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Fang Z, Liu X, Zhang C, Lachman JM, Qiao D. Parenting Interventions That Promote Child Protection and Development for Preschool-Age Children with Developmental Disabilities: A Global Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:2128-2142. [PMID: 37978829 DOI: 10.1177/15248380231207965] [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: 11/19/2023]
Abstract
Global guidelines emphasize the critical role of responsive caregiving in terms of reducing violence against children and promoting early childhood development. However, there is an absence of global evidence synthesis on the effects of early childhood parenting programs for children with developmental disabilities. This systematic review and meta-analysis aims to investigate the effectiveness of parenting interventions delivered for preschool-age children with developmental disabilities in reducing violence against children, altering violence-related factors, and promoting child development. We searched for randomized controlled trials with inactive control. Estimates were pooled using robust variance estimations. Meta-regressions were conducted to explore sources of heterogeneity. In all, 33 studies met the inclusion criteria. The results showed that parenting programs improved child behavior, parental mental health, parenting practices, parental self-efficacy, parent-child interaction, child language skills, and child social skills post-intervention. No studies provided data on the actual occurrence of violence against children. Effects might vary by diagnosis, delivery modality, and world region. The findings supported the delivery of parenting programs to alter factors associated with violence against children and promote child language and social skills for families of young children with developmental disabilities, especially attention deficit hyperactivity disorder, autism, intellectual disability, and language disorders. More research using rigorous methods, long-term follow-ups, and transparent reporting is needed, particularly within more low- and middle-income countries.
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Affiliation(s)
| | | | | | - Jamie M Lachman
- University of Oxford, UK
- University of Cape Town, South Africa
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2
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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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3
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Chacko A, Merrill BM, Kofler MJ, Fabiano GA. Improving the efficacy and effectiveness of evidence-based psychosocial interventions for attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. Transl Psychiatry 2024; 14:244. [PMID: 38851829 PMCID: PMC11162428 DOI: 10.1038/s41398-024-02890-3] [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: 01/16/2023] [Revised: 02/14/2024] [Accepted: 03/22/2024] [Indexed: 06/10/2024] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent, chronic, and impairing mental health disorder of childhood. Decades of empirical research has established a strong evidence-based intervention armamentarium for ADHD; however, limitations exist in regards to efficacy and effectiveness of these interventions. We provide an overview of select evidence-based interventions for children and adolescents, highlighting potential approaches to further improving the efficacy and effectiveness of these interventions. We conclude with broader recommendations for interventions, including considerations to moderators and under-explored intervention target areas as well as avenues to improve access and availability of evidence-based interventions through leveraging underutilized workforces and leveraging technology.
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Baiden P, Zheng Y, Nguyen AJ, Espinosa-Hernandez G, Magis-Weinberg L, Titzmann PF. Embracing the hidden potential: The contribution of majority world research to developmental science. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024; 34:521-525. [PMID: 38753472 DOI: 10.1111/jora.12958] [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: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 05/18/2024]
Abstract
Research on adolescence from the Majority World possesses major hidden potential in contributing to global adolescent research and developmental science more broadly. In this commentary, the authors (1) describe the background and the process through which this special issue came into fruition, (2) introduce the emic approaches to study the influences of macro-contextual variations on developmental science and provide several pertinent examples on the contributions of Majority World research, (3) elaborate on challenges and barriers that Majority World scholars often face in conducting and disseminating their research, and (4) a few actionable steps and recommendations in promoting the representation and inclusion of Majority World research into global developmental science. Only when our field fully integrates findings from all regions of the world will we be able to develop a fundamental scientific representation and understanding of what it means to be an adolescent, how adolescents develop over time, and what tasks or phenomena in adolescent development are truly universal or specific to particular groups, regions, or areas.
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Affiliation(s)
- Philip Baiden
- School of Social Work, The University of Texas at Arlington, Arlington, Texas, USA
| | - Yao Zheng
- Department of Psychology, Faculty of Arts, University of Alberta, Edmonton, Alberta, Canada
| | - Amanda J Nguyen
- Department of Human Services, School of Education and Human Development, University of Virginia, Charlottesville, Virginia, USA
| | | | | | - Peter F Titzmann
- Department of Psychology, Leibniz University Hannover, Hanover, Germany
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5
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Soneson E, Howarth E, Weir A, Jones PB, Fazel M. Empowering School Staff to Support Pupil Mental Health Through a Brief, Interactive Web-Based Training Program: Mixed Methods Study. J Med Internet Res 2024; 26:e46764. [PMID: 38652534 PMCID: PMC11077415 DOI: 10.2196/46764] [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: 02/24/2023] [Accepted: 03/01/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Schools in the United Kingdom and elsewhere are expected to protect and promote pupil mental health. However, many school staff members do not feel confident in identifying and responding to pupil mental health difficulties and report wanting additional training in this area. OBJECTIVE We aimed to explore the feasibility of Kognito's At-Risk for Elementary School Educators, a brief, interactive web-based training program that uses a simulation-based approach to improve school staff's knowledge and skills in supporting pupil mental health. METHODS We conducted a mixed methods, nonrandomized feasibility study of At-Risk for Elementary School Educators in 6 UK primary schools. Our outcomes were (1) school staff's self-efficacy and preparedness to identify and respond to pupil mental health difficulties, (2) school staff's identification of mental health difficulties and increased risk of mental health difficulties, (3) mental health support for identified pupils (including conversations about concerns, documentation of concerns, in-class and in-school support, and referral and access to specialist mental health services), and (4) the acceptability and practicality of the training. We assessed these outcomes using a series of questionnaires completed at baseline (T1), 1 week after the training (T2), and 3 months after the training (T3), as well as semistructured qualitative interviews. Following guidance for feasibility studies, we assessed quantitative outcomes across time points by comparing medians and IQRs and analyzed qualitative data using reflexive thematic analysis. RESULTS A total of 108 teachers and teaching assistants (TAs) completed T1 questionnaires, 89 (82.4%) completed T2 questionnaires, and 70 (64.8%) completed T3 questionnaires; 54 (50%) completed all 3. Eight school staff members, including teachers, TAs, mental health leads, and senior leaders, participated in the interviews. School staff reported greater confidence and preparedness in identifying and responding to mental health difficulties after completing the training. The proportion of pupils whom they identified as having mental health difficulties or increased risk declined slightly over time (medianT1=10%; medianT2=10%; medianT3=7.4%), but findings suggested a slight increase in accuracy compared with a validated screening measure (the Strengths and Difficulties Questionnaire). In-school mental health support outcomes for identified pupils improved after the training, with increases in formal documentation and communication of concerns as well as provision of in-class and in-school support. Referrals and access to external mental health services remained constant. The qualitative findings indicated that school staff perceived the training as useful, practical, and acceptable. CONCLUSIONS The findings suggest that brief, interactive web-based training programs such as At-Risk for Elementary School Educators are a feasible means to improve the identification of and response to mental health difficulties in UK primary schools. Such training may help address the high prevalence of mental health difficulties in this age group by helping facilitate access to care and support.
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Affiliation(s)
- Emma Soneson
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Emma Howarth
- School of Psychology, University of East London, London, United Kingdom
| | - Alison Weir
- Faculty of Education, University of Cambridge, Cambridge, United Kingdom
- Howard Community Academy, Anglian Learning multi-academy trust, Bury St Edmunds, United Kingdom
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Mina Fazel
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Zhang H, Wang W, Lachman JM. The efficacy of an evidence-based parenting program in preventing child maltreatment in mainland China. CHILD ABUSE & NEGLECT 2024; 147:106544. [PMID: 38006633 DOI: 10.1016/j.chiabu.2023.106544] [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: 10/26/2023] [Accepted: 11/08/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND There is limited evidence regarding the effectiveness of online parenting programs for preventing child maltreatment in low- and middle-income countries. Therefore, this study aimed to examine the effectiveness of the online Parenting for Lifelong Health for Young Children (PLH-YC) program in preventing child maltreatment among Chinese families specifically. METHODS A quasi-experiment was conducted, wherein 274 parents with children aged 2-9 years were assigned to either the online PLH-YC group (n = 135) or a waitlist control group (n = 139). Data were collected at baseline and one week after intervention. A difference-in-differences (DiD) design with propensity score weighting was used to estimate the between-group difference for child maltreatment as well as the associated risk and protective factors. RESULTS Compared to the parents in the control group, parents in the online PLH-YC intervention reported a significant reduction in the occurrence of corporal punishment (b = -1.21; 95 % CI [-2.37, -0.03]), emotional abuse (b = -3.09; 95 % CI [-5.36, -0.82]), and general maltreatment (b = -4.94; 95 % CI [-8.86, -1.02]) as well as an increased frequency of positive parenting strategies (b = 6.46; 95 % CI [2.21, 10.72]). Additionally, parents with high levels of depressive symptoms were significantly more likely to drop out of the program, and those with lower education levels engaged in fewer sessions. CONCLUSION The online PLH-YC program can benefit families with young children by reducing the incidence of child maltreatment through improved positive parenting strategies. More randomized controlled trials with long-term follow-ups are required to further verify the accuracy of the results obtained in this study.
