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Wang W, Zhang H. A Scoping Review of Parenting Programs for Preventing Violence Against Children in Low- and Middle-Income Countries. TRAUMA, VIOLENCE & ABUSE 2024; 25:2173-2188. [PMID: 37947081 DOI: 10.1177/15248380231207887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Violence against children affects their well-being globally, with a greater burden in low-and middle-income countries (LMICs). This scoping review aimed to summarize the available evidence on parenting programs for reducing violence against children in LMICs and identify knowledge gaps in this area. Six English databases and gray literature were systematically searched to identify studies in LMICs that examined the efficacy of parenting programs to prevent violence against children, before April 15, 2023. A total of 4,183 independent studies were identified, of which 31 met the inclusion criteria. The majority were conducted in Africa and Asia, delivered by trained local community/childcare workers and lay workers, and targeted younger children aged <10 years. Although the core modules varied in terms of number of group sessions and age of the children, the majority emphasized the importance of building a positive relationship with children and nonviolent discipline strategies. The vast majority demonstrated intervention efficacy in reducing general maltreatment and physical and emotional abuse, and improving positive parenting. Ineffective programs for violence tended to be characterized by self-designed programs, small sample sizes, and low corporal punishment levels in the baseline assessment. In conclusion, parenting programs are promising for preventing and reducing the risk factors for violence in LMICs. Future intervention studies should expand to low-income countries outside Eastern Africa with more trials targeting older children, utilizing direct observational assessments, designing core modules relevant to child neglect, involving more male caregivers, and conducting long-term follow-up assessments.
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Backhaus S, Blackwell A, Gardner F. The effectiveness of parenting interventions in reducing violence against children in humanitarian settings in low- and middle-income countries: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2024:106850. [PMID: 38880688 DOI: 10.1016/j.chiabu.2024.106850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/23/2024] [Accepted: 05/07/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Violence against children is a global phenomenon, yet children living in humanitarian settings are at elevated risk of experiencing violent parenting. Parenting interventions are a recommended prevention strategy. OBJECTIVE To conduct a systematic review and meta-analysis on the effectiveness of parenting interventions in preventing violence against children and related parent and child outcomes. PARTICIPANTS AND SETTING Primary caregivers in humanitarian settings in low- and middle-income countries (LMICs). METHODS A highly sensitive multi-language systematic search in electronic and grey-literature database. Studies were appraised for risk of bias, summary effects by certainty of effect, and effect estimates pooled using robust variance estimation. RESULTS Twenty-three randomized trials were meta-analyzed finding a small effect on physical and psychological violence (n = 14, k = 21, d = -0.36, 95 % CI [-0.69, -0.04]), positive parenting (n = 16, k = 43, d = 0.48, 95 % CI [0.29, 0.67]), negative parenting (n = 17, k = 37, d = -0.42, 95 % CI [-0.67, -0.16]), parental poor mental health (n = 9, k = 15, d = -0.34, 95 % CI [-0.66, -0.02]), and internalizing behaviors (n = 11, k = 29, d = -0.38, 95 % CI [-0.70, -0.05]); a non-significant effect on externalizing child behaviors (n = 9, k = 17, d = -0.12, 95 % CI [-0.50, 0.27]). Too few studies reported intimate partner violence, sexual violence, and parenting stress outcomes. CONCLUSIONS Our findings suggest that parenting interventions in humanitarian settings in LMICs may be an effective strategy to reduce physical and psychological violence, and numerous related parent and child outcomes. However, findings need to be interpreted in light of the limited number of available studies and imprecise statistical significance for selected outcomes.
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Affiliation(s)
- Sophia Backhaus
- Centre for Evidence-based Intervention, Department of Social Policy and Intervention, University of Oxford, UK; Research Institute Child Development and Education, University of Amsterdam, the Netherlands.
| | - Alexandra Blackwell
- Centre for Evidence-based Intervention, Department of Social Policy and Intervention, University of Oxford, UK
| | - Frances Gardner
- Centre for Evidence-based Intervention, Department of Social Policy and Intervention, University of Oxford, UK
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Kılıç C, Yüksel Doğan R, Metin EN. Exploring the Relationship between Turkish Mothers' Parenting and Psychological Well-Being in Early Childhood: The Role of Child Emotion Regulation and Dysregulation. Behav Sci (Basel) 2024; 14:426. [PMID: 38920758 PMCID: PMC11200770 DOI: 10.3390/bs14060426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/30/2024] [Accepted: 05/16/2024] [Indexed: 06/27/2024] Open
Abstract
Although the importance of psychological well-being in early childhood is emphasized, the number of studies conducted with children and adolescents in this field is less than those carried out with adults. The present study aimed to explore the role of child emotion regulation in the relationship between parenting and psychological well-being among a sample of Turkish preschoolers aged 5-6. It further examines the mediating role of emotion regulation. The sample consisted of 416 mothers with children aged 5-6 (Mage = 5.38, SD = 0.48; 50% girls-boys). We collected the data using the Multidimensional Assessment of Parenting Scale (MAPS), the Emotion Regulation Checklist (ERC), and the Psychological Well-Being Scale for Children (PWBS-C). The findings revealed significant relationships among parenting practices (positive/negative), the child's emotion regulation/dysregulation, and the child's psychological well-being. Moreover, the findings revealed that positive parenting, directly and indirectly, affects children's psychological well-being through children's emotion regulation. On the other hand, findings disclosed that negative parenting has both a direct and indirect impact on children's psychological well-being through children's emotion regulation. Overall, the study may shed light on a possible process in which positive parenting boosts a child's emotional regulation and psychological well-being among preschoolers.
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Affiliation(s)
- Ceren Kılıç
- Department of Child Development, Vocational School of Social Sciences, Baskent University, 06790 Ankara, Turkey
| | - Raziye Yüksel Doğan
- Department of Child Development, Faculty of Health Sciences, Hacettepe University, 06100 Ankara, Turkey; (R.Y.D.); (E.N.M.)
| | - Emine Nilgün Metin
- Department of Child Development, Faculty of Health Sciences, Hacettepe University, 06100 Ankara, Turkey; (R.Y.D.); (E.N.M.)
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Alves CRL, Seibel BL, Gaspardo CM, Altafim ERP, Linhares MBM. Home-visiting Parenting Programs to Improve Mother-Infant Interactions at Early Ages: A Systematic Review. PSYCHOSOCIAL INTERVENTION 2024; 33:117-132. [PMID: 38706711 PMCID: PMC11066812 DOI: 10.5093/pi2024a7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/02/2024] [Indexed: 05/07/2024]
Abstract
Objective: To systematically review studies examining the effects of home-visiting preventive parenting programs (HV-PPs) on improving the quality of mother-child interactions in early childhood. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, we identified 3,586 studies published between 2018 and 2022 by searching the following databases: PubMed, Web of Science, BVS/LILACS, SciELO, and PsycNET/PsycINFO. After applying the eligibility criteria, 17 articles were selected for review. Results: Most studies were conducted in high-income countries (53%) and the remainder were conducted in upper-middle-income countries, predominantly using a randomized controlled trial design and with strong methodological quality. The 17 studies applied 13 different HV-PPs, predominantly using video feedback, based on various dosages and schedules. Most studies (77%) showed significant positive effects on mother-child interactions by improving mainly positive maternal behaviors (e.g., sensitivity and responsiveness). Positive effects occurred independent of the study design, sample characteristics, measures, and constructs assessed. However, the findings suggest that the combination of fewer than six sessions, durations shorter than three months, and a very early start did not impact mother-child interactions, as expected. Few studies have explored negative maternal behaviors, children's behaviors, and dyadic interactions such as mutuality and synchrony. Conclusions: HV-PPs positively impacted mother-child interactions in early childhood despite the large heterogeneity across program designs, outcome measures, and overlapping constructs. Based on the results, we discuss the practical and economic implications of using parenting programs as a preventive approach.
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Affiliation(s)
- Claudia R. L. Alves
- Federal University of Minas GeraisBrazilFederal University of Minas Gerais, Brazil;
| | - Bruna L. Seibel
- Federal University of Rio GrandeBrazilFederal University of Rio Grande, Brazil;
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Cuartas J, Salazar A, Backhaus S, Little MT, McCoy D, Yoshikawa H, Bass M, Metheny N, Knaul F. Strategies to Prevent Violence Against Children in the Home: A Systematic Review of Reviews. TRAUMA, VIOLENCE & ABUSE 2024:15248380241247018. [PMID: 38682572 DOI: 10.1177/15248380241247018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Violence against children (VAC) in the home, or by household members, is a human rights and social problem with long-lasting consequences for individuals and society. Global policy instruments like the INSPIRE package have proposed strategies to prevent VAC, including Implementation and enforcement of laws, Norms and values, Safe environments, Parent and caregiver support, Income and economic strengthening, Response and support services, and Education and life skills. This systematic review of reviews aimed to synthesize the recent evidence base (i.e., published since 2000) for each INSPIRE strategy to reduce VAC in the home or by household members. We searched four databases using controlled vocabularies and keywords and searched for additional records in prior reviews of reviews. A total of 67 studies were included in this review, including literature reviews, meta-analyses, systematic reviews, and other types of reviews. We found extensive evidence supporting the effectiveness of parent and caregiver support interventions. However, reviews on other INSPIRE strategies were scarce. We also found a vast underrepresentation of samples from low- and- middle-income countries, children with disabilities, and families affected by forced displacement and conflict. In sum, this systematic review suggests that there are several promising strategies to prevent VAC (e.g., home visiting and parent education), but further research is necessary to strengthen the current body of evidence and effectively inform the implementation and scale-up of evidence-based interventions to protect children from violence globally.
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Affiliation(s)
- Jorge Cuartas
- Harvard Graduate School of Education, Cambridge, MA, USA
- Universidad de los Andes, Bogotá, Colombia
| | | | - Sophia Backhaus
- University of Amsterdam, The Netherlands
- University of Oxford, United Kingdom
| | | | - Dana McCoy
- Harvard Graduate School of Education, Cambridge, MA, USA
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Cooper H, Nadzri FZM, Vyas S, Juhari R, Ismail N, Arshat Z, Rajandiran D, Markle L, Calderon F, Vallance I, Melendez-Torres GJ, Facciolà C, Senesathith V, Gardner F, Lachman JM. A Hybrid Digital Parenting Program Delivered Within the Malaysian Preschool System: Protocol for a Feasibility Study of a Small-Scale Factorial Cluster Randomized Trial. JMIR Res Protoc 2024; 13:e55491. [PMID: 38669679 PMCID: PMC11087859 DOI: 10.2196/55491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/07/2024] [Accepted: 03/13/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The United Nations' Sustainable Development Goal 4, and particularly target 4.2, which seeks to ensure that, by 2030, all children have access to quality early childhood development, care, and preprimary education so that they are ready for primary education, is far from being achieved. The COVID-19 pandemic compromised progress by disrupting education, reducing access to well-being resources, and increasing family violence. Evidence from low- and middle-income countries suggests that in-person parenting interventions are effective at improving child learning and preventing family violence. However, scaling up these programs is challenging because of resource constraints. Integrating digital and human-delivered intervention components is a potential solution to these challenges. There is a need to understand the feasibility and effectiveness of such interventions in low-resource settings. OBJECTIVE This study aims to determine the feasibility and effectiveness of a digital parenting program (called Naungan Kasih in Bahasa Melayu [Protection through Love]) delivered in Malaysia, with varying combinations of 2 components included to encourage engagement. The study is framed around the following objectives: (1) to determine the recruitment, retention, and engagement rates in each intervention condition; (2) to document implementation fidelity; (3) to explore program acceptability among key stakeholders; (4) to estimate intervention costs; and (5) to provide indications of the effectiveness of the 2 components. METHODS This 10-week factorial cluster randomized trial compares ParentText, a chatbot that delivers parenting and family violence prevention content to caregivers of preschool-aged children in combination with 2 engagement components: (1) a WhatsApp support group and (2) either 1 or 2 in-person sessions. The trial aims to recruit 160 primary and 160 secondary caregivers of children aged 4-6 years from 8 schools split equally across 2 locations: Kuala Lumpur and Negeri Sembilan. The primary outcomes concern the feasibility and acceptability of the intervention and its components, including recruitment, retention, and engagement. The effectiveness outcomes include caregiver parenting practices, mental health and relationship quality, and child development. The evaluation involves mixed methods: quantitative caregiver surveys, digitally tracked engagement data of caregivers' use of the digital intervention components, direct assessments of children, and focus group discussions with caregivers and key stakeholders. RESULTS Overall, 208 parents were recruited at baseline December 2023: 151 (72.6%) primary caregivers and 57 (27.4%) secondary caregivers. In January 2024, of these 208 parents, 168 (80.8%) enrolled in the program, which was completed in February. Postintervention data collection was completed in March 2024. Findings will be reported in the second half of 2024. CONCLUSIONS This is the first factorial cluster randomized trial to assess the feasibility of a hybrid human-digital playful parenting program in Southeast Asia. The results will inform a large-scale optimization trial to establish the most effective, cost-effective, and scalable version of the intervention. TRIAL REGISTRATION OSF Registries; https://osf.io/f32ky. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55491.
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Affiliation(s)
- Hal Cooper
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | | | - Seema Vyas
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Rumaya Juhari
- Faculty of Human Ecology, Universiti Putra Malaysia, Selangor, Malaysia
| | - Nellie Ismail
- Faculty of Human Ecology, Universiti Putra Malaysia, Selangor, Malaysia
| | - Zarinah Arshat
- Faculty of Human Ecology, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Laurie Markle
- Parenting for Lifelong Health, Oxford, United Kingdom
| | - Francisco Calderon
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Inge Vallance
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | | | - Chiara Facciolà
- Innovations in Development, Education and the Mathematical Sciences International, Reading, United Kingdom
| | - Vanisa Senesathith
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Frances Gardner
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Jamie M Lachman
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- Parenting for Lifelong Health, Oxford, United Kingdom
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
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Bauer A, Martins RC, Hammerton G, Hoffmann MS, Cardoso AS, Colvara C, Hartmann CF, Calegaro G, Perrone LR, Aurélio N, Menezes AMB, Murray J. Adverse childhood experiences and crime outcomes in early adulthood: A multi-method approach in a Brazilian birth cohort. Psychiatry Res 2024; 334:115809. [PMID: 38401487 PMCID: PMC10985840 DOI: 10.1016/j.psychres.2024.115809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/12/2024] [Accepted: 02/18/2024] [Indexed: 02/26/2024]
Abstract
This study aimed to investigate alternative approaches to a cumulative risk score in the relationship between adverse childhood experiences (ACEs) and crime. Using data from the 1993 Pelotas (Brazil) Birth Cohort (n = 3236), we measured 12 ACEs up to 15 years, and past-year violent and non-violent crime at 22 years. We used four analytical approaches: single adversities, cumulative risk, latent class analysis, and network analysis. When examined individually, physical abuse, emotional abuse, and domestic violence were associated with both crime outcomes, whereas maternal mental illness and discrimination were associated with violent crime only, and parental divorce and poverty with non-violent crime only. There was a cumulative effect of ACEs on crime. The class with child maltreatment and household challenges was associated with both crime outcomes; exposure to household challenges and social risks was associated with violent crime only. In network models, crime showed conditional associations with physical abuse, maternal mental illness, and parental divorce. Although cumulative ACEs did associate with crime, some individual and combinations of ACEs showed particularly strong and robust effects, which were not captured by the cumulative score. Many ACEs are closely connected and/or cluster together, and the usefulness of the ACE score needs to be further evaluated.
