for themselves and other parents. There was an increase in supporting good behaviour (t(21) = 8.15, p < .000) and setting limits (t(18) = 10.03, p < .000); a reduction in physical abuse (t(23) = −2.15, p = .042) and parental stress (t(22) = −7.08, p < .000); results for parental inefficacy were not statistically significant (t(22) = 0.15, p = .882). Conclusions: The adapted program is feasible and acceptable to street-connected mothers, and may reduce child maltreatment and parental stress, and increase positive parenting. Further research should test program effectiveness.
This study examines the feasibility of a culturally adapted parenting intervention (MaPa Teens) within the national cash transfer system to reduce violence against adolescents, the first such program ...in the Philippines.
Thirty caregiver-adolescent dyads who were beneficiaries of a government conditional cash transfer program participated in a pilot of a locally adapted version of the Parenting for Lifelong Health for Parents and Teens program. Primary outcomes of reducing child maltreatment and associated risk factors were evaluated using a single-group, pre-post design. Focus group discussions explored the perceptions of participants and facilitators regarding program acceptability and feasibility.
Significant and moderate reductions were reported in overall child maltreatment and physical abuse (caregiver and adolescent reports) and in emotional abuse (adolescent report). There were significant reductions in neglect, attitudes supporting punishment, parenting stress, parental and adolescent depressive symptoms, parent-child relationship problems, and significant improvement in parental efficacy in managing child behavior. Adolescents reported reduced behavior problems, risk behavior, and witnessing of family violence. Participants valued learning skills using a collaborative approach, sustained their engagement between sessions through text messages and phone calls, and appreciated the close interaction with caring and skilled facilitators. Program areas of improvement included addressing barriers to attendance, increasing adolescent engagement, and revising the sexual health module.
The study provides preliminary support for the effectiveness and feasibility of the program in reducing violence against Filipino adolescents. Findings suggest potential adaptations of the program, and that investment in more rigorous testing using a randomized controlled trial would be worthwhile.
Child abuse is prevalent worldwide, with most of the burden in developing countries. To reduce and prevent child abuse occurrence, many efforts are directed toward reducing maladaptive parental ...behaviors (MPBs), a predictor of parents' risk of engaging in child abusive behaviors. MPBs have been associated with child (e.g., behavioral difficulties) and parent characteristics (e.g., parenting stress and parental cognitions), although little research tested for mediational pathways. This study aimed to test the pathways through which child and parent characteristics are linked to MPB. Consistent with the social information processing model of parenting, we hypothesized that child behavioral difficulties would exert an indirect influence on MPB through parenting stress and that parenting stress will exert a direct and indirect effect on MPB through parental cognitions (i.e., expectations, attitudes, and attributions). This study used data from 243 mothers of children aged between 2 and 9 years in Romania. Two-stage structural equation modeling was employed to test the hypothesized model. Results support the role of child behavior, parenting stress, and parental cognitions in predicting MPB (R
= 0.69). Significant indirect effects were found from child behavior to MPB via parenting stress and parental cognitions. Direct effects from parenting stress and parental cognitions to MPB were significant. Findings show that parenting stress and parental cognitions are important mechanisms through which child behavioral difficulties influence maladaptive parental behavior, underscoring the need to focus on these mechanisms when assessing or intervening with families at risk for child abuse.
This study investigates the co-occurrence of intimate partner violence (IPV) against mothers and their risk of perpetrating child maltreatment (CM) in North Macedonia, the Republic of Moldova, and ...Romania. Risk factors for IPV, CM, and their co-occurrence were identified. Two samples (N1 = 112, N2
= 701) of mothers with children with behavioral problems were assessed. IPV was reported by 64% of mothers, CM by 96%, and their co-occurrence by 63%. Mothers exposed to emotional IPV reported more physical and emotional CM. Mothers exposed to physical IPV reported more physical CM. Motheŕs own history of CM and offspring's behavior problems were associated with IPV and CM co-occurrence.
Caregiver social support has been shown to be protective for caregiver mental health, parenting and child psychosocial outcomes. This is the first known analysis to quantitatively investigate the ...relationship between caregiver social support and adolescent psychosocial outcomes in HIV-endemic, resource–scarce Southern African communities. A cross-sectional household survey was conducted over 2009–2010 with 2,477 South African adolescents aged 10–17 and their adult caregivers (18 years or older) in one urban and one rural community in South Africa’s KwaZulu-Natal province. Adolescent adjustment was assessed using adult caregiver reports of the Strengths and Difficulties questionnaire (SDQ), which measures peer problems, hyperactivity, conduct problems, emotional symptoms and child prosocial behavior. Hierarchical linear regressions and multiple mediation analyses, using bootstrapping procedures, were conducted to assess for: (a) direct effects of more caregiver social support on better adolescent psychosocial wellbeing; and (b) indirect effects mediated by better parenting and caregiver mental health. Direct associations (
p
< .001), and indirect associations mediated through better parenting, were found for all adolescent outcomes. Findings reinforce the importance of social support components within parenting interventions but also point to scope for positive intervention on adolescent psychosocial wellbeing through the broader family social network.