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Affiliation(s)
- Huiping Zhang
- Center for Studies of Sociological Theory and Method, Renmin University of China, P.R. China; Department of Social Work and Social Policy, Renmin University of China, P.R. China.
| | - Weiwei Wang
- Center for Studies of Sociological Theory and Method, Renmin University of China, P.R. China; Department of Social Work and Social Policy, Renmin University of China, P.R. China
| | - Jamie M Lachman
- Department of Social Policy and Intervention, Center for Evidence Based Intervention, University of Oxford, United Kingdom
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Shenderovich Y, Piolanti A, Babii V, Calovska-Hertzog N, Evans RE, Heinrichs N, Burgund Isakov A, Lesco G, Moore G, Mueller J, Raleva M, Shimbov B, Simon J, Waller F, Wienand D, Foran HM. Family-focused intervention to promote adolescent mental health and well-being in Moldova and North Macedonia (FLOURISH): feasibility study protocol. BMJ Open 2023; 13:e080400. [PMID: 38072469 PMCID: PMC11148709 DOI: 10.1136/bmjopen-2023-080400] [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: 12/18/2023] Open
Abstract
INTRODUCTION Family-Focused Adolescent & Lifelong Health Promotion (FLOURISH) project will adapt, implement and evaluate a programme to support adolescent mental health and well-being through strategies, such as strengthening parenting practices, adolescent-caregiver relationships, adolescent and parent socioemotional skills, and social support. METHODS AND ANALYSIS The project will focus on adolescents aged 10-14 years and their caregivers in North Macedonia and Moldova. The countries were selected based on implementation readiness of two organisations and a need for accessible evidence-informed services to help mitigate health risks due to economic, social and political challenges. Parenting for Lifelong Health (PLH) for Parents and Teens is a family-based programme developed for low-resource settings. PLH has been adapted with input from advisory groups. The programme includes additional components to strengthen impacts on adolescents: adolescent mental health tools, based on UNICEF's Helping Adolescents Thrive, adolescent peer support and participation booster. This pilot is first of three study phases. The pilot will be a feasibility testing of the adapted intervention and the assessment and implementation procedures to determine further refinements. The pilot will examine if the adapted programme is acceptable for adolescents, their families and providers, explore contextual factors relevant to embedding this programme into longer-term scale-up and investigate whether the programme can be delivered with fidelity and participation; whether the participants report changes in adolescent emotional and behavioural problems, well-being and other outcomes; and whether the study tools are feasible and appropriate. Pre-post adolescent and caregiver questionnaires will provide outcome data. Process evaluation will include attendance and fidelity data, and focus groups. We will examine delivery cost and resource requirements. ETHICS AND DISSEMINATION The study was approved at the University of Klagenfurt (Austria), Medical Faculty at St. Cyril and Methodius University (North Macedonia) and National Committee of Ethical Expertise for Clinical Trials (Moldova). Through stakeholder engagement and dissemination, FLOURISH will advance scale-up of open-source family interventions. TRIAL REGISTRATION NUMBER Trial registration: ID101095528; project page: https://www.flourish-study.org/about.html; https://www.linkedin.com/company/flourish-study/.
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Affiliation(s)
- Yulia Shenderovich
- Centre for the Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Antonio Piolanti
- Institute of Psychology, University of Klagenfurt, Klagenfurt, Austria
| | - Viorel Babii
- Asociatia Obsteasca Sanatate Pentru Tineri (Health for Youth Association), Chisinau, Moldova
| | - Nevena Calovska-Hertzog
- Department for Psychology, Faculty for Media and Communication, Singidunum University, Belgrade, Serbia
- AST Centre for Education, Belgrade, Serbia
| | - Rhiannon E Evans
- Centre for the Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Nina Heinrichs
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Anita Burgund Isakov
- Faculty of Political Sciences, Department of Social Policy and Social Work, University of Belgrade, Belgrade, Serbia
| | - Galina Lesco
- Asociatia Obsteasca Sanatate Pentru Tineri (Health for Youth Association), Chisinau, Moldova
| | - Graham Moore
- Centre for the Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Janina Mueller
- Institute of Psychology, University of Klagenfurt, Klagenfurt, Austria
| | - Marija Raleva
- Institute for Marriage, Family and Systemic Practice-ALTERNATIVA, Skopje, North Macedonia
- Department of Child and Adolescent Psychiatry, Ss Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | - Bojan Shimbov
- Instituto de Economía Internacional, Department of Economics, University Jaume I Castellon, Castellón de la Plana, Spain
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford University, Oxford, Oxfordshire, UK
| | - Franziska Waller
- Institute of Psychology, University of Klagenfurt, Klagenfurt, Austria
| | - Dennis Wienand
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Heather M Foran
- Institute of Psychology, University of Klagenfurt, Klagenfurt, Austria
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Engelbrektsson J, Salomonsson S, Högström J, Sorjonen K, Sundell K, Forster M. Parent Training via Internet or in Group for Disruptive Behaviors: A Randomized Clinical Noninferiority Trial. J Am Acad Child Adolesc Psychiatry 2023; 62:987-997. [PMID: 36863414 DOI: 10.1016/j.jaac.2023.01.019] [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: 06/15/2022] [Revised: 01/01/2023] [Accepted: 02/21/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVE To evaluate if an internet-delivered parent training program is noninferior to its group-delivered counterpart in reducing child disruptive behavior problems (DBP). METHOD This noninferiority randomized clinical trial enrolled families seeking treatment in primary care in Stockholm, Sweden, for DBP in a child 3-11 years of age. Participants were randomized to internet-delivered (iComet) or group-delivered (gComet) parent training. The primary outcome was parent-rated DBP. Assessments were made at baseline and 3, 6, and 12 months. Secondary outcomes included child and parent behaviors and well-being and treatment satisfaction. The noninferiority analysis was determined by a one-sided 95% CI of the mean difference between gComet and iComet using multilevel modeling. RESULTS This trial included 161 children (mean age 8.0); 102 (63%) were boys. In both intention-to-treat and per-protocol analyses, iComet was noninferior to gComet. There were small differences in between-group effect sizes (d = -0.02 to 0.13) on the primary outcome with the upper limit of the one-sided 95% CI below the noninferiority margin at 3-, 6-, and 12-month follow-up. Parents were more satisfied with gComet (d = 0.49, 95% CI [0.26, 0.71]). At 3-month follow-up, there were also significant differences in treatment effect on attention-deficit/hyperactivity disorder symptoms (d = 0.34, 95% CI [0.07, 0.61]) and parenting behavior (d = 0.41, 95% CI [0.17, 0.65]) favoring gComet. At 12-month follow-up, there were no differences in any outcomes. CONCLUSION Internet-delivered parent training was noninferior to group-delivered parent training in reducing child DBP. The results were maintained at 12-month follow-up. This study supports internet-delivered parent training being used as an alternative to group-delivered parent training in clinical settings. CLINICAL TRIAL REGISTRATION INFORMATION Randomized Controlled Trial of Comet via the Internet or in Group Format; https://www. CLINICALTRIALS gov/; NCT03465384.
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Affiliation(s)
| | - Sigrid Salomonsson
- Centre for Psychiatry Research, Karolinska Institutet and Region Stockholm, Sweden
| | - Jens Högström
- Centre for Psychiatry Research, Karolinska Institutet and Region Stockholm, Sweden
| | | | - Knut Sundell
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
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Hudson JL, Minihan S, Chen W, Carl T, Fu M, Tully L, Kangas M, Rosewell L, McDermott EA, Wang Y, Stubbs T, Martiniuk A. Interventions for Young Children's Mental Health: A Review of Reviews. Clin Child Fam Psychol Rev 2023; 26:593-641. [PMID: 37488453 PMCID: PMC10465658 DOI: 10.1007/s10567-023-00443-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2023] [Indexed: 07/26/2023]
Abstract
To determine the efficacy of intervention programs for young children (4-9 years) with emerging mental health needs, we conducted a review of meta-analytic and systematic reviews of the intervention literature. Of 41,061 abstracts identified and 15,076 screened, 152 review articles met the inclusion criteria. We reviewed interventions across multiple disciplines targeting: (1) general mental health concerns; (2) internalizing symptoms; (3) externalizing symptoms; (4) anxiety; (5) depression; (6) trauma; (7) symptoms of attention-deficit/hyperactivity disorder; and (8) mental health concerns associated with autism spectrum disorder. Substantial evidence was found for the efficacy of behavioral and cognitive behavioral interventions for general mental health concerns, externalizing symptoms (generally, as well as ADHD, conduct, and other behavioral symptoms) and internalizing symptoms (generally, as well as anxiety) aged 4-9 years. Emerging evidence was identified for interventions targeting trauma symptoms, depression symptoms, and social, emotional and behavioral symptoms in autism spectrum disorder in children aged 4-9 years. Currently there is only limited emerging evidence regarding non-behavioral or non-cognitive behavioral interventions for programs targeting children ages 4-9 years where the aim is to deliver an evidence-based program to improve child social, emotional and/or behavioral functioning. Given the recent rises in mental health needs reported in children, targeted behavioral-and/or cognitive behavior therapy-based interventions should be made widely available to children (and their families) who experience elevated symptoms.