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Affiliation(s)
- Andreas Bauer
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Rafaela Costa Martins
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Gemma Hammerton
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil; Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Maurício Scopel Hoffmann
- Department of Neuropsychiatry, Federal University of Santa Maria, Santa Maria, Brazil; Mental Health Epidemiology Group (MHEG), Universidade Federal de Santa Maria, Santa Maria, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andressa Souza Cardoso
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Camila Colvara
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Gabriel Calegaro
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Luciana Rodrigues Perrone
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Nilvia Aurélio
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Ana M B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil.
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Denhard L, Brown C, Kanagasabai U, Thorsen V, Kambona C, Kamagate F, Ramphalla P, Benevides R, Kamami M, McOwen J, Augusto A, Manuel P, Coomer R, Matthews S, Patel P, Annor FB. Service-seeking behaviors among male victims of violence in five African countries: The effects of positive and adverse childhood experiences. CHILD ABUSE & NEGLECT 2024; 150:106452. [PMID: 37704546 DOI: 10.1016/j.chiabu.2023.106452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Violence against boys and men is widely under-reported. Boys and men face unique and gendered barriers to accessing services following experiences of violence. PARTICIPANTS AND SETTING The study is a secondary data analysis of five nationally representative population-based Violence Against Children and Youth Surveys (VACS) conducted in Kenya (2019), Côte d'Ivoire (2018), Lesotho (2018), Mozambique (2019), and Namibia (2019). Analysis was limited to males between 18 and 24 years who experienced lifetime physical or sexual violence. OBJECTIVE AND METHODS We analyzed the association between positive and adverse childhood experiences (PCEs and ACEs), and seeking post-violence services among males using bivariate chi-squared tests and multivariable logistic regression. RESULTS 8.02 % (5.55-10.50 %) of male victims between the ages of 18 and 24 sought services for any lifetime physical or sexual violence. Witnessing interparental violence and experiencing death of one or both parents were each associated with increased odds of having sought post-violence services (aOR 2.43; 95 % CI: 1.25-4.79; aOR 2.27; 95 % CI: 1.14-4.50), controlling for education, violence frequency, and violence type. High parental monitoring was associated with increased odds of service seeking (aOR 1.79; 95 % CI: 1.02-3.16), while strong father-child relationship was associated with lower odds (aOR 0.45; 95 % CI: 0.23-0.89). CONCLUSION These findings contribute to limited research on service-seeking behaviors among men and boys. While some parent-youth relationship factors were associated with higher odds of service-seeking, the outcome remained rare. Age and gender-related barriers should be addressed where post-violence care services are offered.
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Affiliation(s)
- Langan Denhard
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA.
| | - Colvette Brown
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Viva Thorsen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Caroline Kambona
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Kenya
| | - Fathim Kamagate
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Côte d'Ivoire
| | - Puleng Ramphalla
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Lesotho
| | - Regina Benevides
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Mwikali Kamami
- Rollins School of Public Health, Emory University, Atlanta, USA
| | - Jordan McOwen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | | | - Pedro Manuel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | - Rachel Coomer
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Namibia
| | - Sarah Matthews
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Pragna Patel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Francis B Annor
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
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Martin P, Haroz EE, Lee C, Bolton P, Martin K, Meza R, McCarthy E, Dorsey S. A qualitative study of mental health problems among children living in New Delhi slums. Transcult Psychiatry 2024:13634615231202098. [PMID: 38389504 DOI: 10.1177/13634615231202098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Children living in urban slums in India are exposed to chronic stressors that increase their risk of developing mental disorders, but they remain a neglected group. Effective mental health interventions are needed; however, it is necessary to understand how mental health symptoms and needs are perceived and prioritized locally to tailor interventions for this population. We used an existing rapid ethnographic assessment approach to identify mental health problems from the perspective of children living in Indian slums, including local descriptions, perceived causes, impact, and coping behavior. Local Hindi-speaking interviewers conducted 77 free-list interviews and 33 key informant interviews with children and adults (N = 107) from two slums in New Delhi. Results identified a range of internalizing and externalizing symptoms consistent with depression, anxiety, and conduct problems in children. Findings included both common cross-cultural experiences and symptoms as well as uniquely described symptoms (e.g., "madness or anger," "pain in the heart and mind") not typically included on western standardized measures of psychopathology. Mental health problems appeared to be highly interconnected, with experiences such as harassment and fighting often described as both causes and impacts of mental health symptoms in children. Community perspectives indicated that even in the face of several unmet basic needs, mental health problems were important to the community and counseling interventions were likely to be acceptable. We discuss implications for adapting mental health interventions and assessing their effectiveness to reduce the burden of mental illness among children living in urban slums in India.
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Affiliation(s)
- Prerna Martin
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Emily E Haroz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Catherine Lee
- UNICEF New York Child Protection in Humanitarian Action, New York, NY, USA
| | - Paul Bolton
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- USAID, Washington, DC, USA
| | - Kiran Martin
- Asha Community Health and Development Society, New Delhi, India
| | - Rosemary Meza
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Shannon Dorsey
- Department of Psychology, University of Washington, Seattle, WA, USA
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Cluver L, Jochim J, Mapukata Y, Wittesaele C, Shenderovich Y, Mafuya S, Steventon Roberts K, Banougnin B, Sherr L, Toska E. Associations of formal childcare use with health and human capital development for adolescent mothers and their children in South Africa: A cross-sectional study. Child Care Health Dev 2024; 50:e13138. [PMID: 37287209 PMCID: PMC10952304 DOI: 10.1111/cch.13138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/29/2023] [Accepted: 05/10/2023] [Indexed: 06/09/2023]
Abstract
AIM This study aims to investigate associations of formal childcare with maternal and child outcomes in a large sample of adolescent mothers. BACKGROUND Forty percent of adolescent girls in Africa are mothers. Increasing evidence shows positive impacts of formal childcare use for adult women, but no known studies in the Global South examine associations for adolescent mothers and their children. METHODS We interviewed 1046 adolescent mothers and completed developmental assessments with their children (n = 1139) in South Africa's Eastern Cape between 2017 and 2019. Questionnaires measured childcare use, maternal and child outcomes and socio-demographic background variables. Using cross-sectional data, associations between formal childcare use and outcomes were estimated in multivariate multi-level analyses that accounted for individual-level and family-level clustering. RESULTS Childcare use was associated with higher odds of being in education or employment (AOR: 4.01, 95% CIs: 2.59-6.21, p < .001), grade promotion (AOR: 2.08, 95% CIs: 1.42-3.05, p < .001) and positive future ideation (AOR: 1.58, 95% CIs: 1.01-2.49, p = .047) but no differences in mental health. Childcare use was also associated with better parenting on all measures: positive parenting (AOR: 1.66, 95% CIs: 1.16-2.38, p = .006), better parental limit-setting (AOR: 2.00, 95% CIs: 1.37-2.93, p < .001) and better positive discipline (AOR: 1.77, 95% CIs: 1.21-2.59, p = .003). For the children, there were no differences in temperament or illness, but a significant interaction showed stronger associations between childcare use and better cognitive, language and motor scores with increasing child age (AOR: 5.04, 95% CIs: 1.59-15.96, p = .006). CONCLUSIONS Adolescent mothers might benefit substantially from formal childcare, but causal links need to be explored further. Childcare use was also associated with improved parenting and better child development over time, suggesting positive pathways for children. At an average of $9 per month, childcare provisions for adolescent mothers may offer low-cost opportunities to achieve high returns on health and human capital outcomes in Sub-Saharan African contexts.
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Affiliation(s)
- Lucie Cluver
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK
- Department of PsychiatryUniversity of Cape TownCape TownSouth Africa
| | - Janina Jochim
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK
| | | | - Camille Wittesaele
- Department of Infectious Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Yulia Shenderovich
- Wolfson Centre for Young People's Mental HealthUniversity of CardiffCardiffUK
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social SciencesCardiff UniversityCardiffUK
| | | | - Kathryn Steventon Roberts
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK
- Institute for Global HealthUniversity College LondonLondonUK
| | - Bolade Banougnin
- Centre for Social Science ResearchUniversity of Cape TownCape TownSouth Africa
| | - Lorraine Sherr
- Institute for Global HealthUniversity College LondonLondonUK
| | - Elona Toska
- Centre for Social Science ResearchUniversity of Cape TownCape TownSouth Africa
- Department of SociologyUniversity of Cape TownCape TownSouth Africa
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11
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van Tuyll van Serooskereken Rakotomalala S, Stok FM, Yerkes MA, de Wit JBF. A mapping of parenting support policies worldwide to prevent violence against children. CHILD ABUSE & NEGLECT 2023; 146:106484. [PMID: 37788589 DOI: 10.1016/j.chiabu.2023.106484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/25/2023] [Accepted: 09/21/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND While recent systematic reviews indicate that parenting interventions reduce negative parenting behaviours, including child maltreatment, only 26 % of governments worldwide indicate that parenting support programs reach all parents in their country. OBJECTIVE This mapping study investigates which countries have a government policy to provide such parenting support aimed at reducing child-directed violence. SETTING To analyse parenting support within the broad cultural and historical contexts, this study covers all 194 countries and territories worldwide. METHODS A systematic stepwise online search was conducted to establish the existence, or not, of a parenting support policy to prevent violence against children and in the case that a policy was identified, the sectoral policy portfolio in which the policy was published. RESULTS Findings showed that almost half of countries globally have a policy relating to parenting support to prevent child maltreatment. The highest concentration of such policies is in the European, Southeast Asia and Western Pacific Regions and globally parenting support are mainly stand-alone policies or embedded within a child protection policy. CONCLUSIONS Ideas around parenting support have evolved over time however the link between policy and practice as well as the reality of implementation modalities remains unclear. The translation of policy to practice merits further attention if we want to reach every parent in the world who needs it.
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Affiliation(s)
| | - F Marijn Stok
- Department of Interdisciplinary Social Science, Utrecht University, Netherlands.
| | - Mara A Yerkes
- Department of Interdisciplinary Social Science, Utrecht University, Netherlands.
| | - John B F de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Netherlands.
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12
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Martin M, Steele B, Spreckelsen TF, Lachman JM, Gardner F, Shenderovich Y. The Association Between Facilitator Competent Adherence and Outcomes in Parenting Programs: a Systematic Review and SWiM Analysis. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:1314-1326. [PMID: 36884129 PMCID: PMC10575799 DOI: 10.1007/s11121-023-01515-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 03/09/2023]
Abstract
There is increasing interest about the fidelity with which interventions are implemented because it is theorized that better implementation fidelity by facilitators is associated with better participant outcomes. However, in the parenting program literature, there is mixed evidence on the relationship between implementation fidelity and outcomes. This paper provides a synthesis of the evidence on the relationship between facilitator delivery and outcomes in the parenting program literature. Following PRISMA guidelines, this paper synthesizes the results of a systematic review of studies on parenting programs aiming to reduce violence against children and child behavior problems. Specifically, it examines associations between observational measures of facilitator competent adherence and parent and child outcomes. A meta-analysis was not feasible due to study heterogeneity. As a result, Synthesis Without Meta-Analysis guidelines were followed. Searches in electronic databases, reference searching, forward citation tracking, and expert input identified 9653 articles. After screening using pre-specified criteria, 18 articles were included. The review found that most studies (n = 13) reported a statistically significant positive relationship with at least one parent or child outcome. However, eight studies reported inconsistent findings across outcomes, and four studies found no association with outcomes. The results suggest that better facilitator competent adherence is generally associated with positive parent and child outcomes. However, this finding is weakened by the methodological heterogeneity of included studies and due to the wide variety of ways in which studies conceptualized competent adherence-outcome relationships.
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Affiliation(s)
- M Martin
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
| | - B Steele
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - T F Spreckelsen
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - J M Lachman
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - F Gardner
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Y Shenderovich
- Wolfson Centre for Young People's Mental Health, Cardiff, UK
- Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Centre for the Development, Cardiff University, Cardiff, UK
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13
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Martin M, Shenderovich Y, Caron EB, Smith JD, Siu G, Breitenstein SM. The Case for Assessing and Reporting on Facilitator Fidelity: Introducing the Fidelity of Implementation in Parenting Programs Guideline. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2023; 4:1-10. [PMID: 38371716 PMCID: PMC10873439 DOI: 10.1007/s43477-023-00092-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/27/2023] [Indexed: 02/20/2024]
Abstract
The sizeable body of evidence indicating that parenting programs have a positive impact on children and families highlights the potential public health benefits of their implementation on a large scale. Despite evidence and global attention, beyond the highly controlled delivery of parenting programs via randomized trials, little is known about program effectiveness or how to explain the poorer results commonly observed when implemented in community settings. Researchers, practitioners, and policymakers must work together to identify what is needed to spur adoption and sustainment of evidence-based parenting programs in real-world service systems and how to enhance program effectiveness when delivered via these systems. Collecting, analyzing, and using facilitator fidelity data is an important frontier through which researchers and practitioners can contribute. In this commentary, we outline the value of assessing facilitator fidelity and utilizing the data generated from these assessments; describe gaps in research, knowledge, and practice; and recommend directions for research and practice. In making recommendations, we describe a collaborative process to develop a preliminary guideline-the Fidelity of Implementation in Parenting Programs Guideline or FIPP-to use when reporting on facilitator fidelity. Readers are invited to complete an online survey to provide comments and feedback on the first draft of the guideline. Supplementary Information The online version contains supplementary material available at 10.1007/s43477-023-00092-5.