Objective
This study assessed the psychometric properties of three versions of the Parenting Scale (PS; original PS, 13‐item version, and 10‐item version) in three European middle‐income countries.
...Background
The PS is one of the most frequently used questionnaires for measuring dysfunctional discipline strategies. Although its validity has been extensively investigated in American samples, there are mixed results regarding the recommended number of items and subscales, raising the question of replicability across European middle‐income countries.
Method
Multigroup confirmatory factor analysis (MCFA) and item response theory (IRT) were applied to N = 835 parents from North Macedonia, Moldova, and Romania.
Results
All three versions were significantly correlated with parental‐ and child‐related variables. Confirmatory factor analysis indicated the best model fit for the 10‐item version, and configural and partial metric invariance across countries could be established for this version. Item response theory analyses also supported this measure.
Conclusions
Our findings show that the 10‐item version performed better than the 13‐item version and the original PS both overall and on the country level. Reliability values were somewhat lower than reported in studies from the United States.
Implications
The 10‐item version constitutes a promising short measure for assessing dysfunctional parenting in European middle‐income countries for researchers and practitioners.
Parenting interventions and conditional cash transfer (CCT) programmes are promising strategies to reduce the risk of violence against children, but evidence of the effectiveness of combining such ...programmes is lacking for families in low- and middle-income countries with children over two years of age. This study examined the effectiveness of a locally adapted parenting programme delivered as part of a government CCT system to low-income families with children aged two to six years in Metro Manila, Philippines.
Participants were randomly assigned (1:1) to either a 12-session group-based parenting programme or treatment-as-usual services (N = 120). Participation in either service was required among the conditions for receiving cash grants. Baseline assessments were conducted in July 2017 with one-month post-intervention assessments in January-February 2018 and 12-month follow-up in January-February 2019. All assessments were parent-report (ClinicalTrials.gov: NCT03205449).
One-month post-intervention assessments indicated moderate intervention effects for primary outcomes of reduced overall child maltreatment (d = -0.50 -0.86, -0.13), emotional abuse (d = -0.59 -0.95; -0.22), physical abuse (IRR = 0.51 0.27; 0.74), and neglect (IRR = 0.52 0.18; 0.85). There were also significant effects for reduced dysfunctional parenting, child behaviour problems, and intimate partner violence, and increased parental efficacy and positive parenting. Reduced overall maltreatment, emotional abuse, and neglect effects were sustained at one-year follow-up.
Findings suggest that a culturally adapted parenting intervention delivered as part of a CCT programme may be effective in sustaining reductions in violence against children in low- and middle-income countries.
This research was supported by UBS Optimus Foundation and UNICEF Philippines, and by the Complexity and Relationships in Health Improvement Programmes of the Medical Research Council MRC UK and Chief Scientist Office (Grant: MC_UU_00022/1 and CSO SPHSU16, MC_UU_00022/3 and CSO SPHSU18).
Parental engagement in parenting programs is essential for good outcomes but can be challenging for many families. In low- and middle-income countries, where resources are limited and there are fewer ...support services, there is little research examining the factors that influence engagement. This mixed-methods study explored factors associated with parent engagement, as well as barriers and supports, in a pilot evaluation of a parenting program with 140 parents in North Macedonia, Republic of Moldova, and Romania. The relationship between various quantitative types of engagement (e.g., premature drop-out, participation) and a range of demographic, personal, and implementation factors were examined. Qualitative parent interviews explored barriers and supports to program engagement. Implementation variables (e.g., phone calls with parents, program fidelity and text messages sent to parents) were consistently positively associated with different types of engagement after controlling for other factors. Parents of boys, being a victim of intimate partner violence, more children in the household and better parental well-being were positively associated with premature drop-out whilst having a child enrolled in school was positively associated with participation. Barriers included logistical factors such as timing and lack of childcare facilities. Factors that increased engagement included facilitator skills/support, weekly text messages and phone calls and engagement strategies such as transport and childcare. The results emphasise the importance of implementation factors in increasing parent engagement in parenting programs and will help to inform the next phase of the project as well as other family-support initiatives in the three countries. The trial is registered on ClinicalTrials.gov (ID: NCT03552250).
Highlights
A mixed-methods approach was used to examine parent engagement in a parenting program in Southeastern Europe.
The most consistent associated factors across the types of engagement were implementation factors.
Results will inform later phases of the project and support implementation of parenting programs in Southeastern Europe.
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