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Affiliation(s)
- Jennifer L Hudson
- Black Dog Institute, University of New South Wales, Sydney, Australia.
| | - Savannah Minihan
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Wenting Chen
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Talia Carl
- Black Dog Institute, University of New South Wales, Sydney, Australia
- School of Psychology, University of Sydney, Sydney, Australia
| | - Michele Fu
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Lucy Tully
- School of Psychology, University of Sydney, Sydney, Australia
| | - Maria Kangas
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Linda Rosewell
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Emma A McDermott
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Yiwen Wang
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Thomas Stubbs
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Yam-Ubon U, Thongseiratch T. Using a Design Thinking Approach to Develop a Social Media-Based Parenting Program for Parents of Children With Attention-Deficit/Hyperactivity Disorder: Mixed Methods Study. JMIR Pediatr Parent 2023; 6:e48201. [PMID: 37534490 PMCID: PMC10461405 DOI: 10.2196/48201] [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] [Received: 04/15/2023] [Revised: 06/06/2023] [Accepted: 06/13/2023] [Indexed: 08/04/2023] Open
Abstract
Background: Parenting programs have proven effective in improving the behavior of children with attention-deficit/hyperactivity disorder (ADHD). However, barriers such as job and transportation constraints hinder parents from attending face-to-face therapy appointments. The COVID-19 pandemic has further exacerbated these challenges. Objective: This study aimed to develop and test the feasibility of a social media-based parenting program for parents of children with ADHD, considering both the pre-existing challenges faced by parents and the additional barriers imposed by the COVID-19 pandemic. Methods: This study used a 5-stage design thinking process, encompassing empathizing with parents, defining their needs, ideating innovative solutions, prototyping the program, and testing the program with parents. Qualitative interviews were conducted with 18 parents of children with ADHD to understand their unique needs and values. Brainstorming techniques were used to generate creative ideas, leading to the creation of a prototype that was tested with 32 parents. Participants' engagement with the program was measured, and posttraining feedback was collected to assess the program's effectiveness. Results: Parents of children with ADHD encounter specific challenges, including managing impulsive behavior and difficulties in emotion regulation. The social media-based parenting program was delivered through the LINE app (Line Corporation) and consisted of 7 modules addressing topics related to ADHD management and effective parenting strategies. The program exhibited a high completion rate, with 84% (27/32) of participants successfully finishing it. Program provider-participant interaction peaked during the first week and gradually decreased over time. Qualitative feedback indicated that the program was feasible, accessible, and well received by participants. The LINE app was found to be convenient and helpful, and participants preferred content delivery once or twice per week, expressing acceptance for various content formats. Conclusions: This study emphasizes the significance of adopting a human-centered design thinking approach to develop parenting programs that cater to the unique needs and values of parents. By leveraging social media platforms, such as LINE, a parenting program can overcome the challenges posed by the COVID-19 pandemic and other constraints faced by parents. LINE offers a viable and feasible option for supporting parents of children with ADHD, with the potential for customization and widespread dissemination beyond the pandemic context.
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Affiliation(s)
- Umaporn Yam-Ubon
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. https://orcid.org/0009-0000-4753-1122
| | - Therdpong Thongseiratch
- Songklanagarind ADHD Multidisciplinary Assessment and Care Team for Quality Improvement, Child Development Unit, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. https://orcid.org/0000-0002-9907-6106
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11
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Backhaus S, Leijten P, Jochim J, Melendez-Torres G, Gardner F. Effects over time of parenting interventions to reduce physical and emotional violence against children: a systematic review and meta-analysis. EClinicalMedicine 2023; 60:102003. [PMID: 37251634 PMCID: PMC10209692 DOI: 10.1016/j.eclinm.2023.102003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/19/2023] [Accepted: 04/25/2023] [Indexed: 05/31/2023] Open
Abstract
Background Violence against children affects over one billion children globally. International organisations promote parenting interventions as a main strategy to reduce violence against children. Parenting interventions have therefore been implemented rapidly across the globe. Yet, evidence for their longer-term effects remains unclear. We integrated global evidence to estimate effects over time of parenting interventions to reduce physical and emotional violence against children. Methods In this systematic review and meta-analysis, we searched 26 databases and trial registries (14 non-English: Spanish, Chinese, Farsi, Russian, Thai) and conducted an extensive grey literature search up to August 01, 2022. We included randomised controlled trials (RCTs) of parenting interventions based on social learning theory for parents of children aged 2-10 years, without time or context restrictions. We critically appraised studies using Cochrane's Risk of Bias Tool. Data were synthesised using robust variance estimation meta-analyses. This study is registered with PROSPERO, CRD42019141844. Findings We screened 44,411 records and included 346 RCTs. Sixty RCTs reported outcomes on physical or emotional violence. Trials were distributed across 22 countries (22% LMICs). Risk of bias was high for various domains. Outcome data ranged from 0 weeks to 2 years after the intervention, and was largely based on parent self-report. Parenting interventions reduced physical and emotional violent parenting behaviours immediately after the intervention (n = 42, k = 59; d = -0.46; 95% CI: -0.59, -0.33), at 1-6 months follow-up (n = 18, k = 31; d = -0.24; 95% CI: -0.37, -0.11) and at 7-24 months follow-up (n = 12, k = 19; d = -0.18; 95% CI: -0.34, -0.02), but effects were smaller over time. Interpretation Our findings suggest that parenting interventions can reduce physical and emotional violence against children. Effects are maintained up to 24 months follow-up, but with diminished effect sizes. With global policy interest and imminent importance, research beyond 2 years and how effects can be better sustained over time is urgently needed. Funding Student scholarship from the Economic Social Research Council, Clarendon, and Wolfson Isaiah Berlin Fund.
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Affiliation(s)
- Sophia Backhaus
- Centre for Evidence-based Intervention, Department of Social Policy and Intervention, University of Oxford, 32 Wellington Square, OX1 2ER, Oxford, UK
| | - Patty Leijten
- Research Institute Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, Postbus 15776, 1001 NG, Amsterdam, the Netherlands
| | - Janina Jochim
- Centre for Evidence-based Intervention, Department of Social Policy and Intervention, University of Oxford, 32 Wellington Square, OX1 2ER, Oxford, UK
| | | | - Frances Gardner
- Centre for Evidence-based Intervention, Department of Social Policy and Intervention, University of Oxford, 32 Wellington Square, OX1 2ER, Oxford, UK
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12
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Maciel L, Gomis-Pomares A, Day C, Basto-Pereira M. Cross-cultural adaptability of parenting interventions designed for childhood behavior problems: A meta-analysis. Clin Psychol Rev 2023; 102:102274. [PMID: 37018934 DOI: 10.1016/j.cpr.2023.102274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/27/2023] [Accepted: 03/24/2023] [Indexed: 03/28/2023]
Abstract
The dissemination of parenting interventions is one of the advised approaches to globally counteract childhood behavior problems, delinquency, and future criminal careers. Many of these interventions are developed in Anglosphere countries and transported to other contexts with distinct cultural backgrounds. However, there are no meta-analyses evaluating the overall effectiveness of these Anglosphere parenting programs in non-Anglosphere settings. This meta-analysis aimed to examine the effectiveness of parenting interventions developed in Anglosphere countries when transported to non-Anglosphere countries, as well as compare effectiveness levels between Anglosphere and non-Anglosphere trials; and analyze the impact of research and contextual factors in the dissemination of these interventions. Parenting interventions were included if they were: created in an Anglosphere setting; tested in non-Anglosphere countries; focused on reducing childhood behavioral problems; designed for children ranging from two to 12 years old; and tested in an experimental randomized trial. A random-effects model was selected for our meta-analysis. Standardized mean differences, confidence intervals and prediction intervals were also computed. Twenty studies were included, and results suggest that parenting interventions designed for childhood behavior problems can be transported to non-Anglosphere countries and potentially maintain effectiveness. This study is a relevant contribution to the evidence of cross-cultural transportability of parenting interventions.
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Affiliation(s)
- Laura Maciel
- William James Center for Research, Ispa-Instituto Universitário, Rua Jardim do Tabaco 34, 1149-041 Lisbon, Portugal.
| | - Aitana Gomis-Pomares
- Developmental Psychology Department, Universitat Jaume I, Avinguda de Vicent Sos Baynat, s/n, 12006 Castelló de la Plana, Castelló, Spain.
| | - Crispin Day
- Department of Psychology, Child & Adolescent Mental Health Service Research Unit, King's College London, Institute of Psychiatry, Psychology and Neuroscience, and Centre for Parent and Child Support, South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, 16 De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Miguel Basto-Pereira
- William James Center for Research, Ispa-Instituto Universitário, Rua Jardim do Tabaco 34, 1149-041 Lisbon, Portugal.
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13
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Sun J, Liu M, Li X, Zhou Y, Li Y. Effectiveness of Group Parent-Child Interaction Therapy on Problem Behaviors in Chinese Kindergartners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3446. [PMID: 36834140 PMCID: PMC9964906 DOI: 10.3390/ijerph20043446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/18/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Problem behaviors in early childhood may put young children at risk for negative behavioral and psychosocial problems. This study examined the effectiveness of group PCIT on Chinese young children's externalizing and internalizing problems. The participants were 58 mothers with their children aged 2-3 years (M = 2.95 years, SD = 0.22), assigned to an immediate treatment (n = 26) group or to a waitlist (n = 32) control group. The program involved comprehensive group intervention and featured weekly 60-90-min sessions, totaling ten sessions over three months. Results indicate that group PCIT not only significantly improved teacher-reported problem behaviors in children, but also improved observed maternal parenting behavior. These findings support the use of group PCIT in Chinese children and provide mothers with an evidence-based tool to address problem behaviors in a non-clinical population.
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Affiliation(s)
- Juanjuan Sun
- Shanghai Early Childhood Education College, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai 200234, China
| | - Mowei Liu
- Department of Psychology, Trent University, Peterborough, ON K9J 7B8, Canada
| | - Xiaoyun Li
- Shanghai Early Childhood Education College, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai 200234, China
| | - Yuena Zhou
- Shanghai Early Childhood Education College, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai 200234, China
| | - Yan Li
- Shanghai Early Childhood Education College, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai 200234, China
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14
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Copeland L, Littlecott HJ, Couturiaux D, Hoddinott P, Segrott J, Murphy S, Moore G, Evans RE. Adapting population health interventions for new contexts: qualitative interviews understanding the experiences, practices and challenges of researchers, funders and journal editors. BMJ Open 2022; 12:e066451. [PMID: 36288840 PMCID: PMC9615984 DOI: 10.1136/bmjopen-2022-066451] [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] [Received: 07/07/2022] [Accepted: 09/26/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Research on the adaptation of population health interventions for implementation in new contexts is rapidly expanding. This has been accompanied by a recent increase in the number of frameworks and guidance to support adaptation processes. Nevertheless, there remains limited exploration of the real-world experiences of undertaking intervention adaptation, notably the challenges encountered by different groups of stakeholders, and how these are managed. Understanding experiences is imperative in ensuring that guidance to support adaptation has practical utility. This qualitative study examines researcher and stakeholder experiences of funding, conducting and reporting adaptation research. SETTING Adaptation studies. PARTICIPANTS Participants/cases were purposefully sampled to represent a range of adapted interventions, types of evaluations, expertise and countries. Semistructured interviews were conducted with a sample of researchers (n=23), representatives from research funding panels (n=6), journal editors (n=5) and practitioners (n=3). MEASURES A case study research design was used. Data were analysed using the framework approach. Overarching themes were discussed within the study team, with further iterative refinement of subthemes. RESULTS The results generated four central themes. The first three relate to the experience of intervention adaptation (1) involving stakeholders throughout the adaptation process and how to integrate the evidence base with experience; (2) selecting the intervention and negotiating the mismatch between the original and the new context; and (3) the complexity and uncertainty when deciding the re-evaluation process. The final theme (4) reflects on participants' experiences of using adaptation frameworks in practice, considering recommendations for future guidance development and refinement. CONCLUSION This study highlights the range of complexities and challenges experienced in funding, conducting and reporting research on intervention adaptation. Moving forward, guidance can be helpful in systematising processes, provided that it remains responsive to local contexts and encourage innovative practice.