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Affiliation(s)
- Mackenzie Martin
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Community-University Partnership for the Study of Children, Youth and Families, School of Public Health, University of Alberta, Edmonton, Canada
| | - Yulia Shenderovich
- Wolfson Centre for Young People’s Mental Health, Cardiff University, Cardiff, UK
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHER), School of Social Sciences, Cardiff University, Cardiff, UK
| | - E. B. Caron
- Department of Psychology, University of Hartford, West Hartford, Connecticut USA
| | - Justin D. Smith
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah USA
| | - Godfrey Siu
- Child Health and Development Centre, Makerere University, Kampala, Uganda
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14
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Cuartas J, Bhatia A, Carter D, Cluver L, Coll C, Donger E, Draper CE, Gardner F, Herbert B, Kelly O, Lachman J, M'jid NM, Seidel F. Climate change is a threat multiplier for violence against children. CHILD ABUSE & NEGLECT 2023:106430. [PMID: 37648573 DOI: 10.1016/j.chiabu.2023.106430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/25/2023] [Accepted: 08/22/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND The climate crisis is the biggest threat to the health, development, and wellbeing of the current and future generations. While there is extensive evidence on the direct impacts of climate change on human livelihood, there is little evidence on how children and young people are affected, and even less discussion and evidence on how the climate crisis could affect violence against children. PARTICIPANTS AND SETTING In this commentary, we review selected research to assess the links between the climate crisis and violence against children. METHODS We employ a social-ecological perspective as an overarching framework to organize findings from the literature and call attention to increased violence against children as a specific, yet under-examined, direct and indirect consequence of the climate crisis. RESULTS Using such a perspective, we examine how the climate crisis exacerbates the risk of violence against children at the continually intersecting and interacting levels of society, community, family, and the individual levels. We propose increased risk of armed conflict, forced displacement, poverty, income inequality, disruptions in critical health and social services, and mental health problems as key mechanisms linking the climate crisis and heightened risk of violence against children. Furthermore, we posit that the climate crisis serves as a threat multiplier, compounding existing vulnerabilities and inequities within populations and having harsher consequences in settings, communities, households, and for children already experiencing adversities. CONCLUSIONS We conclude with a call for urgent efforts from researchers, practitioners, and policymakers to further investigate the specific empirical links between the climate crisis and violence against children and to design, test, implement, fund, and scale evidence-based, rights-based, and child friendly prevention, support, and response strategies to address violence against children.
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Affiliation(s)
- Jorge Cuartas
- Harvard Graduate School of Education, Harvard University, USA; Centro de Estudios sobre Seguridad y Drogas (CESED), Universidad de los Andes, Colombia.
| | - Amiya Bhatia
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, UK
| | - Daniel Carter
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, UK
| | - Lucie Cluver
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, UK; Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Carolina Coll
- Human Development and Violence Research Centre, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Elizabeth Donger
- New York University School of Law, Center for Human Rights and Global Justice, USA
| | - Catherine E Draper
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, UK
| | - Bess Herbert
- Global Partnership to End Violence Against Children, USA
| | - Orla Kelly
- UCD School of Social Policy, Social Work and Social Justice, University College Dublin, Ireland
| | - Jamie Lachman
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, UK; Centre for Social Science Research, University of Cape Town, South Africa
| | - Najat Maalla M'jid
- United Nations Special Representative of the Secretary-General on Violence Against Children, USA
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15
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Merrill KG, Knight L, Nakuti J, Mirembe A, Allen E, Bhatia A, Parkes J, Naker D, Devries KM. The association between violence victimization and subsequent unplanned pregnancy among adolescent girls in Uganda: Do primary schools make a difference? PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001141. [PMID: 37523344 PMCID: PMC10389730 DOI: 10.1371/journal.pgph.0001141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 06/26/2023] [Indexed: 08/02/2023]
Abstract
Violence victimization is a risk factor for adolescent pregnancy in high-income, low violence prevalence countries, but longitudinal data are lacking from settings where violence and adolescent pregnancy are common, including sub-Saharan Africa. We also know little about contextual factors which modify this association. We analyzed data from the Contexts of Violence in Adolescence Cohort (CoVAC) study in Luwero District, Uganda. Primary students in 42 schools completed surveys in 2014 (Wave 1) and 2018 (Wave 2). Our outcome was unplanned pregnancy. Our exposure was violence victimization, including any violence, type of violence (physical, emotional, sexual), perpetrator group (teacher, peer, family member), and polyvictimization. We fit mixed-effects logistic regression models and examined school factors (e.g., connectedness, absenteeism) as effect modifiers, using data from students (n = 3,431) and staff (n = 591) at the 42 schools. 1,449 girls were included in analyses (78% follow-up). At Wave 1, 88% (n = 1,281/1,449) reported any violence (mean age = 12.73, SD = 1.44 years). At Wave 2, 13.9% (n = 201/1,449) reported an unplanned pregnancy. In adjusted models, compared to no violence, significant associations (p<0.05) were observed for any violence (OR = 1.99, 95%CI = 1.03-3.85), physical violence (OR = 1.96, 95%CI = 1.02-3.79), teacher violence (OR = 1.96, 95%CI = 1.01-3.79), peer violence (OR = 2.00, 95%CI = 1.00-4.03), family violence (OR = 2.23, 95%CI = 1.07-4.65), violence from one perpetrator group (OR = 2.04, 95%CI = 1.01-4.15), and violence from three perpetrator groups (OR = 2.21, 95%CI = 0.99-4.95). Sexual and emotional violence were associated in crude but not adjusted analyses. School and peer connectedness modified the association (p<0.05); girls who experienced violence had higher odds of unplanned pregnancy in schools with lower versus higher connectedness. Violence victimization in early adolescence is strongly associated with subsequent unplanned pregnancy among adolescent girls in Uganda but attending schools with more school or peer connectedness attenuated this link. Interventions should seek to reduce violence against girls to prevent unplanned pregnancy. Interventions promoting positive connections to school may be especially important for violence victims.
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Affiliation(s)
- Katherine G Merrill
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Louise Knight
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Elizabeth Allen
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Amiya Bhatia
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jenny Parkes
- University College London-Institute of Education, London, United Kingdom
| | | | - Karen M Devries
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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16
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Swit CS, Coyne SM, Shawcroft J, Gath M, Barr R, Holmgren HG, Stockdale L. Problematic media use in early childhood: The role of parent-child relationships and parental wellbeing in families in New Zealand and the United States. JOURNAL OF CHILDREN AND MEDIA 2023; 17:443-466. [PMID: 38222896 PMCID: PMC10786582 DOI: 10.1080/17482798.2023.2230321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 06/23/2023] [Indexed: 01/16/2024]
Abstract
Problematic media use (PMU) during early childhood has the potential to interfere with the healthy functioning of family systems and may be associated with significant long-term problems for the child. However, we know very little about what contributes to early childhood PMU, particularly in the family context. We examine parenting factors as correlates of child PMU in two studies, from two different countries, using two different methods. Study 1 (N=93, Mage=45.3months, SD=10.15, 58%males, 87%mothers) investigated the concurrent role of self-reported parental burnout and parent-child conflict and closeness as correlates of child PMU in an early childhood sample in New Zealand. Study 2 (N=269, Mage=41.17months, SD=3.06 months, 49%males, 95%mothers) investigated observed parental warmth and harsh criticism as predictors of concurrent and longitudinal PMU in an early childhood sample in the United States. Together, findings showed that in both countries approximately 22-25% of young children show symptoms of PMU. After controlling for parent's PMU, parent-child conflict, warmth and parental burnout were not associated with child PMU. Low levels of parent-child closeness and parent's use of harsh criticism were predictive of child PMU. The findings advance our understanding of some of the parenting factors that influence the development of PMU in young children.
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Affiliation(s)
- Cara S. Swit
- Faculty of Health, University of Canterbury, Christchurch, New Zealand 8041
| | - Sarah M. Coyne
- School of Family Life, Brigham Young University, Provo, UT, USA 84653
| | - Jane Shawcroft
- Department of Communication, University of California, Davis, USA
| | - Megan Gath
- Child Well-being Research Institute, University of Canterbury
| | - Rachel Barr
- Department of Psychology, Georgetown University
| | | | - Laura Stockdale
- School of Family Life, Brigham Young University, Provo, UT, USA 84653
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17
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Bähr C, Taylor LK. Growing up amid conflict: Implications of the Developmental Peacebuilding Model. ADVANCES IN CHILD DEVELOPMENT AND BEHAVIOR 2023; 65:199-234. [PMID: 37481298 DOI: 10.1016/bs.acdb.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
Worldwide, 420 million children are affected by conflict and over half of all children experience violence every year. Thus, youth are unarguably affected by war and settings of persisting societal violence. Despite often being conceptualized as either powerless victims or violent perpetrators, recent advances in research and international policy recognize young people as key change agents in transforming adverse settings into positive environments. Framed by the Developmental Peacebuilding Model, this paper focuses on predictors, outcomes and intervention points within the family for youth peacebuilding. Recent advances of family-based interventions in diverse, non-WEIRD samples will be highlighted. Rooted in existing knowledge, we conclude with concrete suggestions on how to use secondary data to investigate youth peacebuilding across the globe.
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Affiliation(s)
- Celia Bähr
- Freie Universität Berlin, Berlin, Germany
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18
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Gayles J, Yahner M, Barker KM, Moreau C, Li M, Koenig L, Mafuta E, Mbela P, Lundgren R. Balancing Quality, Intensity and Scalability: Results of a Multi-level Sexual and Reproductive Health Intervention for Very Young Adolescents in Kinshasa. J Adolesc Health 2023; 73:S33-S42. [PMID: 37330819 DOI: 10.1016/j.jadohealth.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 01/09/2023] [Accepted: 02/03/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE In addition to the rapid physical and cognitive transformations very young adolescents (VYAs) experience between ages 10-14, gender and social norms internalized during this period have long-term implications as adolescents become sexually active. This age presents critical opportunities for early intervention to promote gender-equitable attitudes and norms for improved adolescent health. METHODS In Kinshasa, DRC, Growing Up GREAT! implemented a scalable approach to engage in- and out-of-school VYAs, caregivers, schools, and communities. A quasi-experimental study evaluated the outcomes of sexual and reproductive health (SRH) knowledge, assets and agency, and gender-equitable attitudes and behaviors among VYA participants. Ongoing monitoring and qualitative studies provided insights into implementation challenges and contextual factors. RESULTS Results show significant improvement in SRH knowledge and assets such as caregiver connectedness, communication, and body satisfaction among the intervention group. The intervention was also associated with significant improvements in gender-equitable attitudes related to adolescents' household responsibilities and decreased teasing and bullying. Intervention effects on awareness of SRH services, body satisfaction, chore-sharing, and bullying were stronger for out-of-school and younger VYAs, suggesting the intervention's potential to increase positive outcomes among vulnerable adolescents. The intervention did not shift key gender norm perceptions assessed. Implementation research suggests design decisions made to increase the intervention's scalability necessitated reductions in training and program dosing that may have affected results. DISCUSSION Results affirm the potential of early intervention to increase SRH knowledge, assets and gender-equitable behaviors. They also highlight the need for more evidence on effective program approaches and segmentation for shifting VYA and SRH norms.
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Affiliation(s)
- Jennifer Gayles
- Department of Global Health, Save the Children Federation, Washington, D.C..
| | - Melanie Yahner
- Department of Global Health, Save the Children Federation, Washington, D.C
| | - Kathryn M Barker
- Center for Gender Equity and Health, University of California San Diego, San Diego, California
| | - Caroline Moreau
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Soins et Santé Primaire, CESP Centre for Research in Epidemiology and Population Health, Villejuif, France
| | - Mengmeng Li
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Leah Koenig
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Eric Mafuta
- Department of Health Systems Management and Policy, School of Public Health, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Pierrot Mbela
- Save the Children International, Democratic Republic of the Congo Country Office, Kinshasa, Democratic Republic of the Congo
| | - Rebecka Lundgren
- Center for Gender Equity and Health, University of California San Diego, San Diego, California
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19
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Jordans MJD, Bakolis I, Arnous M, Koppenol-Gonzalez GV, Tossyeh F, Chen A, Miller KE. Effectiveness of the caregiver support intervention on child psychosocial wellbeing among Syrian refugees in Lebanon: Mediation and secondary analysis of a Randomized Controlled Trial. CHILD ABUSE & NEGLECT 2023:106335. [PMID: 37400323 DOI: 10.1016/j.chiabu.2023.106335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 05/07/2023] [Accepted: 06/24/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND War and violence have a serious negative impact on the wellbeing and mental health of many children. Caregivers play an important role in mitigating or exacerbating this impact. OBJECTIVE This study evaluates the impact of the nine session Caregiver Support Intervention on improving children's wellbeing and examines putative mediators of changes in children's psychosocial wellbeing. PARTICIPANTS AND SETTING 240 female caregivers were randomly allocated (1:1) to the CSI or a waitlist control comparison condition. The study was implemented in Lebanon, in an area characterized by high levels of poverty and a high number of the Syrian refugees. METHODS A parallel group Randomized Controlled Trial reporting on caregiver-reported child-level wellbeing. We used a combination of the Kid- and Kiddy-KINDL (parent version) for index children ages three to 12. Putative mediators of the CSI on children's psychosocial wellbeing included harsh parenting, caregiver psychological distress, caregiver wellbeing. Measurements were conducted at baseline, post-intervention and 3-months follow-up. RESULTS We demonstrated a statistically significant change in caregiver reported children's psychosocial wellbeing at post-intervention (Mdiff =4.39, 95 % CI = 1.12, 7.65, p < 0.01, d = 0.28) but not at follow-up (Mdiff = -0.97, 95 % CI = -4.27, 2.32, p > 0.05). The proportion of the total effect of the CSI intervention on child psychosocial wellbeing mediated by caregiver distress, caregiver wellbeing and harsh parenting was 77 %. CONCLUSION The CSI holds potential for down-stream short-term effect on improving children's psychosocial wellbeing, beyond the previously reported positive caregiver outcomes. This effect was not sustained three months post intervention. The study confirms caregiver wellbeing and parenting support as dual pathways mediating child psychosocial wellbeing. Prospective trial registration: ISRCTN22321773.