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Affiliation(s)
- Lauren Copeland
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Hannah J Littlecott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
- Pettenkofer School of Public Health (PSPH), Institute for Medical Information Processing, Biometry and Epidemiology, LMU, Munchen, Bayern, Germany
| | - Danielle Couturiaux
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UK
| | - Jeremy Segrott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Simon Murphy
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Graham Moore
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Rhiannon E Evans
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
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15
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Jansen E, Frantz I, Hutchings J, Lachman J, Williams M, Taut D, Baban A, Raleva M, Lesco G, Ward C, Gardner F, Fang X, Heinrichs N, Foran HM. Preventing child mental health problems in southeastern Europe: Feasibility study (phase 1 of MOST framework). FAMILY PROCESS 2022; 61:1162-1179. [PMID: 34494263 DOI: 10.1111/famp.12720] [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] [Received: 08/01/2020] [Revised: 07/14/2021] [Accepted: 07/27/2021] [Indexed: 06/13/2023]
Abstract
The prevalence of child emotional and behavioral problems is an international problem but is higher in low- and middle-income countries (LMIC) where there are often less mental health supports for families. Parenting programs can be an effective means of prevention, but must be low-cost, scalable, and suitable for the local context. The RISE project aims to systematically adapt, implement, and evaluate a low-cost parenting program for preventing/reducing child mental health problems in three middle-income countries in Southeastern Europe. This small pre-post pilot study is informed by the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework and tested the feasibility of the intervention, the implementation, and evaluation procedures: Phase 1 of the three-phase Multiphase Optimization Strategy (MOST) for program adaptation. Local facilitators delivered the Parenting for Lifelong Health (PLH) for Young Children program to parents of children aged 2-9 in North Macedonia, the Republic of Moldova and Romania in 2018. Parents completed assessments pre- and post-program. Results demonstrated positive pre-post change for participating families (N = 140) on various outcomes including child externalizing and internalizing symptoms and parenting behavior, in all three countries, all in the expected direction. Program participation was associated with positive outcomes in participating families. Based on the experiences of this pilot study, we outline the practical implications for the successful implementation of parenting programs in the three countries that will inform our next study phases, factorial experiment, and RCT.
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Affiliation(s)
- Elena Jansen
- Institute of Psychology, University of Klagenfurt, Klagenfurt, Austria
| | - Inga Frantz
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Bremen, Bremen, Germany
| | - Judy Hutchings
- Centre for Evidence Based Early Intervention, School of Psychology, Bangor University, Bangor, UK
| | - Jamie Lachman
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Margiad Williams
- Centre for Evidence Based Early Intervention, School of Psychology, Bangor University, Bangor, UK
| | - Diana Taut
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Adriana Baban
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Marija Raleva
- Institute for Marriage, Family and Systemic Practice-ALTERNATIVA, Skopje, Macedonia
| | - Galina Lesco
- Health for Youth Association, Chișinău, Republic of Moldova
| | - Cathy Ward
- Department of Psychology, University of Cape Town, Rondebosch, South Africa
| | - Frances Gardner
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Xiangming Fang
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Nina Heinrichs
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Bremen, Bremen, Germany
| | - Heather M Foran
- Institute of Psychology, University of Klagenfurt, Klagenfurt, Austria
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16
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Cuartas J, Baker-Henningham H, Cepeda A, Rey-Guerra C. The Apapacho Violence Prevention Parenting Program: Conceptual Foundations and Pathways to Scale. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148582. [PMID: 35886432 PMCID: PMC9325014 DOI: 10.3390/ijerph19148582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/04/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022]
Abstract
Violence against children (VAC) is a major global issue with long-lasting negative consequences on individuals and societies. The present study presents a review of the literature on drivers of VAC and the core components of evidence-based violence prevention programs. Moreover, it analyzes the existing services and social infrastructure in Colombia to rigorously inform the design of the Apapacho violence prevention parenting program for families with children younger than five targeted toward Colombia. Findings indicate that (1) VAC in Colombia is a multidimensional issue with roots at the individual, family, community, and society levels, (2) evidence-based violence prevention programs share a common set of content and delivery strategies that could inform the components of the Apapacho program, and (3) there is an urgent need for scalable and flexible violence prevention programs for families with young children in Colombia. Considering existing evidence, the Apapacho violence prevention parenting program will be designed using ecological, developmental, and neuroscience-informed perspectives. This article concludes by presenting the initial components of the theory of change and discussing future directions for the design of the Apapacho program and other violence prevention interventions in LMICs.
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Affiliation(s)
- Jorge Cuartas
- Harvard Graduate School of Education, Harvard University, Cambridge, MA 02138, USA
- Department of Psychology, Universidad de los Andes, Bogotá 111711, Colombia
- Correspondence:
| | - Helen Baker-Henningham
- School of Psychology, Bangor University, Bangor LL57 2DG, UK;
- Caribbean Institute for Health Research, University of the West Indies, Kingston BB11000, Jamaica
| | - Andrés Cepeda
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Catalina Rey-Guerra
- Lynch School of Education and Human Development, Boston College, Chesnut Hill, MA 02467, USA;
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17
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Hafting M, Puthy P, Aadland G, Fjermestad K, Jegannathan B. Competence building in child mental health -A Norway-Cambodia transcultural experience. NORDIC PSYCHOLOGY 2022. [DOI: 10.1080/19012276.2022.2066561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Marit Hafting
- Regional Centre for Child and Youth Mental Health, Norwegian Research Centre AS, NORCE, PO Box 7810, N-5020 Bergen, Norway
- Member of Global Mental Health Research Group, Centre for International Health, University of Bergen, PO Box 7804, N-5009 Bergen, Norway
- Haukeland University Hospital, Department of Psychiatry, Bergen, Norway
| | - Pat Puthy
- Centre for Child and Adolescent Mental Health (Caritas-CCAMH), Takhmau, Cambodia
| | - Gunn Aadland
- University Hospital of Stavanger, Gerd Ragna Bloch Thorsensgate 8, N-4019 Stavanger, Norway
| | - Krister Fjermestad
- Department of Psychology, University of Oslo, PO Box 1094, Oslo N-0317, Norway
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18
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Harrison L, Sharma N, Irfan O, Zaman M, Vaivada T, Bhutta ZA. Mental Health and Positive Development Prevention Interventions: Overview of Systematic Reviews. Pediatrics 2022; 149:186940. [PMID: 35503329 DOI: 10.1542/peds.2021-053852g] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
CONTEXT Previous reviews of mental health interventions have focused on adolescents (10-19 years), with a paucity of comprehensive evidence syntheses on preventive interventions for school-aged children (5-10 years). OBJECTIVE To summarize and synthesize the available evidence from systematic reviews of mental health and positive development interventions for children aged 5-14.9 years in both high-income (HIC) and low- and middle-income countries (LMIC), with a focus on preventive and promotive strategies. DATA SOURCES This overview includes all relevant reviews from OVID Medline, The Cochrane Library, and Campbell Systematic Reviews through December 2020. STUDY SELECTION We included systematic reviews that synthesized empirical studies using experimental or quasi-experimental designs to evaluate the effectiveness of interventions in children aged 5-14.9 years. DATA EXTRACTION Data extraction and quality assessment were completed independently and in duplicate by two review authors. The AMSTAR2 tool was used to assess methodological quality. RESULTS We included 162 reviews. The greatest evidence was found in support of school-based universal and anti-bullying interventions in predominantly HIC. Moderate evidence was found for the use of substance abuse prevention, and early learning and positive development interventions in mixed settings. In LMIC-only contexts, the most promising evidence was found for positive youth development programs. LIMITATIONS The review was primarily limited by paucity of high-quality research due to methodological issues and high heterogeneity. CONCLUSIONS This overview of reviews highlights the need for further research to consolidate findings and understand the specific criteria involved in creating positive mental health and development outcomes from the various interventions considered.
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Affiliation(s)
- Leila Harrison
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Naeha Sharma
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Omar Irfan
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Michele Zaman
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Tyler Vaivada
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Center of Excellence in Women and Child Health, Institute for Global Health & Development, Aga Khan University Hospital, Karachi, Pakistan
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19
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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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20
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Lansford JE. Annual Research Review: Cross-cultural similarities and differences in parenting. J Child Psychol Psychiatry 2022; 63:466-479. [PMID: 34763373 PMCID: PMC8940605 DOI: 10.1111/jcpp.13539] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 01/03/2023]
Abstract
This article reviews contemporary research on cross-cultural similarities and differences in parenting. The article begins by providing a definition of culture and how both parenting and culture can change over historical time. The article then presents some classic theoretical frameworks for understanding culture and parenting before considering why parenting may be similar across cultures and why parenting may be different across cultures. The article next turns to a review of cross-cultural similarities and differences in several aspects of parenting, including physical caregiving, cognitive stimulation, warmth and acceptance, control and monitoring, and discipline. Cultural normativeness and beliefs on the legitimacy of parental authority are then considered as potential moderators that contribute to cross-cultural similarities and differences in relations between parenting and child outcomes. The article then considers implications for parenting interventions and laws and policies related to parenting. Finally, the article suggests directions for future research.
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Affiliation(s)
- Jennifer E. Lansford
- Duke University, Center for Child and Family Policy, Box 90545, Durham, NC 27708, USA
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21
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Lord C, Charman T, Havdahl A, Carbone P, Anagnostou E, Boyd B, Carr T, de Vries PJ, Dissanayake C, Divan G, Freitag CM, Gotelli MM, Kasari C, Knapp M, Mundy P, Plank A, Scahill L, Servili C, Shattuck P, Simonoff E, Singer AT, Slonims V, Wang PP, Ysrraelit MC, Jellett R, Pickles A, Cusack J, Howlin P, Szatmari P, Holbrook A, Toolan C, McCauley JB. The Lancet Commission on the future of care and clinical research in autism. Lancet 2022; 399:271-334. [PMID: 34883054 DOI: 10.1016/s0140-6736(21)01541-5] [Citation(s) in RCA: 258] [Impact Index Per Article: 129.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/13/2022]
Affiliation(s)
| | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Paul Carbone
- Department of Pediatrics at University of Utah, Salt Lake City, UT, USA
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | | | - Themba Carr
- Rady Children's Hospital San Diego, Encinitas, CA, USA
| | - Petrus J de Vries
- Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | | | | | | | | | | | - Peter Mundy
- University of California, Davis, Davis, CA, USA
| | | | | | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | | | - Emily Simonoff
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Vicky Slonims
- Evelina Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Paul P Wang
- Simons Foundation Autism Research Initiative, Simons Foundation, New York, NY, USA; Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | | | - Rachel Jellett
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Patricia Howlin
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peter Szatmari
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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22
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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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Mamauag BL, Alampay LP, Lachman JM, Madrid BJ, Hutchings J, Ward CL, Gardner F. A South-to-South Cultural Adaptation of an Evidence-Based Parenting Program for Families in the Philippines. FAMILY PROCESS 2021; 60:1202-1216. [PMID: 33410184 PMCID: PMC9189706 DOI: 10.1111/famp.12625] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Rates of child maltreatment are higher in low- and middle-income countries due to risk factors such as social inequities, economic adversity, and sociocultural norms. Given the evidence showing the effectiveness of parenting interventions to prevent child maltreatment, this study embarked on a cultural adaptation of an evidence-based parenting program with the eventual goal of integrating it within a nationwide conditional cash transfer program for low-income Filipino parents with children aged 2-6 years. We document the systematic adaptation of the Parenting for Lifelong Health for Young Children program that was developed and tested in South Africa, for low-resource Filipino families using the heuristic framework for the cultural adaptation of interventions. We underscore the merits of conducting a multistage top-down and bottom-up process that uses a participatory approach among cultural insiders and outsiders to develop a parenting intervention that reflects the contextual realities and cultural values of end users. The adapted program, Masayang Pamilya Para sa Batang Pilipino, is the product of a delicate and deliberate effort to balance Filipino childrearing goals and values with the scientific evidence on components of parenting interventions known to promote positive parenting and prevent child maltreatment.
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Affiliation(s)
- Bernice Landoy Mamauag
- Department of PsychologyAteneo de Manila UniversityQuezon CityPhilippines
- Division of Social SciencesCollege of Arts and SciencesUniversity of the Philippines VisayasMiagaoIloiloPhilippines
| | - Liane Peña Alampay
- Department of PsychologyAteneo de Manila UniversityQuezon CityPhilippines
| | - Jamie M. Lachman
- Centre for Evidence‐Based Intervention, Department of Social Policy and InterventionUniversity of OxfordOxfordUK
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Bernadette J. Madrid
- Child Protection Unit, Philippine General HospitalUniversity of the Philippines ManilaManilaPhilippines
| | - Judy Hutchings
- School of Psychology, College of Health and Behavioural Sciences, Centre for Evidence Based Early InterventionBangor UniversityGwyneddWalesUK
| | - Catherine L. Ward
- Department of PsychologyUniversity of Cape TownRondeboschSouth Africa
| | - Frances Gardner
- Centre for Evidence‐Based Intervention, Department of Social Policy and InterventionUniversity of OxfordOxfordUK
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Moore G, Campbell M, Copeland L, Craig P, Movsisyan A, Hoddinott P, Littlecott H, O'Cathain A, Pfadenhauer L, Rehfuess E, Segrott J, Hawe P, Kee F, Couturiaux D, Hallingberg B, Evans R. Adapting interventions to new contexts-the ADAPT guidance. BMJ 2021; 374:n1679. [PMID: 34344699 PMCID: PMC8329746 DOI: 10.1136/bmj.n1679] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Graham Moore
- Centre for Development, Evaluation, Complexity and Implementation in Public Health improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Mhairi Campbell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Lauren Copeland
- Centre for Development, Evaluation, Complexity and Implementation in Public Health improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Ani Movsisyan
- Pettenkofer School of Public Health, Munich, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Hannah Littlecott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Alicia O'Cathain
- School for Health and Related Research, University of Sheffield, Sheffield, UK
| | - Lisa Pfadenhauer
- Pettenkofer School of Public Health, Munich, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany
| | - Eva Rehfuess
- Pettenkofer School of Public Health, Munich, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany
| | - Jeremy Segrott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health improvement (DECIPHer), Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Penelope Hawe
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
| | - Frank Kee
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - Danielle Couturiaux
- Centre for Development, Evaluation, Complexity and Implementation in Public Health improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Britt Hallingberg
- Centre for Development, Evaluation, Complexity and Implementation in Public Health improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Rhiannon Evans
- Centre for Development, Evaluation, Complexity and Implementation in Public Health improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
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Murphy K, Embleton L, Lachman JM, Owino E, Kirwa S, Makori D, Braitstein P. "From Analog to Digital": The Feasibility, Acceptability, and Preliminary Outcomes of a Positive Parenting Program for Street-Connected Mothers in Kenya. CHILDREN AND YOUTH SERVICES REVIEW 2021; 127:106077. [PMID: 34421160 PMCID: PMC8372834 DOI: 10.1016/j.childyouth.2021.106077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Children of street-connected women in Kenya are at risk of child maltreatment. There have been increasing calls for positive parenting programs for parents experiencing homelessness, however never has one been implemented with this population. We therefore adapted the evidence-based Parenting for Lifelong Health for Young Children program using participatory methods, and piloted the adapted program with street-connected mothers in Kenya. OBJECTIVES To (a) determine if the adapted program was feasible and acceptable with street-connected mothers, and (b) assess indicative effects on child maltreatment, positive parenting, and parental stress. PARTICIPANTS AND SETTING Two groups of 15 mothers (ages 19+, and 20- ) participated between June-July 2018 in Eldoret, Kenya. Participants were eligible if they (a) were the mother of at least one child and (b) self-identified as street-connected. METHODS Feasibility was measured via enrollment, attendance, drop-out rates, and engagement in take-away activities. Focus groups explored program acceptability and program outcomes. Self-report surveys assessed pre-post changes in child maltreatment, parental stress, parental sense of inefficacy, and positive parenting practices. RESULTS 70% of participants attended ≥3/4 of sessions, 10% dropped out, and >50% of take-away activities were completed. Participants reported high acceptability and requested its continuation for themselves and other parents. There was an increase in supporting good behaviour (t(21)=8.15, p < .000) and setting limits (t(18) = 10.03, p < .000); a reduction in physical abuse (t(23) = -2.15, p = .042) and parental stress (t(22) = -7.08, p < .000); results for parental inefficacy were not statistically significant (t(22) = 0.15, p = .882). CONCLUSIONS The adapted program is feasible and acceptable to street-connected mothers, and may reduce child maltreatment and parental stress, and increase positive parenting. Further research should test program effectiveness.
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Affiliation(s)
- Kathleen Murphy
- Dalhousie University, Halifax, Canada, 6420 Coburg Rd., Halifax, Nova Scotia, B3H 4R2, Canada
| | - Lonnie Embleton
- University of Toronto, Dalla Lana School of Public Health, Toronto, Canada, 155 College St, Toronto, Ontario, M5T 3M7, Canada
| | - Jamie M. Lachman
- Department of Social Policy and Intervention, University of Oxford, UK; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK, 32 Wellington Square, Oxford, United Kingdom, OX1 2ER
| | - Eucabeth Owino
- Beruham, Eldoret, Kenya, P.O. Box 3950 Eldoret, 30100 Kenya
| | - Sheila Kirwa
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya, P.O. Box 4606, Eldoret, Kenya, 30100
| | - Dominic Makori
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya, P.O. Box 4606, Eldoret, Kenya, 30100
| | - Paula Braitstein
- University of Toronto, Dalla Lana School of Public Health, Division of Epidemiology, Toronto, Canada, Moi University, College of Health Sciences, School of Public Health, Department of Epidemiology and Medical Statistics, Eldoret, Kenya, 155 College Street, Toronto, ON Canada M5T 3M7
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Copeland L, Littlecott H, Couturiaux D, Hoddinott P, Segrott J, Murphy S, Moore G, Evans R. The what, why and when of adapting interventions for new contexts: A qualitative study of researchers, funders, journal editors and practitioners' understandings. PLoS One 2021; 16:e0254020. [PMID: 34242280 PMCID: PMC8270163 DOI: 10.1371/journal.pone.0254020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/17/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The adaptation of interventions for new contexts is a rapidly developing research area. To date there is no consensus-based guidance to support decision-making and recommend adaptation processes. The ADAPT study is developing such guidance. This aim of the qualitative component of the study was to explore stakeholders' understandings of adaptation, as to date there has limited consideration of how different concepts and meanings shape decision-making and practice. METHODS A case study research design was used. Participants/cases were purposefully sampled based on study outcome, study design, expertise, context and country. Semi-structured interviews were conducted with a sample of researchers (n = 23); representatives from research funding panels (n = 6); journal editors (n = 5) and practitioners (n = 3). Data were analysed using the Framework approach. Overarching themes were discussed with the ADAPT study team, with further iterative refinement of subthemes. RESULTS The results generated four central themes. Four themes related to stakeholders' understanding: 1) definitions of adaptation and related concepts; 2) rationales for undertaking adaptation; 3) the appropriate timing for adaptation; and 4) ensuring fidelity when implementing adapted interventions. CONCLUSION The findings highlight the lack of clarity around key concepts and uncertainty about central decision-making processes, notably why interventions should be adapted, when and to what extent. This has informed the ADAPT study's guidance, shaping the scope and nature of recommendations to be included and surfacing key uncertainties that require future consideration.