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Affiliation(s)
- M J D Jordans
- Research and Development, War Child Holland, Amsterdam, the Netherlands; Amsterdam Institute of Social Science Research, University of Amsterdam, the Netherlands; Health Service and Population Research Department & Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - I Bakolis
- Health Service and Population Research Department & Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | | | | | - A Chen
- Department of Psychology, Harvard University, United States of America
| | - K E Miller
- Research and Development, War Child Holland, Amsterdam, the Netherlands; Faculty of Education, University of British Columbia, Canada
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20
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Jocson RM, Alampay LP, Lachman JM, Maramba DHA, Melgar ME, Ward CL, Madrid BJ, Gardner F. Pre-post Mixed Methods Study of a Parent and Teen Support Intervention to Prevent Violence Against Adolescents in the Philippines. J Adolesc Health 2023; 73:102-109. [PMID: 37086250 DOI: 10.1016/j.jadohealth.2023.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 01/30/2023] [Accepted: 02/17/2023] [Indexed: 04/23/2023]
Abstract
PURPOSE 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. METHODS 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. RESULTS 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. DISCUSSION 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.
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Affiliation(s)
- Rosanne M Jocson
- National Institute of Education, Nanyang Technological University, Singapore, Singapore.
| | - Liane Peña Alampay
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
| | - Jamie M Lachman
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom; Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | | | - Marika E Melgar
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
| | - Catherine L Ward
- Department of Psychology and Safety and Violence Initiative, University of Cape Town, Rondebosch, South Africa
| | - Bernadette J Madrid
- Child Protection Unit, Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Frances Gardner
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
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21
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Janowski R, Green O, Shenderovich Y, Stern D, Clements L, Wamoyi J, Wambura M, Lachman JM, Melendez-Torres GJ, Gardner F, Baerecke L, Te Winkel E, Booij A, Setton O, Tsoanyane S, Mjwara S, Christine L, Ornellas A, Chetty N, Klapwijk J, Awah I, Manjengenja N, Sokoine K, Majikata S, Cluver LD. Optimising engagement in a digital parenting intervention to prevent violence against adolescents in Tanzania: protocol for a cluster randomised factorial trial. BMC Public Health 2023; 23:1224. [PMID: 37353844 PMCID: PMC10288745 DOI: 10.1186/s12889-023-15989-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/25/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Violence against adolescents is a universal reality, with severe individual and societal costs. There is a critical need for scalable and effective violence prevention strategies such as parenting programmes, particularly in low- and middle-income countries where rates of maltreatment are highest. Digital interventions may be a scalable and cost-effective alternative to in-person delivery, yet maximising caregiver engagement is a substantial challenge. This trial employs a cluster randomised factorial experiment and a novel mixed-methods analytic approach to assess the effectiveness, cost-effectiveness, and feasibility of intervention components designed to optimise engagement in an open-source parenting app, ParentApp for Teens. The app is based on the evidence-based Parenting for Lifelong Health for Teens programme, developed collaboratively by academic institutions in the Global South and North, the WHO, and UNICEF. METHODS/DESIGN Sixteen neighbourhoods, i.e., clusters, will be randomised to one of eight experimental conditions which consist of any combination of three components (Support: self-guided/moderated WhatsApp groups; App Design: sequential workshops/non-sequential modules; Digital Literacy Training: on/off). The study will be conducted in low-income communities in Tanzania, targeting socioeconomically vulnerable caregivers of adolescents aged 10 to 17 years (16 clusters, 8 conditions, 640 caregivers, 80 per condition). The primary objective of this trial is to estimate the main effects of the three components on engagement. Secondary objectives are to explore the interactions between components, the effects of the components on caregiver behavioural outcomes, moderators and mediators of programme engagement and impact, and the cost-effectiveness of components. The study will also assess enablers and barriers to engagement qualitatively via interviews with a subset of low, medium, and high engaging participants. We will combine quantitative and qualitative data to develop an optimised ParentApp for Teens delivery package. DISCUSSION This is the first known cluster randomised factorial trial for the optimisation of engagement in a digital parenting intervention in a low- and middle-income country. Findings will be used to inform the evaluation of the optimised app in a subsequent randomised controlled trial. TRIAL REGISTRATION Pan African Clinical Trial Registry, PACTR202210657553944. Registered 11 October 2022, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=24051 .
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Affiliation(s)
- Roselinde Janowski
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32-37 Wellington Square, Oxford, Ox1 2ER, UK.
| | - Ohad Green
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32-37 Wellington Square, Oxford, Ox1 2ER, UK
| | - Yulia Shenderovich
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Science, Cardiff University, Cardiff, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - David Stern
- Innovations in Development, Education, and the Mathematical Sciences (IDEMS International), Reading, UK
| | - Lily Clements
- Innovations in Development, Education, and the Mathematical Sciences (IDEMS International), Reading, UK
| | - Joyce Wamoyi
- National Institute for Medical Research Mwanza Research Centre, Mwanza, Tanzania
| | - Mwita Wambura
- National Institute for Medical Research Mwanza Research Centre, Mwanza, Tanzania
| | - Jamie M Lachman
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32-37 Wellington Square, Oxford, Ox1 2ER, UK
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
- Parenting for Lifelong Health, Oxford, UK
| | | | - Frances Gardner
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32-37 Wellington Square, Oxford, Ox1 2ER, UK
| | - Lauren Baerecke
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Esmee Te Winkel
- Innovations in Development, Education, and the Mathematical Sciences (IDEMS International), Reading, UK
| | - Anna Booij
- Clowns Without Borders South Africa, Durban, South Africa
| | - Orli Setton
- Freelance Designer and Illustrator, Cape Town, South Africa
| | | | - Sussie Mjwara
- Clowns Without Borders South Africa, Durban, South Africa
| | - Laetitia Christine
- Innovations in Development, Education, and the Mathematical Sciences (INNODEMS), Kakamega, Kenya
| | - Abigail Ornellas
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Nicole Chetty
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Jonathan Klapwijk
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32-37 Wellington Square, Oxford, Ox1 2ER, UK
| | - Isang Awah
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32-37 Wellington Square, Oxford, Ox1 2ER, UK
| | | | - Kudely Sokoine
- Investing in Children and Strengthening Their Societies, Shinyanga, Tanzania
| | - Sabrina Majikata
- Investing in Children and Strengthening Their Societies, Shinyanga, Tanzania
| | - Lucie D Cluver
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32-37 Wellington Square, Oxford, Ox1 2ER, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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22
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Forbes B, Fosuah C, Tidwell B, Nitkin T, Davis T. Effects of a Nurturing Care Group behavior change program on child protection outcomes in Ghana: A controlled before and after trial. CHILD ABUSE & NEGLECT 2023; 139:106067. [PMID: 36827866 DOI: 10.1016/j.chiabu.2023.106067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 12/16/2022] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND As part of an effort to rigorously apply behavioral science to child protection efforts, a behavior change model called Nurturing Care Groups (NCGs) was tested for effectiveness in changing child abuse and corporal punishment behaviors. OBJECTIVE The primary research question was to what degree NCGs could change child protection knowledge, attitudes, and practices among caregivers in a low-cost program with broad reach, which could feasibly be scaled. PARTICIPANTS AND SETTING The NCG project was implemented in two distinct ecological zones in Ghana, reaching 73,959 caregivers of children under 5 across 41 communities; while 20 communities were control sites with no NCG intervention. METHODS Stratified random sampling was used to select intervention area respondents. Cluster sampling was utilized in control areas, using the Probability Proportional to Size method. Standard measures were used to assess changes in practices of violence and abuse, stress experience and management, parenting techniques, and the household environment. Difference-in-difference linear regression was used to compare intervention and control results. RESULTS Intervention areas demonstrated statistically-significant and substantial changes in reported knowledge, attitudes and behaviors related to physical abuse and corporal punishment. Knowledge of negative impacts of stress on parenting, as well as stress reduction techniques increased in intervention areas, as did positive discipline and parenting practices. CONCLUSIONS The NCG model demonstrated important promising results for changing child protection behaviors in this descriptive study. Statistically-significant decreases in reported physical and psychological punishment and corresponding increases in reported positive discipline indicate that this may be an effective and low-cost intervention for child protection behavior change.
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Affiliation(s)
- Bill Forbes
- World Vision International, 800 West Chestnut Avenue, Monrovia, CA 91016, USA.
| | - Cynthia Fosuah
- World Vision Ghana, No. 3 Kotei Robertson Road, North Industrial Area, North, Kaneshie, PMB, Accra, Ghana.
| | - Ben Tidwell
- World Vision United States, 300 I St NE, Washington, DC 20002, USA.
| | - Todd Nitkin
- World Vision International, 1 Roundwood Avenue Stockley Park Uxbridge, Middlesex UB11 1FG, UK.
| | - Tom Davis
- World Vision International, 1 Roundwood Avenue Stockley Park Uxbridge, Middlesex UB11 1FG, UK.
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23
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Schwind B, Zemp E, Jafflin K, Späth A, Barth M, Maigetter K, Merten S, Kurth E. "But at home, with the midwife, you are a person": experiences and impact of a new early postpartum home-based midwifery care model in the view of women in vulnerable family situations. BMC Health Serv Res 2023; 23:375. [PMID: 37076842 PMCID: PMC10114462 DOI: 10.1186/s12913-023-09352-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/30/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Postpartum home-based midwifery care is covered by basic health insurance in Switzerland for all families with newborns but must be self-organized. To ensure access for all, Familystart, a network of self-employed midwives, launched a new care model in 2012 by ensuring the transition from hospital to home through cooperation with maternity hospitals in the Basel area. It has particularly improved the access to follow-up care for families in vulnerable situations needing support beyond basic services. In 2018, the SORGSAM (Support at the Start of Life) project was initiated by Familystart to enhance parental resources for better postpartum health outcomes for mothers and children through offering improved assistance to psychosocially and economically disadvantaged families. First, midwives have access to first-line telephone support to discuss challenging situations and required actions. Second, the SORGSAM hardship fund provides financial compensation to midwives for services not covered by basic health insurance. Third, women receive financial emergency support from the hardship fund. AIM The aim was to explore how women living in vulnerable family situations experienced the new early postpartum home-based midwifery care model provided in the context of the SORGSAM project, and how they experienced its impact. METHODS Findings are reported from the qualitative part of the mixed-methods evaluation of the SORGSAM project. They are based on the results of seven semi-structured interviews with women who, due to a vulnerable family postpartum situation at home, received the SORGSAM support. Data were analyzed following thematic analysis. RESULTS Interviewed women experienced the early postpartum care at home, as "relieving and strengthening" in that midwives coordinated patient care that opened up access to appropriate community-based support services. The mothers expressed that they felt a reduction in stress, an increase in resilience, enhanced mothering skills, and greater parental resources. These were attributed to familiar and trusting relationships with their midwives where participants acknowledged deep gratitude. CONCLUSION The findings show the high acceptance of the new early postpartum midwifery care model. These indicate how such a care model can improve the well-being of women in vulnerable family situations and may prevent early chronic stress in children.
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Affiliation(s)
- Bettina Schwind
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Elisabeth Zemp
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kristen Jafflin
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Anna Späth
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Monika Barth
- Midwifery Network, Familystart beider Basel, Basel, Switzerland
| | - Karen Maigetter
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sonja Merten
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Elisabeth Kurth
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Midwifery Network, Familystart beider Basel, Basel, Switzerland
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24
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Lachman JM, Juhari R, Stuer F, Zinser P, Han Q, Gardner F, McCoy A, Yaacob SN, Kahar R, Mansor M, Madon Z, Arshat Z, Nadzri FZM, Aftar NFA, Landers C. "Before I was like a Tarzan. But now, I take a pause": mixed methods feasibility study of the Naungan Kasih parenting program to prevent violence against children in Malaysia. BMC Public Health 2023; 23:241. [PMID: 36737719 PMCID: PMC9898888 DOI: 10.1186/s12889-023-15065-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Despite impressive strides in health, social protection, and education, children continue to experience high rates of child maltreatment in Malaysia. This mixed-methods study assessed the feasibility of a five-session, social learning-based parenting program delivered by government staff in a community setting to reduce violence against children. METHODS Parents of children from birth to 17 years were recruited from two communities near Kuala Lumpur to participate in the government-run program called the Naungan Kasih Positive Parenting Program ("Protecting through Love" in Bahasa Melayu). Quantitative data from female caregivers (N = 74) and children ages 10-17 (N = 26) were collected along with qualitative interviews and focus groups with parents, children, and facilitators. The primary outcome was child maltreatment with secondary outcomes including neglect, positive parenting, acceptability of corporal punishment, harsh parenting, positive discipline, and child behavior problems. Multilevel Poisson regression and multilevel linear regression were conducted to compare baseline and post-test outcomes. Qualitative interviews and focus groups examined how participants experienced the program utilizing a thematic analysis approach. RESULTS Quantitative analyses found pre-post reductions in overall child maltreatment, physical abuse, emotional abuse, attitudes supporting corporal punishment, parent sense of inefficacy, and child behavior problems. There were no reported changes on positive and harsh parenting, parental mental health, and marital satisfaction, nor were there any other significant changes reported by children. Qualitative findings suggested that the program had tangible benefits for female caregivers involved in the program, with the benefits extending to their family members. CONCLUSIONS This feasibility study is one of the few studies in Southeast Asia that examined the feasibility and initial program impact of a parenting program delivered by government staff to families with children across the developmental spectrum from birth to 17 years. Promising results suggest that the program may reduce child maltreatment across a range of child ages. Findings also indicate areas for program improvement prior to further delivery and testing, including additional training and content on sexual and reproductive health, parenting children with disabilities, and online child protection.