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Affiliation(s)
- Lauren Copeland
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Hannah Littlecott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Danielle Couturiaux
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Pat Hoddinott
- Primary Care, Stirling University, Stirling, Scotland, United Kingdom
| | - Jeremy Segrott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Centre for Trials Research, Cardiff University, Cardiff, Wales, United Kingdom
| | - Simon Murphy
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Graham Moore
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Rhiannon Evans
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, Wales, United Kingdom
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27
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McCoy A, Lachman JM, Ward CL, Tapanya S, Poomchaichote T, Kelly J, Mukaka M, Cheah PY, Gardner F. Feasibility pilot of an adapted parenting program embedded within the Thai public health system. BMC Public Health 2021; 21:1009. [PMID: 34051772 PMCID: PMC8164235 DOI: 10.1186/s12889-021-11081-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/17/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND This feasibility pilot of the Parenting for Lifelong Health for Young Children program in Thailand aimed to: 1) explore the feasibility of study evaluation approaches; 2) assess the feasibility of delivering an adapted program; 3) report indicative effects on child maltreatment and related outcomes; and 4) examine intervention content associated with key mechanisms of change perceived by caregivers and facilitators. METHOD Sixty primary caregivers of children aged 2-9 years were recruited for an 8-week parenting program embedded within the local health system. Mixed-methods approaches included quantitative caregiver-report and observational data from standardized instruments, and qualitative data from individual and group interviews with caregivers and program facilitators. Analyses involved Wilcoxon signed-rank tests, paired t-tests, Friedman's ANOVA, and thematic analysis. RESULTS Participants reported that most (65%) were grandparents or great-grandparents. Study retention and response rates were high, and enrolled caregivers attended an average of 93% of sessions. Primary outcomes showed caregiver-reported pre-post reductions in overall child maltreatment (d = - 0.58, p < 0.001), as well as reductions in physical (d = - 0.58, p < 0.001) and emotional abuse (d = - 0.40, p < 0.001). Combined caregiver report and observational assessments using the HOME Inventory showed reductions in abusive and harsh parenting (d = - 0.52, p < 0.001). Secondary outcomes demonstrated decreases in child neglect; dysfunctional parenting; poor child monitoring and supervision; parental sense of inefficacy; child behavior problems; daily report on child problem behavior; parent overall depression, anxiety, and stress; and attitudes supporting physical punishment and harsh discipline. There were increases in overall positive parenting, daily positive parenting behavior, as well as HOME Inventory assessments on parent-child relationships. Thematic analyses from interviews and focus group data identified six key program themes associated with strengthened parent-child relationships, reduced child behavior problems, improved attitudes and strategies toward discipline, and improved management of parental stress. CONCLUSIONS This study represents one of few evaluations to test the feasibility of an evidence-based parenting program embedded within routine public health service delivery in a low- or middle-income country. Findings show preliminary effectiveness in reducing child maltreatment, improvements on 22 of 24 secondary outcomes, and perceived mechanisms of change that support quantitative findings. Prospects are promising for program scalability, pending randomized controlled trial results. TRIAL REGISTRATION 11/01/2019, ClinicalTrials.gov, ID# NCT03539341 .
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Affiliation(s)
- Amalee McCoy
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK.
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Jamie M Lachman
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Sombat Tapanya
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Tassawan Poomchaichote
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Jane Kelly
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Mavuto Mukaka
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK
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Divan G, Bhavnani S, Leadbitter K, Ellis C, Dasgupta J, Abubakar A, Elsabbagh M, Hamdani SU, Servili C, Patel V, Green J. Annual Research Review: Achieving universal health coverage for young children with autism spectrum disorder in low- and middle-income countries: a review of reviews. J Child Psychol Psychiatry 2021; 62:514-535. [PMID: 33905120 DOI: 10.1111/jcpp.13404] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Autism presents with similar prevalence and core impairments in diverse populations. We conducted a scoping review of reviews to determine key barriers and innovative strategies which can contribute to attaining universal health coverage (UHC), from early detection to effective interventions for autism in low- and middle-income countries (LAMIC). METHODS A systematic literature search of review articles was conducted. Reviews relevant to the study research question were included if they incorporated papers from LAMIC and focused on children (<eight years old) with autism or their caregivers. The database search was supplemented with bibliographic search of included articles and key informant suggestions. Data were extracted and mapped onto a Theory of Change model toward achieving UHC for autism in LAMIC. RESULTS We identified 31 articles which reviewed data from over fifty countries across Africa, Latin America, Middle East, and Asia and addressed barriers across one or more of four inter-related domains: (a) the social context and family experience for a child with autism; (b) barriers to detection and diagnosis; (c) access to appropriate evidence-based intervention; and (d) social policy and legislation. Key barriers identified included: lack of appropriate tools for detection and diagnosis; low awareness and experienced stigma impacting demand for autism care; and the prevalence of specialist models for diagnosis and treatment which are not scalable in LAMIC. CONCLUSIONS We present a Theory of Change model which describe the strategies and resources needed to realize UHC for children with autism in LAMIC. We highlight the importance of harnessing existing evidence to best effect, using task sharing and adapted intervention strategies, community participation, and technology innovation. Scaling up these innovations will require open access to appropriate detection and intervention tools, systematic approaches to building and sustaining skills in frontline providers to support detection and deliver interventions embedded within a stepped care architecture, and community awareness of child development milestones.
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Affiliation(s)
- Gauri Divan
- Child Development Group, Sangath, Bardez, Goa, India
| | | | - Kathy Leadbitter
- Division of Neuroscience & Experimental Psychology, University of Manchester, Manchester, UK
| | - Ceri Ellis
- Division of Neuroscience & Experimental Psychology, University of Manchester, Manchester, UK
| | | | - Amina Abubakar
- Institute of Human Development, Aga Khan University, Nairobi, Kenya
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Syed Usman Hamdani
- Human Development Research Foundation, Punjab, Pakistan.,University of Liverpool, Liverpool, UK
| | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Jonathan Green
- Child and Adolescent Psychiatry, University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK.,Royal Manchester Children's Hospital, Manchester, UK
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Parent Support Programmes for Families Who are Immigrants: A Scoping Review. J Immigr Minor Health 2021; 24:506-525. [PMID: 33768483 PMCID: PMC8854318 DOI: 10.1007/s10903-021-01181-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 11/05/2022]
Abstract
Parental support is of paramount importance in the promotion of positive parenting, strengthening parenthood and protecting children from disadvantages due to immigration experiences. The aim was to describe what is known about parent support programmes targeted to families who are immigrants. Electronic databases and the grey literature were systematically and comprehensively searched with no time/language restrictions. JBI approach and PRISMA-ScR were used to guide the review. N = 88 articles were sourced. Interventions were targeted to improve parental practices, skills and family wellbeing, usually through group-based methods. Most interventions included components of positive parenting and family communication. Identifying the needs of the target group and cultural tailoring were reported to be highly important in gaining acceptability, promoting engagement and producing benefits. Parent support programmes for families who are immigrants potentially improve positive parental practices and families’ wellbeing. There are many applicable and effective interventions to be exploited.
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Shenderovich Y, Ward CL, Lachman JM, Wessels I, Sacolo-Gwebu H, Okop K, Oliver D, Ngcobo LL, Tomlinson M, Fang Z, Janowski R, Hutchings J, Gardner F, Cluver L. Evaluating the dissemination and scale-up of two evidence-based parenting interventions to reduce violence against children: study protocol. Implement Sci Commun 2020; 1:109. [PMID: 38624613 PMCID: PMC7719848 DOI: 10.1186/s43058-020-00086-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/12/2020] [Indexed: 12/31/2022] Open
Abstract
Background Eliminating violence against children is a prominent policy goal, codified in the Sustainable Development Goals, and parenting programs are one approach to preventing and reducing violence. However, we know relatively little about dissemination and scale-up of parenting programs, particularly in low- and middle-income countries (LMICs). The scale-up of two parenting programs, Parenting for Lifelong Health (PLH) for Young Children and PLH for Parents and Teens, developed under Creative Commons licensing and tested in randomized trials, provides a unique opportunity to study their dissemination in 25 LMICs. Methods The Scale-Up of Parenting Evaluation Research (SUPER) study uses a range of methods to study the dissemination of these two programs. The study will examine (1) process and extent of dissemination and scale-up, (2) how the programs are implemented and factors associated with variation in implementation, (3) violence against children and family outcomes before and after program implementation, (4) barriers and facilitators to sustained program delivery, and (5) costs and resources needed for implementation.Primary data collection, focused on three case study projects, will include interviews and focus groups with program facilitators, coordinators, funders, and other stakeholders, and a summary of key organizational characteristics. Program reports and budgets will be reviewed as part of relevant contextual information. Secondary data analysis of routine data collected within ongoing implementation and existing research studies will explore family enrolment and attendance, as well as family reports of parenting practices, violence against children, child behavior, and child and caregiver wellbeing before and after program participation. We will also examine data on staff sociodemographic and professional background, and their competent adherence to the program, collected as part of staff training and certification. Discussion This project will be the first study of its kind to draw on multiple data sources and methods to examine the dissemination and scale-up of a parenting program across multiple LMIC contexts. While this study reports on the implementation of two specific parenting programs, we anticipate that our findings will be of relevance across the field of parenting, as well as other violence prevention and social programs.