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Affiliation(s)
- J. M. Lachman
- grid.4991.50000 0004 1936 8948Department of Social Policy and Intervention, Centre for Evidence Based Intervention, University of Oxford, Oxford, England ,grid.8756.c0000 0001 2193 314XSocial and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland ,grid.7836.a0000 0004 1937 1151Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - R. Juhari
- grid.11142.370000 0001 2231 800XFaculty of Human Ecology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - F. Stuer
- Maestral International, Minneapolis, USA
| | - P. Zinser
- grid.4991.50000 0004 1936 8948Department of Social Policy and Intervention, Centre for Evidence Based Intervention, University of Oxford, Oxford, England
| | - Q. Han
- grid.4991.50000 0004 1936 8948Department of Social Policy and Intervention, Centre for Evidence Based Intervention, University of Oxford, Oxford, England
| | - F. Gardner
- grid.4991.50000 0004 1936 8948Department of Social Policy and Intervention, Centre for Evidence Based Intervention, University of Oxford, Oxford, England
| | - A. McCoy
- Peace Culture Foundation, Chiang Mai, Thailand
| | - S. N. Yaacob
- grid.11142.370000 0001 2231 800XFaculty of Human Ecology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - R. Kahar
- grid.11142.370000 0001 2231 800XFaculty of Human Ecology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - M. Mansor
- grid.11142.370000 0001 2231 800XFaculty of Human Ecology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Z. Madon
- grid.11142.370000 0001 2231 800XFaculty of Human Ecology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Z. Arshat
- grid.11142.370000 0001 2231 800XFaculty of Human Ecology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - F. Z. M. Nadzri
- grid.11142.370000 0001 2231 800XFaculty of Human Ecology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - N. F. A. Aftar
- grid.265727.30000 0001 0417 0814Faculty of Psychology and Education, University Malaysia Sabah, Kota Kinabalu, Malaysia
| | - C. Landers
- grid.21729.3f0000000419368729Mailman School of Public Health, Columbia University, New York City, USA
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25
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Carter S, Sadiq S, Calear AL, Housen T, Joshy G, Fredj N, Lokuge K. The feasibility and acceptability of implementing and evaluating a caregiver group intervention to address child mental health: A pilot study in Iraq. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
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26
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Miller KE, Chen A, Koppenol-Gonzalez GV, Bakolis I, Arnous M, Tossyeh F, El Hassan A, Saleh A, Saade J, Nahas N, Abboud M, Jawad L, Jordans MJD. Supporting parenting among Syrian refugees in Lebanon: a randomized controlled trial of the caregiver support intervention. J Child Psychol Psychiatry 2023; 64:71-82. [PMID: 35837815 DOI: 10.1111/jcpp.13668] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Parenting interventions in humanitarian settings have prioritized the acquisition of parenting knowledge and skills, while overlooking the adverse effects of stress and distress on parenting-a key mediator of refugee children's mental health. We evaluated the effectiveness of the Caregiver Support Intervention (CSI), which emphasizes caregiver wellbeing together with training in positive parenting. METHODS We conducted a two-arm randomized controlled trial of the CSI with Syrian refugees in Lebanon, with an intent-to-treat design, from September 2019-December 2020. A total of 480 caregivers from 240 families were randomized to the CSI or a waitlist control group (1:1). Retention from baseline to endline was 93%. Data on parenting and caregiver psychological wellbeing were collected at baseline, endline, and three-month follow-up. Prospective trial registration: ISRCTN22321773. RESULTS We did not find a significant change on overall parenting skills at endline (primary outcome endpoint) (d = .11, p = .126) or at follow-up (Cohen's d = .15, p = .054). We did find a significant effect on overall parenting skills among participants receiving the full intervention-the sub-sample not interrupted by (COVID-19) (d = 0.25, p < .05). The CSI showed beneficial effects in the full sample at endline and follow-up on harsh parenting (d = -.17, p < .05; d = .19, p < .05), parenting knowledge (d = .63, p < .001; d = .50, p < .001), and caregiver distress (d = -.33, p < .001; d = .23, p < .01). We found no effects on parental warmth and responsiveness, psychosocial wellbeing, stress, or stress management. Changes in caregiver wellbeing partially mediated the impact of the CSI on harsh parenting, accounting for 37% of the reduction in harsh parenting. CONCLUSIONS The CSI reduced harsh parenting and caregiver distress, and demonstrated the value of addressing caregiver wellbeing as a pathway to strengthening parenting in adversity. These effects were achieved despite a pandemic-related lockdown that impacted implementation, a severe economic crisis, and widespread social unrest. Replication under less extreme conditions may more accurately demonstrate the intervention's full potential.
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Affiliation(s)
- Kenneth E Miller
- Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, BC, Canada.,War Child, Research and Development Department, Amsterdam, The Netherlands
| | - Alexandra Chen
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | | | - Ioannis Bakolis
- Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | | | | | | | | | | | - Nayla Nahas
- Department of Psychology, University of Balamand, Tripoli, Lebanon
| | | | | | - Mark J D Jordans
- Department of Psychology, Harvard University, Cambridge, MA, USA.,Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.,Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
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27
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Mehta D, Kelly AB, Laurens KR, Haslam D, Williams KE, Walsh K, Baker PRA, Carter HE, Khawaja NG, Zelenko O, Mathews B. Child Maltreatment and Long-Term Physical and Mental Health Outcomes: An Exploration of Biopsychosocial Determinants and Implications for Prevention. Child Psychiatry Hum Dev 2023; 54:421-435. [PMID: 34586552 PMCID: PMC8480117 DOI: 10.1007/s10578-021-01258-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2021] [Indexed: 02/08/2023]
Abstract
Child maltreatment rates remain unacceptably high and rates are likely to escalate as COVID-related economic problems continue. A comprehensive and evidence-building approach is needed to prevent, detect and intervene where child maltreatment occurs. This review identifies key challenges in definitions, overviews the latest data on prevalence rates, reviews risk and protective factors, and examines common long-term mental health outcomes for children who experience maltreatment. The review takes a systems approach to child maltreatment outcomes through its focus on the overall burden of disease, gene-environment interactions, neurobiological mechanisms and social ecologies linking maltreatment to mental ill-health. Five recommendations relating to the accurate measurement of trends, research on brain structures and processes, improving the reach and impact of teleservices for detecting, preventing and treating child maladjustment, community-based approaches, and building population-focused multidisciplinary alliances and think tanks are presented.
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Affiliation(s)
- Divya Mehta
- grid.1024.70000000089150953Centre for Genomics and Personalised Health, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Adrian B. Kelly
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953Centre for Inclusive Education, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Australia
| | - Kristin R. Laurens
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953Centre for Inclusive Education, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Australia
| | - Divna Haslam
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1003.20000 0000 9320 7537Parenting and Family Support Centre, The University of Queensland, Brisbane, Australia
| | - Kate E. Williams
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Early Childhood and Inclusive Education, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953Centre for Child & Family Studies, Queensland University of Technology (QUT), Brisbane, Australia
| | - Kerryann Walsh
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Early Childhood and Inclusive Education, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953Centre for Child & Family Studies, Queensland University of Technology (QUT), Brisbane, Australia
| | - Philip R. A. Baker
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Public Health and Social Work, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Hannah E. Carter
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Public Health and Social Work, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Nigar G. Khawaja
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Australia
| | - Oksana Zelenko
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia
| | - Ben Mathews
- grid.1024.70000000089150953Present Address: Child Adversity, Mental Health and Resilience Theme, Centre for Child Health and Well-being, Queensland University of Technology (QUT), Brisbane, Australia ,grid.1024.70000000089150953School of Law, Queensland University of Technology (QUT), Brisbane, Australia ,grid.21107.350000 0001 2171 9311Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
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28
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Sherr L, Mebrahtu H, Mwaba K, Nurova N, Chetty AN, Swartz A, Cluver L, Steventon Roberts KJ, Lachman JM. ‘Tipping the balance' – an evaluation of COVID-19 parenting resources developed and adapted for child protection during global emergency responses. Health Psychol Behav Med 2022; 10:676-694. [PMID: 35957956 PMCID: PMC9359164 DOI: 10.1080/21642850.2022.2104285] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background: Parenting was severely affected by lockdown, school closure, illness, movement restrictions and the many sudden changes wrought by the global emergence of COVID-19. Responding to the need for a rapid emergency response to support parents and caregivers, a consortium of providers developed a suite of COVID-19 parenting resources based on evidence-based parenting interventions. Launched in March 2020, these were adapted for online use, with versions in over 100 languages, and the possibility for downloading, radio, and oral provision. A rapid qualitative evaluation initiative was conducted from September 2020 to February 2021 to inform the procedure, understand the impact and to drive future provision. Methods: The evaluation collected openended responses surveys (n = 495 participants) and in-depth interviews with parents, providers, and adolescent children (n = 22) from 14 countries and one global source. Data were gathered on parenting challenges during COVID-19 and the utility of the COVID-19 parenting resources. In-depth, semi-structured interviews explored the same concepts and elaborated on challenges, utility of the resources, and recommendations for the future. Data were coded in a hierarchy from basic, organising and global theme generation.Results: The parenting resources equipped parents with information and practices transforming everyday lives, and interactions. The tips provided prompts and permissions related to children’s behaviour, enabled communications, and offered ways to reduce stress, monitor behaviour and navigate discipline challenges. The timeliness of the resources as well as the clarity and ease of use were seen as advantages. Future direction and possible hurdles related to adaptations needed according to recipient, child age, local context, culture, and new challenges. Conclusions: Overall findings point to the value and utility of this unprecedented global response to theCOVID-19 pandemic. Results suggest that rapid provision of parenting resources at scale is feasible and of use and opens a pathway for providing evidence-based interventions under COVID-19 constraints.
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Affiliation(s)
- Lorraine Sherr
- Institute for Global Health, University College London, London, UK
| | - Helen Mebrahtu
- Institute for Global Health, University College London, London, UK
| | - Kasonde Mwaba
- Institute for Global Health, University College London, London, UK
| | - Nisso Nurova
- Department of Social Policy & Intervention, University of Oxford, Oxford, UK
| | - Angelique Nicole Chetty
- Department of Social Policy & Intervention, University of Oxford, Oxford, UK
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Alison Swartz
- Department of Social Policy & Intervention, University of Oxford, Oxford, UK
| | - Lucie Cluver
- Department of Social Policy & Intervention, University of Oxford, Oxford, UK
- Division of Social and Behavioural Sciences, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Jamie M. Lachman
- Department of Social Policy & Intervention, University of Oxford, Oxford, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
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Al-Mohannadi AS, Al-Harahsheh S, Atari S, Jilani N, Al-Hail G, Sigodo K. Addressing violence against children: A case review in the state of Qatar. Front Public Health 2022; 10:859325. [PMID: 36561874 PMCID: PMC9764335 DOI: 10.3389/fpubh.2022.859325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Violence against children (VAC) is a critical public health issue that affects billions of children worldwide. The combination of its prevalence and severity of effects on children creates an urgent need for effective interventions. Multiple studies associate VAC with lifelong implications that affect children through adulthood. In Qatar, multiple approaches such as legislation are being used to protect children from all forms of violence. Despite the gravity of the issue, there is still low readiness for the prevention of VAC in Qatar. This review aimed to map approaches to addressing VAC in Qatar from the panelists' perspectives on current approaches to addressing VAC. Methods The review obtained data from a recorded video entitled "A Public Health Approach to Addressing Violence Against Children." The panel discussion in this video clip was organized as a side event of the WISH virtual summit by UNICEF and WISH on World Children's Day, held in Qatar in November 2020. The video was transcribed and analyzed using thematic analysis. Findings It shows the importance of both global and national level interventions in addressing VAC. The review uses the socioecological model to show relationships among different levels of interventions addressing VAC in Qatar. The findings highlight the national approaches to addressing VAC using public health, and legislative and policy approaches. Discussion The interventions addressing VAC at different levels in Qatar are interconnected. Delineating each level is key to the formation of holistic interventions that leverage global, regional, national, communal, familial, and individual factors that support interventions to address VAC.
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Affiliation(s)
- Abdulla Saeed Al-Mohannadi
- World Innovation Summit for Health (WISH), Qatar Foundation, Doha, Qatar,*Correspondence: Abdulla Saeed Al-Mohannadi
| | - Sanaa Al-Harahsheh
- World Innovation Summit for Health (WISH), Qatar Foundation, Doha, Qatar
| | | | - Nadeem Jilani
- Sidra Child Advocacy Program, Department of Emergency Medicine, Sidra Medicine, Doha, Qatar
| | - Ghalya Al-Hail
- World Innovation Summit for Health (WISH), Qatar Foundation, Doha, Qatar
| | - Kennedy Sigodo
- Department of Nursing and Community Health, Glasgow Caledonian University, London, United Kingdom
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Branco MSS, Altafim ERP, Linhares MBM. Universal Intervention to Strengthen Parenting and Prevent Child Maltreatment: Updated Systematic Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:1658-1676. [PMID: 33973499 DOI: 10.1177/15248380211013131] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Child maltreatment is a severe worldwide public health problem because of its negative consequences and should therefore be prevented through parenting programs to improve parental behavior and practices. The present review aimed to update a published review of 5 years of empirical studies on universal parenting programs to strengthen positive parenting and prevent child maltreatment. A systematic search of the PubMed, Web of Science, PsycINFO, Lilacs, and SciELO databases was performed to identify the studies of group-based structured parenting programs published from 2015 to 2019. Eighteen studies were found that fulfilled the inclusion and exclusion criteria. The results showed that 14 different parenting programs were conducted in high-, medium-, and low-income countries, showing an increase in the number of studies in low-income countries compared with the previous review. In 89% of the studies, the parenting outcomes improved in the post-intervention. Additionally, studies have demonstrated that these programs also improved other parental outcomes such as mental health, couple relationships, coparenting, and coping ability of parents. From 18 studies, nine child variables were evaluated, and eight of them showed a decrease in behavior problems. Regarding the methodological quality of the studies, 55%, 28%, and 17% were classified as moderate, weak, and strong, respectively. In conclusion, the positive changes in parenting and child behavior outcomes encourage the implementation of parenting programs as a universal prevention strategy. Further research should increase the methodological quality of the design study.
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Affiliation(s)
- Marília Souza Silva Branco
- Department of Neurosciences and Behavior, Ribeirao Preto Medical School, University of São Paulo, Brazil
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Ruiz-Casares M, Thombs BD, Mayo NE, Andrina M, Scott SC, Platt RW. The Families First Program to Prevent Child Abuse: Results of a Cluster Randomized Controlled Trial in West Java, Indonesia. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1457-1469. [PMID: 36098893 DOI: 10.1007/s11121-022-01433-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 11/24/2022]
Abstract
The Families First parenting program is a 10-week paraprofessional-administered adaptation of the Positive Discipline in Everyday Parenting program for West Java, Indonesia. It has not been tested in a randomized controlled trial. The objective was to evaluate the effects of Families First on physical and emotional punishment. We conducted a cluster randomized controlled trial and randomly assigned 20 rural and urban villages in West Java, Indonesia, to intervention or waitlist. Caregivers of children aged 0-7 years in intervention villages received Families First. Between 2017 and 2018, measurements were taken before randomization, immediately post-intervention, and 6 months post-intervention. Primary outcome was presence versus absence of caregiver-reported physical or emotional punishment immediately post-intervention. Intention-to-treat regression models accounted for clustering within villages and were run to compare between groups. Participants and study personnel could not be blinded. There were 374 caregivers in the 10 intervention villages and 362 in the 10 waitlist villages included in the trial and in outcome analyses. The intervention did not result in a lower proportion of intervention families using punishment immediately post-intervention (odds ratio [OR] for physical or emotional punishment immediately post intervention = 1.20 (95% CI 0.79-1.82). There were no significant differences for positive and involved parenting, setting limits, and opinion on discipline, but caregivers in the intervention group had significantly lower odds of using positive discipline (OR = 0.65 (95% CI 0.53-0.80). Families First did not prevent punishment in a setting with low levels of reported punishment but should be tested in a setting with higher levels or among people selected for risk or presence.