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Affiliation(s)
- Yulia Shenderovich
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Catherine L. Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Jamie M. Lachman
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Inge Wessels
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | | | - Kufre Okop
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | | | | | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
- School of Nursing and Midwifery, Queens University, Belfast, UK
| | - Zuyi Fang
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Roselinde Janowski
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | | | - Frances Gardner
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Lucie 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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31
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Kleyn LM, Hewstone M, Ward CL, Wölfer R. Using Longitudinal Social Network Analysis to Evaluate a Community-Wide Parenting Intervention. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 22:130-143. [PMID: 33211255 PMCID: PMC7762743 DOI: 10.1007/s11121-020-01184-6] [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] [Accepted: 10/27/2020] [Indexed: 11/03/2022]
Abstract
Harsh parenting attitudes and behaviors negatively impact children's behavior and development, and are linked to heightened levels of violence in children. Parent training programs are effective preventive interventions, but only reach caregivers who attend them. In this study, programs were implemented alongside a community mobilization process, intended to use caregivers' social networks to disseminate new parenting skills community wide. We used social network analysis to explore whether this intervention, first, increased positive parenting, second, changed social networks of female caregivers (selection), and, third, influenced parenting behavior via connections (socialization), while controlling for psychiatric morbidity, parenting stress, alcohol misuse, and child's age. "Colored" Afrikaans-speaking female caregivers (N = 235; mean age 35.92 years) in a rural community in South Africa, with children between 1½ and 18 years old, were included in the study; two waves of data were collected (January-April 2016 and June-October 2017). We detected community-wide increases in positive parenting behavior (involvement, supervision, consistent discipline, and reduced corporal punishment). Attending at least one session of a parenting skills training program (n = 51; 21.7%) significantly predicted increases in network centrality (i.e., outdegree and indegree). Caregivers appeared to use similar parenting behavior to other caregivers they were connected to within the network, especially when those others attended a parenting skills training program. Overall, the results suggest that the information in the intervention was spread throughout the community through social interactions with program attendees and the community mobilization process. The results also illustrate the value of social network analysis for ascertaining the processes by which the intervention achieved its impact.
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Affiliation(s)
- Lisa M Kleyn
- Department of Psychology, University of Cape Town, Cape Town, South Africa. .,Department of Experimental Psychology, University of Oxford, Oxford, UK.
| | - Miles Hewstone
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Department of Experimental Psychology, University of Newcastle, Callaghan, Australia
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Ralf Wölfer
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Deutsches Zentrum für Integrations- und Migrationsforschung, Berlin, Germany
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Francis T, Baker-Henningham H. Design and Implementation of the Irie Homes Toolbox: A Violence Prevention, Early Childhood, Parenting Program. Front Public Health 2020; 8:582961. [PMID: 33304875 PMCID: PMC7701241 DOI: 10.3389/fpubh.2020.582961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/06/2020] [Indexed: 11/23/2022] Open
Abstract
This paper describes the development of the Irie Homes Toolbox, a violence prevention program targeting parents of children aged two to six years. The intervention was designed to complement an existing, teacher-training, violence prevention program, the Irie Classroom Toolbox, thus promoting an integrated approach across home and school settings. The Irie Homes Toolbox was developed through a four-stage process by integrating data from theory, formative research, and practice to ensure the intervention is acceptable, feasible, relevant, and effective in the context. The perspectives of Jamaican preschool teachers and parents of preschool children, who are the end users, were integrated into the design of the intervention throughout the development process. Stage one involved integrating theory and formative research to inform the initial intervention design. Stages two and three involved iterative cycles of design, implementation and evaluation of the intervention content, process of delivery, structure and materials. Stage four involved a further cycle of learning through a process evaluation conducted as part of a cluster-randomized controlled trial. Data from each of these four stages was used to inform the design and ongoing revisions of the toolbox with the aim of developing a low-cost, scalable and sustainable intervention for the Jamaican context. The resulting program is theory-informed and uses empirically derived content and behavior change principles operationalized for the context in which it will be delivered. The Irie Homes Toolbox is suitable for integration into the existing preschool provision in Jamaica, thus utilizing an existing service and existing staff and increasing the likelihood for wide-scale dissemination.
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Affiliation(s)
- Taja Francis
- Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Helen Baker-Henningham
- Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
- School of Psychology, Bangor University, Bangor, United Kingdom
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Schippers EE, Hoogsteder LM, Stams GJJ. Responsive Aggression Regulation Therapy (Re‐ART) Improves Executive Functioning in Adolescents and Young Adults with Severe Aggression Problems: A Pilot Study. J Forensic Sci 2020; 65:2058-2064. [DOI: 10.1111/1556-4029.14539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/14/2020] [Accepted: 07/17/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Geert Jan J.M. Stams
- Faculty of Social and Behavioral Sciences, Forensic Child and Youth Care University of Amsterdam Postbus 15776 Amsterdam Noord‐Holland1001 NGThe Netherlands
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Leijten P, Scott S, Landau S, Harris V, Mann J, Hutchings J, Beecham J, Gardner F. Individual Participant Data Meta-analysis: Impact of Conduct Problem Severity, Comorbid Attention-Deficit/Hyperactivity Disorder and Emotional Problems, and Maternal Depression on Parenting Program Effects. J Am Acad Child Adolesc Psychiatry 2020; 59:933-943. [PMID: 32084529 DOI: 10.1016/j.jaac.2020.01.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/10/2020] [Accepted: 01/12/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE There is concern whether established parenting programs for children's conduct problems meet the needs of families with severe and complex mental health problems. For example, many children with conduct problems show comorbid attention-deficit/hyperactivity disorder (ADHD) or emotional problems, or have parents who are depressed, but families with such complex mental health problems typically seen in real life are often underrepresented in evaluation trials. We tested whether children with more severe conduct problems, and those with more complex mental health problems, benefit less from the Incredible Years parenting program, using individual participant data meta-analysis of randomized trials in Europe. METHOD In 1,696 families from 13 children aged (child age 2-11 years; 37% girls; 58% low income; 30% ethnic minority; 98% mothers), we used moderator analysis within a multilevel model to test whether initial conduct problem severity, comorbid ADHD or emotional problems, and maternal depression would diminish intervention effects for children's conduct problems. RESULTS The Incredible Years program reduced children's conduct problems overall (Cohen's d = -0.35), but more so in children with more severe conduct problems. There was no evidence that children's comorbid ADHD and emotional problems changed the intervention benefits. Children of mothers with more depressive symptoms benefited more. CONCLUSION Children with more severe conduct problems derive greater, rather than lesser, benefits from a high-quality group parenting program, and comorbid ADHD and emotional problems do not reduce effects; maternal depression, rather than being linked to less child change, was associated with greater reductions in children's conduct problems.
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Dell’armi M, Kruck J, Niec L. Prise en charge des troubles du comportement du jeune enfant par le programme Parent-Child Interaction Therapy (PCIT). PRAT PSYCHOL 2020. [DOI: 10.1016/j.prps.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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McCoy A, Melendez-Torres GJ, Gardner F. Parenting interventions to prevent violence against children in low- and middle-income countries in East and Southeast Asia: A systematic review and multi-level meta-analysis. CHILD ABUSE & NEGLECT 2020; 103:104444. [PMID: 32171126 DOI: 10.1016/j.chiabu.2020.104444] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/23/2020] [Accepted: 03/01/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Currently, the strongest evidence for preventing violence against children lies with social learning theory-based parenting interventions. An increasing number of experimental studies on such interventions have been conducted in low- and middle-income countries (LMICs) in East and Southeast Asia. OBJECTIVE To conduct a systematic review and meta-analysis on the effectiveness of parenting interventions in preventing violence against children. PARTICIPANTS AND SETTING Parents and primary caregivers living in LMICs in East and Southeast Asia. METHODS Eleven studies were retrieved through electronic databases, expert contacts, and the reference sections of previous reviews. Studies were appraised for risk of bias and effect estimates pooled using random effects multilevel meta-analysis. RESULTS Forty-four effect estimates were meta-analyzed based on five outcome category models, finding a small effect on abusive, harsh, or negative parenting (n = 3, d = -0.42, 95 % CI [- 0.81, -0.02], p < .01, I2 = 72 %); a large, non-significant effect on parental knowledge or attitudes (n = 5, d = 1.40, 95 % CI [-0.30, 3.10], I2 = 95 %); a small effect on positive parent-child interactions (n = 5, d = 0.25, 95 % CI [0.19, 0.32], p < .001, I2 = 0); a small, non-significant effect on parental stress (n = 2, d = -0.13, 95 % CI [-0.38, 0.11], I2 = 0); and a small, non-significant effect on family environment (n = 3, d = 0.21, 95 % CI [-0.12, 0.53], I2 = 85 %). CONCLUSIONS The results suggest that parenting interventions can reduce rates of particular forms of violence against children, as well as promote positive parent-child interactions.