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Affiliation(s)
- Mónica Ruiz-Casares
- Department of Psychiatry, McGill University, Montreal, QC, Canada. .,SHERPA University Institute, CIUSSS du centre-ouest-de-l'île-de-Montréal, 7085 Hutchison, 204.2.14, Montreal, QC, H3N 1Y9, Canada.
| | - Brett D Thombs
- Department of Psychiatry, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Nancy E Mayo
- Research Institute, McGill University Health Centre, Montreal, QC, Canada.,Department of Medicine and School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | | | - Susan C Scott
- Research Institute, McGill University Health Centre, Montreal, QC, Canada
| | - Robert William Platt
- Research Institute, McGill University Health Centre, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
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Jiang Y, Harrison SE, Li X. Resilience-Based Intervention to Promote Mental and Behavioral Health in Children. Pediatr Clin North Am 2022; 69:795-805. [PMID: 35934500 DOI: 10.1016/j.pcl.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The resilience framework offers a powerful tool to study how individuals respond to adversity. Intervention efforts building on 40 years of resilience research show promise in promoting mental and behavioral health of children in the context of adversity. This paper provides an overview of resilience and resilience-based interventions on mental and behavioral health in children. The importance of understanding resilience through the lens of the socioecological systems theory is highlighted, and the potential benefit of multilevel interventions in promoting mental and behavioral health is discussed.
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Affiliation(s)
- Yanping Jiang
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA; Department of Family Medicine and Community Health, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.
| | - Sayward E Harrison
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA; South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Department of Health Promotion, Education, & Behavior, University of South Carolina, Columbia, SC 29208, USA
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Pulerwitz J, McClair T, Gottert A, Shabangu P, Cawood C, Chipeta E, Mathur S. Effects of men's lifetime adverse events experience on violence, HIV risk, and wellbeing: insights from three countries. AIDS 2022; 36:S99-S108. [PMID: 35766579 DOI: 10.1097/qad.0000000000003224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess men's experiences of adverse events in both child and adulthood and their effects on violence, HIV risk, and well being in three sub-Saharan countries. DESIGN We conducted cross-sectional surveys from 2017 to 2018 with men (all 18+) recruited via the PLACE methodology at community hotspots and HIV service sites in Eswatini (n = 1091), South Africa (n = 932), and Malawi (n = 611). METHODS Prevalence of men's adverse events in childhood (e.g. beaten at home often) and adulthood (e.g. robbed at gunpoint) was described. We examined associations between cumulative effects of these events on health outcomes, via log binomial regression. RESULTS About 70% of men in each country experienced adverse events in childhood, while adult experience varied from 47 to 64%. There was a dose-response effect of cumulative exposure. Among men with 0, 1-2, and 3+ traumas, for example, 22, 35, and 52% reported depression/anxiety in Malawi, and 8, 17, and 27% perpetrated intimate partner violence (IPV) in South Africa. In multivariate analyses, experiencing at least one event in both childhood and adulthood (vs. neither) was significantly associated with various health outcomes (e.g. multiple sexual partnerships: adjusted risk ratio or aRR = 2.40 in Malawi; IPV perpetration: aRR = 3.59 in South Africa; depression/anxiety: aRR = 1.37 in Eswatini). CONCLUSION Men who experienced adverse events in childhood or adulthood faced increased HIV risk/negative health outcomes. More events were associated with worse outcomes. Interventions for men addressing trauma in both childhood and adulthood are essential for their (and their partners') health and well being.
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Affiliation(s)
| | | | | | - Patrick Shabangu
- IHM-Institute for Health Measurement Southern Africa, Mbabane, Eswatini
| | | | - Effie Chipeta
- University of Malawi, College of Medicine, Centre for Reproductive Health, Blantyre, Malawi
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Ward KP, Lee SJ, Grogan-Kaylor AC, Ma J, Pace GT. Patterns of caregiver aggressive and nonaggressive discipline toward young children in low- and middle-income countries: A latent class approach. CHILD ABUSE & NEGLECT 2022; 128:105606. [PMID: 35349948 DOI: 10.1016/j.chiabu.2022.105606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Caregivers use a variety of disciplinary methods to respond to undesired child behavior. Many caregivers use nonaggressive forms of discipline, such as verbal reasoning and redirection. Some caregivers use aggressive forms of discipline, such as spanking and yelling. However, most caregivers use a combination of aggressive and nonaggressive discipline. To date, a disproportionately small number of caregiver discipline studies are conducted in low- and middle-income countries (LMICs), and few studies in low-resource contexts examine aggressive and nonaggressive behaviors simultaneously. OBJECTIVE This study aims to elucidate caregiver patterns of 11 disciplinary behaviors used in LMICs, and examine how these patterns relate to child outcomes and household characteristics. PARTICIPANTS AND SETTING Data came from the fourth and fifth rounds of UNICEF Multiple Indicator Cluster Surveys (MICS) distributed between 2009 and 2017 (N = 218,824 respondents across 63 countries). Focal children were 3-4 years old. METHODS Patterns of disciplinary behaviors were estimated using a multilevel latent class analysis (LCA). Multinomial regression analyses examined associations of disciplinary patterns with caregiver-reported child outcomes and household characteristics. RESULTS The LCA suggested caregiver discipline fell into three overall patterns: high behavioral control, moderate behavior control, and lower behavioral control. The lower behavioral control class was associated with the most advantageous child outcomes and household socio-demographic characteristics, whereas the high behavioral control class was associated with the most disadvantageous child outcomes and household characteristics. CONCLUSIONS Efforts should be employed to reduce aggressive behaviors and promote positive parenting among caregivers in LMICs.
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Affiliation(s)
- Kaitlin P Ward
- University of Michigan, School of Social Work, 1080 South University Avenue, Ann Arbor, MI 48109, USA.
| | - Shawna J Lee
- University of Michigan, School of Social Work, 1080 South University Avenue, Ann Arbor, MI 48109, USA.
| | - Andrew C Grogan-Kaylor
- University of Michigan, School of Social Work, 1080 South University Avenue, Ann Arbor, MI 48109, USA.
| | - Julie Ma
- University of Michigan-Flint, Department of Social Work, 303 E. Kearsley St., Flint, MI 48502, USA.
| | - Garrett T Pace
- University of Michigan, School of Social Work, 1080 South University Avenue, Ann Arbor, MI 48109, USA.
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Family Education and Support Programme: Implementation and Cultural Adaptation in Cape Verde. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11060232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This article describes some preliminary data on the implementation of the Family Education and Support Programme (FAF) on psychosocially at-risk families of Boavista Island, Cape Verde, specifically in relation to its effectiveness in parenting competences. The FAF is a family intervention programme designed to be integrated into preventive and formative actions and it has the purpose of promoting positive parenting and preventing child abuse. This study aims to (a) describe the participants’ psychosocial profile regarding sociodemographic characteristics and negative or risky life events, (b) analyse the effectiveness of the FAF on improving parenting competences, and (c) address the main procedural topics related to the implementation of the FAF in Cape Verde. An experiential and participatory methodology was used with 66 parents, who participated in 12 group sessions, with a weekly periodicity, for four months. The evaluation was performed, in the pre-test and post-test, with the control group and the intervention group. Results show the effectiveness of the FAF in an African context, including its impact. The intervention group improved their post-intervention scores on perceived efficacy and satisfaction with a moderate and high effect size, respectively. We present some recommendations to be considered in future programs to promote positive parenting, since improvements in parents’ competences, are key to reducing neglectful or abusive situations.
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Koris A, Steven S, Akika V, Puls C, Okoro C, Bitrus D, Seff I, Deitch J, Stark L. Opportunities and challenges in preventing violence against adolescent girls through gender transformative, whole-family support programming in Northeast Nigeria. Confl Health 2022; 16:26. [PMID: 35550180 PMCID: PMC9096748 DOI: 10.1186/s13031-022-00458-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 05/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Household violence is one of the most prevalent forms of gender-based violence faced by adolescent girls in humanitarian settings. A growing evidence base demonstrates the extent to which multiple forms of familial violence, including intimate partner violence, violence against children, and sibling violence overlap in the same households. However, existing evidence of family support programming that effectively reduces violence against girls by addressing intersecting forms of household violence are limited, particularly in the Global South. Through a qualitative implementation evaluation informed by a grounded theoretical approach, we explored the perceived impact of a gender transformative, whole-family support intervention aimed at building adolescent girls’ protective assets against violence, among program participants in two communities of internally displaced people Maiduguri, Borno State, Northeast Nigeria. Methods We conducted six in-depth interviews and six focus group discussions with adult caregivers; six participatory activities and four paired interviews with adolescent girls and boys; and 12 key informant interviews with program staff. Criterion sampling was used to recruit 21 male caregivers, 21 female caregivers, 23 adolescent boys, and 21 adolescent girls; purposive sampling was used to recruit 12 program staff to participate in qualitative research activities. We audio recorded, translated, and transcribed all interviews. In a collaborative coding process, a multi-stakeholder team used applied thematic analysis in Dedoose to identify emergent themes in the data. Results Participants reported a decreased tolerance for and perpetration of violence against girls at the household level, and endorsed their right to protection from violence at the community level. However, alongside these self-reported changes in attitude and behavior, aspects of normative, patriarchal norms governing the treatment of adolescent girls were maintained by participants. Conclusions This study builds the evidence base for gender transformative, whole-family support programming and its impact on preventing violence against adolescent girls in humanitarian emergencies. Situating our findings in a feminist analysis of violence, this study calls attention to the complexity of gender norms change programming amongst families in conflict-affected settings, and highlights the need for programming which holistically addresses the relational, community, and structural drivers of violence against girls in emergencies.
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Affiliation(s)
- Andrea Koris
- Women's Refugee Commission, 15 W. 37th St, New York, NY, 10018, USA
| | - Shadrack Steven
- Mercy Corps Nigeria, 35 Patrick Bokkor Crescent, Jabi, Utako District, Abuja, Nigeria
| | - Veronica Akika
- Mercy Corps Nigeria, 35 Patrick Bokkor Crescent, Jabi, Utako District, Abuja, Nigeria
| | - Cassondra Puls
- Women's Refugee Commission, 15 W. 37th St, New York, NY, 10018, USA
| | - Charles Okoro
- Mercy Corps Nigeria, 35 Patrick Bokkor Crescent, Jabi, Utako District, Abuja, Nigeria
| | - David Bitrus
- Mercy Corps Nigeria, 35 Patrick Bokkor Crescent, Jabi, Utako District, Abuja, Nigeria
| | - Ilana Seff
- Brown School at Washington University in St. Louis, Campus Box 1196, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Julianne Deitch
- Women's Refugee Commission, 15 W. 37th St, New York, NY, 10018, USA
| | - Lindsay Stark
- Brown School at Washington University in St. Louis, Campus Box 1196, 1 Brookings Drive, St. Louis, MO, 63130, USA.
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Vaivada T, Lassi ZS, Irfan O, Salam RA, Das JK, Oh C, Carducci B, Jain RP, Als D, Sharma N, Keats EC, Patton GC, Kruk ME, Black RE, Bhutta ZA. What can work and how? An overview of evidence-based interventions and delivery strategies to support health and human development from before conception to 20 years. Lancet 2022; 399:1810-1829. [PMID: 35489360 DOI: 10.1016/s0140-6736(21)02725-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 09/14/2021] [Accepted: 11/23/2021] [Indexed: 12/14/2022]
Abstract
Progress has been made globally in improving the coverage of key maternal, newborn, and early childhood interventions in low-income and middle-income countries, which has contributed to a decrease in child mortality and morbidity. However, inequities remain, and many children and adolescents are still not covered by life-saving and nurturing care interventions, despite their relatively low costs and high cost-effectiveness. This Series paper builds on a large body of work from the past two decades on evidence-based interventions and packages of care for survival, strategies for delivery, and platforms to reach the most vulnerable. We review the current evidence base on the effectiveness of a variety of essential and emerging interventions that can be delivered from before conception until age 20 years to help children and adolescents not only survive into adulthood, but also to grow and develop optimally, support their wellbeing, and help them reach their full developmental potential. Although scaling up evidence-based interventions in children younger than 5 years might have the greatest effect on reducing child mortality rates, we highlight interventions and evidence gaps for school-age children (5-9 years) and the transition from childhood to adolescence (10-19 years), including interventions to support mental health and positive development, and address unintentional injuries, neglected tropical diseases, and non-communicable diseases.
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Affiliation(s)
- Tyler Vaivada
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Zohra S Lassi
- Robinson Research Institute and Adelaide Medical School, the University of Adelaide, SA, Australia; Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Omar Irfan
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Rehana A Salam
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Christina Oh
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Bianca Carducci
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Reena P Jain
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Daina Als
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Naeha Sharma
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Emily C Keats
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Margaret E Kruk
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Robert E Black
- Institute for International Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, Johns Hopkins University, MD, USA
| | - Zulfiqar A Bhutta
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; Centre of Excellence in Women and Child Health and Institute for Global Health and Development, The Aga Khan University, Karachi, Pakistan.
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Wight D, Sekiwunga R, Namutebi C, Zalwango F, Siu GE. A Ugandan Parenting Programme to Prevent Gender-Based Violence: Description and Formative Evaluation. RESEARCH ON SOCIAL WORK PRACTICE 2022; 32:448-464. [PMID: 35431527 PMCID: PMC7612614 DOI: 10.1177/10497315211056246] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Purpose: To develop a culturally-sensitive intervention for the early prevention of gender-based violence (GBV) in Uganda. Methods: Programme design followed the 6SQuID model of intervention development and multi-sectorial advice. A formative evaluation was conducted in two communities with six groups and 138 participants. Findings: Four familial predictors of GBV were identified as potentially malleable: poor parent-child attachment, harsh parenting, inequitable gendered socialization and parental conflict. A community-based parenting programme was developed to address them. Its programme theory incorporates Attachment Theory, the concept that positive behavioural control develops emotional control, and Social Learning Theory. Its rationale, structure and content are presented using the TIDieR checklist. A formative evaluation showed the programme to be widely acceptable, culturally appropriate, and perceived to be effective, but also identified challenges. Conclusion: The careful development of this community-based parenting programme shows promise for the early prevention of GBV.
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Affiliation(s)
- Daniel Wight
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Richard Sekiwunga
- Child Health and Development Centre, Makerere University, Kampala, Uganda
| | - Carol Namutebi
- Child Health and Development Centre, Makerere University, Kampala, Uganda
| | | | - Godfrey E. Siu
- Child Health and Development Centre, Makerere University, Kampala, Uganda
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Fang Z, Barlow J, Zhang C. Parenting Programs That Address Physical Abuse in Childhood for Families of Children With Developmental Disabilities in Mainland China: Systematic Review and Meta-Regression. TRAUMA, VIOLENCE & ABUSE 2022; 23:457-475. [PMID: 32323637 PMCID: PMC8905128 DOI: 10.1177/1524838020915599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Millions of children in China are diagnosed with developmental disabilities (DD), many of whom are subject to physical abuse. While a significant body of research suggests that parenting interventions can reduce the incidence and risk of such abuse, there is currently limited evidence of their effectiveness for this population or from non-English-speaking countries. This review involved searches in both English and Chinese databases to identify randomized controlled trials and quasi-experimental studies of parenting interventions for families of children with DD in mainland China. Multilevel meta-analyses were undertaken to examine the effectiveness of parenting programs. Subgroup analyses and meta-regression were conducted to investigate heterogeneity and identify potential moderators with a focus on intervention and delivery components. Risk of bias was assessed for each study. Thirty-one studies were included. The results showed that parenting interventions could reduce child emotional and behavioral problems (CEBP) and improve the parent-child relationship, although only one study directly measured the actual incidence of abuse. Programs for autism and epilepsy had stronger treatment effects. Teaching knowledge about CEBP, skills to improve parental mental health, and techniques to cultivate empathy were associated with program success; however, positive reinforcement was associated with more problems. The results also supported the delivery of programs with longer duration, a combination of group and individual sessions, efforts to build rapport, ongoing communication outside the programs, and delivery in hospitals or service agencies. Further research is needed, however, in addition to improvements in the quality of research and reporting.
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Affiliation(s)
- Zuyi Fang
- Department of Social Policy and Intervention, University of Oxford, United Kingdom
| | - Jane Barlow
- Department of Social Policy and Intervention, University of Oxford, United Kingdom
| | - Cheng Zhang
- School of Sociology and Social Policy, University of Leeds, United Kingdom
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Quail KR, Ward CL. Nonviolent Discipline Options for Caregivers and Teachers: A Systematic Overview of the Evidence. TRAUMA, VIOLENCE & ABUSE 2022; 23:620-638. [PMID: 33111651 DOI: 10.1177/1524838020967340] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Violence against children is a widespread problem with devastating consequences, and corporal punishment is a risk factor for more serious forms of physical abuse. One reason for the persistence of corporal punishment may be the lack of awareness of positive disciplinary alternatives. Nonviolent options offered to caregivers and teachers must be effective in addressing challenging behavior, or they may be rejected in favor of a return to physical punishment. There is an urgent need to determine which discipline options are evidence-supported and what that evidence says so that robust alternatives to corporal punishment can be made available. The primary objective of this research was to find, and explore the state of the science on, individual nonviolent interventions for challenging behavior, in so doing forming a "tool kit" for use by caregivers and teachers. A systematic overview of systematic reviews was conducted. Included systematic reviews were peer-reviewed and published in English between 1999 and 2018. Screening, quality assessment using AMSTAR, and data extraction were performed independently by two reviewers. A total of 223 reviews were included, covering data from 3,921 primary studies. A wide range of evidence-supported interventions exist, many of which have been found effective with severely challenging behavior. Important positive outcomes shown suggest that the use of these tools should be promoted not only for the prevention of violence but also for optimum child development. More research is needed on the use of these methods in home situations and on de-escalation skills.
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Affiliation(s)
- Karen R Quail
- Department of Psychology, University of Cape Town, South Africa
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Woodfield MJ, Merry S, Hetrick SE. Clinician adoption of Parent–Child Interaction Therapy: A systematic review of implementation interventions. IMPLEMENTATION RESEARCH AND PRACTICE 2022; 3:26334895221082330. [PMID: 37091096 PMCID: PMC9924277 DOI: 10.1177/26334895221082330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Parent–Child Interaction Therapy (PCIT) is a parent training intervention for childhood conduct problems, distinctive in its use of live clinician coaching of the parent–child dyad via a one-way mirror and discrete earpiece. However, despite a compelling evidence base, uptake of evidence-based parent training programmes such as PCIT by clinicians in routine care settings remains poor. This systematic review aimed to identify and synthesise implementation interventions that have sought to increase clinician adoption of PCIT in usual care settings. Methods We searched MEDLINE (Ovid), Embase (Ovid), PsycInfo (Ovid), CINAHL (EBSCO), Science Citation Index and Social Sciences Citation Index, and Web of Science Core Collection from inception to October 2020. Articles were included if they tested (by way of randomised controlled trials, controlled clinical trials, interrupted time series and controlled before and after trials) implementation interventions across any and all of the patient, clinician, clinic, system or policy domains. Two independent reviewers screened and selected studies, assessed risk of bias and extracted data – summarising implementation intervention components according to items from the Template for Intervention Description and Replication (TIDieR) checklist ( Hoffmann et al., 2014 ). Results Of the 769 articles identified once duplicates were removed, 13 papers relating to three studies met the inclusion criteria – all were quantitative or mixed-methods examinations of the effectiveness of different PCIT clinician training or training-related consultation methods. A narrative description of interventions was provided, as quantitative synthesis was not possible. Conclusions Research attention has to date been focussed on the establishment of an evidence-base for PCIT's effectiveness, with relatively little attention to the dissemination, implementation and sustainment of this treatment. Those studies that do exist have focused on training methods and training-related expert consultation. Research attention could usefully turn to both adoption and sustainment of this effective treatment in usual care settings. Plain language summary In this review, we aimed to summarise what is already known about how to implement PCIT in community settings after clinicians have received training in the approach. While research relating to the implementation of other parent training programmes is interesting and informative, implementation efforts are most effective when tailored to a specific programme in a specific context. As such, it was important to review published studies relating to PCIT specifically. We identified three relevant studies, one of which is yet to publish its main implementation findings. The three studies have focused on how best to train clinicians in PCIT, including how best to provide post-training support from expert trainers. We concluded that a fruitful line for future research would be to focus on the post-training period, particularly how best to support clinicians to adopt and sustain PCIT in their practice. Systematic review registration The study was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 01/10/2020 (CRD42020207118).
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Affiliation(s)
- Melanie J Woodfield
- The Werry Centre, Department of Psychological Medicine, University of Auckland, New Zealand
| | - Sally Merry
- The Werry Centre, Department of Psychological Medicine, University of Auckland, New Zealand
| | - Sarah E Hetrick
- The Werry Centre, Department of Psychological Medicine, University of Auckland, New Zealand
- Centre for Youth Mental Health, University of Melbourne, Australia
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Giusto AM, Ayuku D, Puffer ES. Learn, Engage, Act, Dedicate (LEAD): development and feasibility testing of a task-shifted intervention to improve alcohol use, depression and family engagement for fathers. Int J Ment Health Syst 2022; 16:16. [PMID: 35246218 PMCID: PMC8896316 DOI: 10.1186/s13033-022-00522-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 01/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Men's depression, alcohol use, and family problems commonly co-occur to create of cluster of mental health problems. Yet, few treatments exist to address these problems, especially in low and middle-income countries (LMICs). This paper describes the development and initial feasibility and acceptability of a novel task-shifted intervention to address this cluster of men's mental health problems with a focus on engaging and retaining men in treatment. METHODS The intervention, Learn, Engage, Act, Dedicate (LEAD), is based in behavioral activation blended with motivational interviewing and was pilot tested in Kenya. To develop LEAD, we engaged in a community-engaged multi-step, collaborative process with local Kenyan stakeholders. LEAD was piloted with nine fathers reporting problem drinking. To assess initial feasibility and acceptability, recruitment and participation were tracked and descriptive statistics were generated given engagement of men was key for proof of concept. Semi-structured interviews were conducted with participants and analyzed using thematic content analysis. RESULTS The development process resulted in a weekly 5-session intervention rooted in behavioral activation, motivational interviewing, and masculinity discussion strategies. These approaches were combined and adapted to fit contextually salient constructs, such as the importance of the man as provider, and streamlined for lay providers. Feasibility and acceptability results were promising with high attendance, acceptability of delivery and intervention content, and perceived intervention helpfulness. CONCLUSION Results describe an acceptable task-shifted treatment that may engage men in care and addresses a cluster of common mental health problems among men in ways that consider social determinants like masculinity. Findings set the stage for a larger trial. Trial registration ISRCTN, ISRCTN130380278. Registered 7 October 2019-Retrospectively registered, http://www.isrctn.com/ISRCTN13038027.
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Affiliation(s)
- Ali M Giusto
- Duke University Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA. .,Duke Global Health Institute, 310 Trent Dr, Durham, NC, 27710, USA. .,Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, 40 Haven Ave., #171, New York, NY, 10032, USA.
| | - David Ayuku
- Moi University, Academic Highway, Eldoret, Usain Gishu County, Kenya
| | - Eve S Puffer
- Duke University Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.,Duke Global Health Institute, 310 Trent Dr, Durham, NC, 27710, USA
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Mathias K, Nayak P, Singh P, Pillai P, Goicolea I. Is the Parwarish parenting intervention feasible and relevant for young people and parents in diverse settings in India? A mixed methods process evaluation. BMJ Open 2022; 12:e054553. [PMID: 35177452 PMCID: PMC8860057 DOI: 10.1136/bmjopen-2021-054553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To assess the feasibility, acceptability and relevance of the Parwarish, a positive parenting intervention (adapted from PLH-Teens) in three diverse settings in India. DESIGN This mixed methods study used the Medical Research Council framework for process evaluations of complex interventions. SETTING This study was set in disadvantaged communities in urban Agra, rural Uttar Pradesh and tribal Jharkhand in India. PARTICIPANTS Data were collected from 86 facilitators, implementers, parents and teens who participated in the Parwarish intervention among 239 families. INTERVENTION Couples from target communities facilitated groups of parents and teens over the 14-module structured, interactive Parwarish intervention which focused on building communication, reducing harsh parenting and building family budgeting skills. OUTCOME MEASURES We assessed relevance, acceptability and feasibility of the intervention using mixed methods. Qualitative data collected included semistructured interviews and focus group discussions with implementers, facilitators, parents and young people who were transcribed, translated and thematically analysed to develop themes inherent in the data. Quantitative data which assessed attendance, fidelity to the intervention and facilitator training and coaching were analysed descriptively. RESULTS Findings were grouped under the three domains of facilitation, community engagement and programme support with the following seven themes: (1) community-based facilitators increased contextual validity of the intervention; (2) gender relations were not only influenced by Parwarish implementation but were also influenced and transformed by Parwarish; (3) facilitator responsiveness to group concerns increased participation; (4) participation gathered momentum; (5) Parwarish's strong core and porous periphery allowed adaptations to local contexts; (6) technology that included Skype and WhatsApp enhanced implementation and (7) critical reflection with community trained coaches strengthened facilitation quality and programme fidelity. CONCLUSION This study found Parwarish engaging, feasible and acceptable in three diverse, low-income communities, although constrained by patriarchal gender relations. It paves the way for larger-scale implementation in other South Asian settings.
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Affiliation(s)
- Kaaren Mathias
- Global Health and Epidemiology, Umea University, Umea, Sweden
- Community Health and Development, Emmanuel Hospital Association, New Delhi, Delhi, India
| | - Prabhudutt Nayak
- Chhatarpur Christian Hospital, Community Health and Development Programme, Emmanuel Hospital Association, Chhatarpur, Madhya Pradesh, India
| | - Pratibha Singh
- Community Health and Development, Emmanuel Hospital Association, New Delhi, Delhi, India
| | - Pooja Pillai
- Burans, Herbertpur Christian Hospital, Emmanuel Hospital Association, Dehradun, Uttarakhand, India
| | - Isabel Goicolea
- Global Health and Epidemiology, Umea University, Umea, Sweden
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Basto-Pereira M, Gouveia-Pereira M, Pereira CR, Barrett EL, Lawler S, Newton N, Stapinski L, Prior K, Costa MSA, Ximenes JM, Rocha AS, Michel G, Garcia M, Rouchy E, Al Shawi A, Sarhan Y, Fulano C, Magaia AJ, El-Astal S, Alattar K, Sabbah K, Holtzhausen L, Campbell E, Villanueva L, Gomis-Pomares A, Adrián JE, Cuervo K, Sakulku J. The global impact of adverse childhood experiences on criminal behavior: A cross-continental study. CHILD ABUSE & NEGLECT 2022; 124:105459. [PMID: 35007971 DOI: 10.1016/j.chiabu.2021.105459] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/23/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) have been associated with a greater risk of later criminal offending. However, existing research in this area has been primarily conducted in Western developed countries and cross-cultural studies are rare. OBJECTIVES This study examined the relationship between ACEs and criminal behaviors in young adults living in 10 countries located across five continents, after accounting for sex, age, and cross-national differences. PARTICIPANTS AND SETTING In total, 3797 young adults aged between 18 and 20 years (M = 18.97; DP = 0.81) were assessed locally in community settings within the 10 countries. METHOD The ACE Questionnaire was used to assess maltreatment and household dysfunction during childhood and a subset of questions derived from the Deviant Behavior Variety Scale (DBVS) was used to determine past-year criminal variety pertaining to 10 acts considered crime across participating countries. RESULTS Physical and sexual abuse, physical neglect, and household substance abuse were related to criminal variety, globally, and independently across sexes and countries ranked differently in the United Nations Human Development Index (HDI). In addition, three out of five experiences of household dysfunction were related to criminal variety, but subsequent analyses indicate that some forms of household dysfunction only hold statistical significance among males or females, or in countries ranking lower in the HDI. CONCLUSIONS This research strengthens the finding that there are cross-cultural mechanisms perpetuating the cycle of violence. It also indicates that forms of household dysfunction have an impact on criminal behavior that is shaped by gender and the country's levels of social well-being.
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Affiliation(s)
- Miguel Basto-Pereira
- William James Center for Research, ISPA-Instituto Universitário, R. Jardim do Tabaco 34, 1100-304 Lisboa, Portugal..
| | - Maria Gouveia-Pereira
- APPsyCI, ISPA - Intituto Universitário, R. Jardim do Tabaco 34, 1100-304 Lisboa, Portugal
| | - Cicero Roberto Pereira
- Institute of Social Sciences, University of Lisbon (ICS-ULisboa), Av. Prof. Aníbal Bettencourt 9, 1600-189, Lisbon, Portugal; Federal University of Paraíba, Campus I - Lot. Cidade Universitaria, PB 58051-900, Brazil
| | - Emma Louise Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW 2006, Australia
| | - Siobhan Lawler
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW 2006, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW 2006, Australia
| | - Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW 2006, Australia
| | - Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW 2006, Australia
| | - Maria Suely Alves Costa
- Universidade Federal do Ceará, UFC, Campus Sobral, R. Cel. Estanislau Frota, 563 - Centro, Sobral, CE 62010-560, Brazil
| | - Jocélia Medeiros Ximenes
- Universidade Federal do Ceará, UFC, Campus Sobral, R. Cel. Estanislau Frota, 563 - Centro, Sobral, CE 62010-560, Brazil
| | - André Sousa Rocha
- Universidade Federal do Ceará, UFC, Campus Sobral, R. Cel. Estanislau Frota, 563 - Centro, Sobral, CE 62010-560, Brazil
| | - Grégory Michel
- Institut de Sciences Criminelles et de la Justice (ISCJ), University of Bordeaux, 4 rue du Maréchal Joffre, 1er étage, 33000 Bordeaux, France; Department of Psychology, University of Bordeaux, ISCJ, 4 rue du Maréchal Joffre, 33075 Bordeaux, France
| | - Mathieu Garcia
- Institut de Sciences Criminelles et de la Justice (ISCJ), University of Bordeaux, 4 rue du Maréchal Joffre, 1er étage, 33000 Bordeaux, France; Department of Psychology, University of Bordeaux, ISCJ, 4 rue du Maréchal Joffre, 33075 Bordeaux, France
| | - Emma Rouchy
- Institut de Sciences Criminelles et de la Justice (ISCJ), University of Bordeaux, 4 rue du Maréchal Joffre, 1er étage, 33000 Bordeaux, France; Department of Psychology, University of Bordeaux, ISCJ, 4 rue du Maréchal Joffre, 33075 Bordeaux, France
| | - Ameel Al Shawi
- Department of Community & Family Medicine, College of Medicine, University of Fallujah, Fallujah City, Anbar Governorate, Iraq
| | - Yassen Sarhan
- Department of Community & Family Medicine, College of Medicine, University of Anbar, Ramadi city, Anbar Governorate, Iraq
| | - Celso Fulano
- Universidade Pedagógica, Rua João Carlos Raposo Beirão n° 135, Maputo, Mozambique; Maputo Municipal Council, Bairro Chali, n°142, estrada 403, Maputo, Mozambique
| | - Angélica José Magaia
- Ministry of Gender, Children and Social Action, National Director of Children, Av Ahmed S Touré 908, Maputo, Mozambique
| | - Sofián El-Astal
- Al Azhar University-Gaza, Jamal Abdl Naser St., Gaza, Palestine
| | - Kefaya Alattar
- Al Azhar University-Gaza, Jamal Abdl Naser St., Gaza, Palestine
| | - Khetam Sabbah
- Al Azhar University-Gaza, Jamal Abdl Naser St., Gaza, Palestine
| | - Leon Holtzhausen
- Department of Social Development, University of Cape Town, Rondebosch, Cape Town 7700, South Africa
| | - Emma Campbell
- Department of Social Development, University of Cape Town, Rondebosch, Cape Town 7700, South Africa
| | - Lidón Villanueva
- Developmental Psychology Department, Universitat Jaume I, Avda. Sos Baynat, s/n 12071, Castellón, Spain
| | - Aitana Gomis-Pomares
- Developmental Psychology Department, Universitat Jaume I, Avda. Sos Baynat, s/n 12071, Castellón, Spain
| | - Juan E Adrián
- Developmental Psychology Department, Universitat Jaume I, Avda. Sos Baynat, s/n 12071, Castellón, Spain
| | - Keren Cuervo
- Developmental Psychology Department, Universitat Jaume I, Avda. Sos Baynat, s/n 12071, Castellón, Spain
| | - Jaruwan Sakulku
- School of Psychology, Faculty of Liberal Arts, Thammasat University, 99 Moo 18 Paholyothin Rd. Khlong Nueng, Khlong Luang, Pathumthani 12121, Thailand
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Florio E, Caso L, Castelli I. Detrimental educational practices deemed as culturally acceptable: Adultcentrism and Black Pedagogy in Italian primary schools. SOCIAL PSYCHOLOGY OF EDUCATION 2022. [DOI: 10.1007/s11218-021-09676-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Awah I, Green O, Baerecke L, Janowski R, Klapwijk J, Chetty AN, Wamoyi J, Cluver LD. 'It provides practical tips, practical solutions!': acceptability, usability, and satisfaction of a digital parenting intervention across African countries. PSYCHOL HEALTH MED 2022; 27:107-123. [PMID: 35980251 DOI: 10.1080/13548506.2022.2113106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The parenting evidence base is well established, and the question is how best to transfer the evidence to an app. App-based interventions could expand access to evidence-based parenting support; however, current provision lacks rigorous evidence, shows low user engagement, and is primarily for commercial gain. This study aimed at testing the feasibility and acceptability of ParentApp for Teens, an open-source, mobile parenting intervention application based on the Parenting for Lifelong Health Teens programme targeting parents of teens. The objective was to gather feedback from users on the relevance, acceptability, satisfaction, and usability of ParentApp for Teens across contexts in Africa, and subsequently, use the feedback to improve the app experience for target users. Caregivers and their adolescents aged 10-17 years, from nine different countries, were purposefully selected for user testing. The study involved 18 caregivers participating in the programme by using the app for 13 weeks and providing feedback on it through remote, semi-structured interviews that explored the app's acceptability and usability. Adolescents of six caregivers were also interviewed. Data were analysed thematically. Participants expressed a high level of satisfaction with the app's content and described it as easy to use and useful. However, views on the app's animated characters varied. Although effectiveness was not a primary aim of the user testing, several caregivers commented that they perceived their participation in the study had helped to enforce positive parenting skills in themselves. Adolescents' data supported the caregivers' reports of less harsh parenting and improved relationships between caregivers and their children due to the caregivers' participation in the study. Findings indicate the app could be relevant and acceptable in participants' communities, but possible barriers to its uptake may be lack of android smartphones, lack of data for app download, and inability of non-literate caregivers to read the content.
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Affiliation(s)
- Isang Awah
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Ohad Green
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK.,The Haruv Institute, Jerusalem, Israel
| | - Lauren Baerecke
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Roselinde Janowski
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Jonathan Klapwijk
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Angelique N Chetty
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Joyce Wamoyi
- National Institute for Medical Research, Department of Sexual and Reproductive Health, Mwanza Centre, Tanzania
| | - Lucie D Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK.,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Arruabarrena I, Rivas GR, Cañas M, Paúl JD. The Incredible Years Parenting and Child Treatment Programs: A Randomized Controlled Trial in a Child Welfare Setting in Spain. INTERVENCION PSICOSOCIAL 2022; 31:43-58. [PMID: 37362617 PMCID: PMC10268544 DOI: 10.5093/pi2022a2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 11/08/2021] [Indexed: 06/28/2023]
Abstract
Incredible Years (IY) is a well-established multicomponent group-based program designed to promote young children's emotional and social competence, to prevent and treat child behavioral and emotional problems, and to improve parenting practices and the parent-child relationship. This study presents the first randomized controlled trial carried out in Spain to test the effectiveness of the Incredible Years Basic Parenting and Small Group Dinosaur Programs in a sample of families involved in child welfare due to substantiated or risk for child maltreatment. One hundred and eleven families with 4- to 8-year-old children were randomly allocated to IY or to a control group who received standard services. Baseline, post-intervention, and 12-month follow-up assessments were compared. Results showed that compared to the control group, the IY intervention made a significant positive difference in parents' observed and reported use of praise, and a significant reduction in reported use of inconsistent discipline, parenting stress, depressive symptomatology, and perception of child behavior problems. A full serial mediation effect was found between participation in IY, changes in parenting practices, subsequent parenting stress reduction, and both final child abuse potential reduction and perception of child behavior problems. No moderating influence on IY effects was found. Findings provide evidence that transporting the IY Basic Parenting and the Small Group Dinosaur Programs with fidelity is feasible in Child Welfare Services in Spain.
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Affiliation(s)
- Ignacia Arruabarrena
- University of the Basque CountryDonostia-San SebastiánSpainUniversity of the Basque Country (UPV/EHU), Donostia-San Sebastián, Spain
| | - Gabriela R. Rivas
- University of the Basque CountryDonostia-San SebastiánSpainUniversity of the Basque Country (UPV/EHU), Donostia-San Sebastián, Spain
| | - María Cañas
- University of the Basque CountryDonostia-San SebastiánSpainUniversity of the Basque Country (UPV/EHU), Donostia-San Sebastián, Spain
| | - Joaquín De Paúl
- University of the Basque CountryDonostia-San SebastiánSpainUniversity of the Basque Country (UPV/EHU), Donostia-San Sebastián, Spain
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Linhares MBM, Altafim ERP, Gaspardo CM, de Oliveira RC. A Personalized Remote Video-Feedback Universal Parenting Program: A Randomized Controlled Trial. INTERVENCION PSICOSOCIAL 2022; 31:21-32. [PMID: 37362619 PMCID: PMC10268541 DOI: 10.5093/pi2021a9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/09/2021] [Indexed: 06/28/2023]
Abstract
The randomized controlled trial examined the efficacy of a personalized remote video feedback parenting program to improve parenting and child behavior outcomes. Ninety-two mothers of 2-6-year-old children were randomly allocated into the intervention group (n = 50) and waiting-list control group (n = 42). The Strengthening Bonds preventive program was performed to improve positive parenting. The mothers participated in one in-person group session. During six weeks, the mothers received, via smartphone, remote personalized video feedback about their mother-child interactions in a play situation. Parenting was the primary outcome, and child behavior was the secondary one. Pre- and post-intervention assessments were performed. The generalized estimating equation analysis showed no significant results in the intention-to-treat (ITT). In the treatment-on-the-treated (TOT), there were statistically significant effects of the intervention decreasing mothers' coercive parenting practices and child behavior problems. The structural equation model analysis showed that the intervention-induced reductions in children's behavior problems were mediated by improvements in coercive practices. There was a direct effect of the intervention to improve the parental sense of competence. Despite the null findings in the ITT analysis, the TOT analysis showed promising results to strengthen positive parenting behaviors and beliefs and reduce child behavior problems.
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Harsh parenting and child conduct and emotional problems: parent- and child-effects in the 2004 Pelotas Birth Cohort. Eur Child Adolesc Psychiatry 2022; 31:1-11. [PMID: 33738622 PMCID: PMC9343272 DOI: 10.1007/s00787-021-01759-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 03/11/2021] [Indexed: 12/23/2022]
Abstract
In high-income countries, links between harsh and abusive parenting and child conduct and emotional problems are well-documented. However, less is known about these relationships in low- and middle-income countries, where harsh parenting may be more widely accepted and higher rates of conduct or emotional problems may exist which could influence the strength of these associations. We sought to investigate these relationships in a large population-based, prospective longitudinal study from Brazil, which also allowed us to test for sex differences. Using data from the 2004 Pelotas Birth Cohort Study (N = 4231) at ages 6 and 11 years, we applied cross-lagged path analysis to examine the relationships between harsh parenting (Conflict Tactics Scale Parent-Child version), and child conduct and emotional problems (Strengths and Difficulties Questionnaire). We found reciprocal relationships between harsh parenting and child conduct problems, with harsh parenting at age 6 predicting child conduct problems at age 11, and vice versa, even after adjusting for initial levels of conduct problems and harsh parenting, respectively. For child emotional problems, only unidirectional effects were found, with harsh parenting at age 6 predicting child emotional problems at age 11, after adjusting for initial levels of emotional problems, but not vice versa. No significant sex differences were observed in these relationships. These observations based on a middle-income country birth cohort highlight the potential universality of detrimental effects of harsh parenting on child conduct and emotional problems and affirm the importance of addressing parent- and child-effects in preventive and treatment interventions, especially those targeting conduct problems.
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Tăut D, Băban A, Frantz I, Dănilă I, Lachman JM, Heinrichs N, Ward CL, Gardner F, Fang X, Hutchings J, Raleva M, Lesco G, Murphy H, Foran H. Prevention of child mental health problems through parenting interventions in Southeastern Europe (RISE): study protocol for a multi-site randomised controlled trial. Trials 2021; 22:960. [PMID: 34961518 PMCID: PMC8710933 DOI: 10.1186/s13063-021-05817-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood adversities, such as poor parental practices, exposure to violence, and risk behaviours strongly impact children's future mental and behavioural problems. Adversities affect families living in disadvantaged environments and low- and middle-income countries (LMICs) to a greater extent than in high-income countries. Parenting programmes are an effective way to alleviate them, although their outreach and scalability is still limited in LMICs. METHODS/DESIGN A multi-site randomised controlled trial will be conducted in North Macedonia, Republic of Moldova and Romania to test the efficacy and cost-effectiveness of an optimised version of the promising Parenting for Lifelong Health Programme for Young Children (PLH-YC, 5 sessions), against a standard lecture on parenting issues (control group, 1 session). At least 864 participants who report having children between 2 and 9 years old who display elevated levels of behavioural difficulties will be randomised on a 1:1 basis to the intervention and control groups. The primary outcome will consist of parent report of child oppositional aggressive behaviour. Post-test (four months) and follow-up (12 months) assessments will provide information on short- and longer-term effects of PLH-YC compared to the parenting lecture in the control group. DISCUSSION This randomised trial will test the efficacy of PLH-YC in alleviating child behavioural problems and assess the cost-effectiveness, transportability across three different cultural contexts, and potential for scalability of the programme. TRIAL REGISTRATION ClinicalTrials.gov ., Registration number: NCT04721730 ( https://clinicaltrials.gov/ct2/show/NCT04721730 ). Registered 13.01.2021.
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Affiliation(s)
- Diana Tăut
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania.
| | - Adriana Băban
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Inga Frantz
- Department of Psychology, Clinical Psychology, and Psychotherapy, University of Bremen, Bremen, Germany
| | - Ingrid Dănilă
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Jamie M Lachman
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.,MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Nina Heinrichs
- Department of Psychology, Clinical Psychology, and Psychotherapy, University of Bremen, Bremen, Germany
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Xiangming Fang
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | | | - Marija Raleva
- Institute for Marriage, Family and Systemic Practice - ALTERNATIVA, Skopje, North Macedonia
| | - Galina Lesco
- Health for Youth Association, Chișinău, Republic of Moldova
| | - Hugh Murphy
- Institute for Psychology, University of Klagenfurt, Klagenfurt, Austria
| | - Heather Foran
- Institute for Psychology, University of Klagenfurt, Klagenfurt, Austria
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