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Affiliation(s)
- Amalee McCoy
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, Barnett House, 32 Wellington Square, University of Oxford, Oxford, OX1 2ER, United Kingdom; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand.
| | - G J Melendez-Torres
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, 1-3 Museum Place, Cardiff University, Cardiff, CF10 3BD, United Kingdom
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, Barnett House, 32 Wellington Square, University of Oxford, Oxford, OX1 2ER, United Kingdom
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Ward CL, Wessels IM, Lachman JM, Hutchings J, Cluver LD, Kassanjee R, Nhapi R, Little F, Gardner F. Parenting for Lifelong Health for Young Children: a randomized controlled trial of a parenting program in South Africa to prevent harsh parenting and child conduct problems. J Child Psychol Psychiatry 2020; 61:503-512. [PMID: 31535371 PMCID: PMC7155004 DOI: 10.1111/jcpp.13129] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Parenting programs suitable for delivery at scale in low-resource contexts are urgently needed. We conducted a randomized trial of Parenting for Lifelong Health (PLH) for Young Children, a low-cost 12-session program designed to increase positive parenting and reduce harsh parenting and conduct problems in children aged 2-9. METHODS Two hundred and ninety-six caregivers, whose children showed clinical levels of conduct problems (Eyberg Child Behavior Inventory Problem Score, >15), were randomly assigned using a 1:1 ratio to intervention or control groups. At t0 , and at 4-5 months (t1 ) and 17 months (t2 ) after randomization, research assistants blind to group assignment assessed (through caregiver self-report and structured observation) 11 primary outcomes: positive parenting, harsh parenting, and child behavior; four secondary outcomes: parenting stress, caregiver depression, poor monitoring/supervision, and social support. TRIAL REGISTRATION ClinicalTrials.gov (NCT02165371); Pan African Clinical Trial Registry (PACTR201402000755243); Violence Prevention Trials Register (http://www.preventviolence.info/Trials?ID=24). RESULTS Caregivers attended on average 8.4 sessions. After adjustment for 30 comparisons, strongest results were as follows: at t1 , frequency of self-reported positive parenting strategies (10% higher in the intervention group, p = .003), observed positive parenting (39% higher in the intervention group, p = .003), and observed positive child behavior (11% higher in the intervention group, p = .003); at t2, both observed positive parenting and observed positive child behavior were higher in the intervention group (24%, p = .003; and 17%, p = .003, respectively). Results with p-values < .05 prior to adjustment were as follows: At t1 , the intervention group self-reported 11% fewer child problem behaviors, 20% fewer problems with implementing positive parenting strategies, and less physical and psychological discipline (28% and 14% less, respectively). There were indications that caregivers reported 20% less depression but 7% more parenting stress at t1 . Group differences were nonsignificant for observed negative child behavior, and caregiver-reported child behavior, poor monitoring or supervision, and caregiver social support. CONCLUSIONS PLH for Young Children shows promise for increasing positive parenting and reducing harsh parenting.
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Affiliation(s)
- Catherine L. Ward
- Department of Psychology and Safety and Violence InitiativeUniversity of Cape TownCape TownSouth Africa
| | - Inge M. Wessels
- Department of Psychology and Safety and Violence InitiativeUniversity of Cape TownCape TownSouth Africa,Department of Social Policy and InterventionUniversity of OxfordOxfordUK
| | - Jamie M. Lachman
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK,MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Judy Hutchings
- Centre for Evidence‐Based Early InterventionBangor UniversityBangorUK
| | - Lucie D. Cluver
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK,Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
| | - Reshma Kassanjee
- Department of Statistical SciencesUniversity of Cape TownCape TownSouth Africa,Centre for Infectious Disease Epidemiology and Research (CIDER)School of Public Health and Family MedicineUniversity of Cape TownCape TownSouth Africa
| | - Raymond Nhapi
- Department of Statistical SciencesUniversity of Cape TownCape TownSouth Africa
| | - Francesca Little
- Department of Statistical SciencesUniversity of Cape TownCape TownSouth Africa
| | - Frances Gardner
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK
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The application of meta-analytic (multi-level) models with multiple random effects: A systematic review. Behav Res Methods 2020; 52:2031-2052. [DOI: 10.3758/s13428-020-01373-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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39
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Hornor G, Quinones SG, Boudreaux D, Bretl D, Chapman E, Chiocca EM, Donnell C, Herendeen P, Kahn D, Loyke J, Morris KA, Mulvaney B, Perks DH, Terreros A, VanGraafeiland B. Building a Safe and Healthy America: Eliminating Corporal Punishment via Positive Parenting. J Pediatr Health Care 2020; 34:136-144. [PMID: 31836354 DOI: 10.1016/j.pedhc.2019.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 09/10/2019] [Accepted: 09/25/2019] [Indexed: 11/30/2022]
Abstract
corporal punishment (CP) is associated with negative short-term and long-term children outcomes. However, many caregivers continue to administer spankings and other forms of CP. Pediatric nurse practitioners are in a unique position to affect change in parental behavior related to CP use and other parenting practices. This article will summarize the research on the dangers of CP and the corresponding benefits of positive parenting. It defines positive parenting and offers resources pediatric health care providers, including pediatric nurse practitioners, can use to educate both themselves and caregivers about specific discipline techniques appropriate to each developmental stage. Finally, it suggests practice strategies pediatric nurse practitioners can use to help caregivers replace CP and other harsh parenting practices with positive parenting to build a safe and healthy America.
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McCabe KM, Yeh M, Zerr AA. Personalizing Behavioral Parent Training Interventions to Improve Treatment Engagement and Outcomes for Culturally Diverse Families. Psychol Res Behav Manag 2020; 13:41-53. [PMID: 32021508 PMCID: PMC6966146 DOI: 10.2147/prbm.s230005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/18/2019] [Indexed: 12/14/2022] Open
Abstract
Behavioral Parent Training (BPT) interventions are efficacious for young children with externalizing behavior problems. However, not all families benefit, and ethnic minority families in particular are less likely to enroll, engage, and improve in BPT. Versions of BPT interventions tailored for specific ethnic groups have been successful at improving engagement and outcomes for ethnic minorities; however, the specificity of these models presents challenges for broad dissemination. This article presents a personalization approach (PersIn) that utilizes cultural assessment results to tailor treatment protocols to the characteristics of individual families. We believe this approach has the potential to maximize cultural sensitivity while preserving generalizability to both minority and non-minority ethnic groups. We further propose that personalization on Parent Explanatory Model (PEM) parameters that have been found to vary across ethnic groups and to impact treatment engagement and/or outcomes is a promising approach to decreasing disparities in BPTs. We describe examples of evidence-supported PEMs that present good targets for personalization and provide examples from MY PCIT to illustrate how PersIn can be applied to Parent-Child Interaction Therapy (PCIT).
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Affiliation(s)
- Kristen M McCabe
- Department of Psychological Sciences, University of San Diego, San Diego, CA, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
| | - May Yeh
- Child and Adolescent Services Research Center, San Diego, CA, USA
- Department of Psychology, San Diego State University, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Argero A Zerr
- Department of Psychological Sciences, University of San Diego, San Diego, CA, USA
- Department of Psychology, California State University Channel Islands, Camarillo, CA, USA
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Movsisyan A, Arnold L, Evans R, Hallingberg B, Moore G, O’Cathain A, Pfadenhauer LM, Segrott J, Rehfuess E. Adapting evidence-informed complex population health interventions for new contexts: a systematic review of guidance. Implement Sci 2019; 14:105. [PMID: 31847920 PMCID: PMC6918624 DOI: 10.1186/s13012-019-0956-5] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 11/28/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Adapting interventions that have worked elsewhere can save resources associated with developing new interventions for each specific context. While a developing body of evidence shows benefits of adapted interventions compared with interventions transported without adaptation, there are also examples of interventions which have been extensively adapted, yet have not worked in the new context. Decisions on when, to what extent, and how to adapt interventions therefore are not straightforward, particularly when conceptualising intervention effects as contingent upon contextual interactions in complex systems. No guidance currently addresses these questions comprehensively. To inform development of an overarching guidance on adaptation of complex population health interventions, this systematic review synthesises the content of the existing guidance papers. METHODS We searched for papers published between January 2000 and October 2018 in 7 bibliographic databases. We used citation tracking and contacted authors and experts to locate further papers. We double screened all the identified records. We extracted data into the following categories: descriptive information, key concepts and definitions, rationale for adaptation, aspects of adaptation, process of adaptation, evaluating and reporting adapted interventions. Data extraction was conducted independently by two reviewers, and retrieved data were synthesised thematically within pre-specified and emergent categories. RESULTS We retrieved 6694 unique records. Thirty-eight papers were included in the review representing 35 sources of guidance. Most papers were developed in the USA in the context of implementing evidence-informed interventions among different population groups within the country, such as minority populations. We found much agreement on how the papers defined key concepts, aims, and procedures of adaptation, including involvement of key stakeholders, but also identified gaps in scope, conceptualisation, and operationalisation in several categories. CONCLUSIONS Our review found limitations that should be addressed in future guidance on adaptation. Specifically, future guidance needs to be reflective of adaptations in the context of transferring interventions across countries, including macro- (e.g. national-) level interventions, better theorise the role of intervention mechanisms and contextual interactions in the replicability of effects and accordingly conceptualise key concepts, such as fidelity to intervention functions, and finally, suggest evidence-informed strategies for adaptation re-evaluation and reporting. TRIAL REGISTRATION PROSPERO 2018, CRD42018112714.
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Affiliation(s)
- A. Movsisyan
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
- Pettenkofer School of Public Health, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
| | - L. Arnold
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
- Pettenkofer School of Public Health, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
| | - R. Evans
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, CF10 3BD Cardiff, Wales UK
| | - B. Hallingberg
- Cardiff School of Sport & Health Sciences, Llandaff Campus, Cardiff Metropolitan University, Western Avenue, Cardiff, CF5 2YB Wales UK
| | - G. Moore
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, CF10 3BD Cardiff, Wales UK
| | - A. O’Cathain
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 20 Regent Street, S1 4DA Sheffield, UK
| | - L. M. Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
- Pettenkofer School of Public Health, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
| | - J. Segrott
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, CF10 3BD Cardiff, Wales UK
| | - E. Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
- Pettenkofer School of Public Health, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
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Lachman JM, Heinrichs N, Jansen E, Brühl A, Taut D, Fang X, Gardner F, Hutchings J, Ward CL, Williams ME, Raleva M, Båban A, Lesco G, Foran HM. Preventing child mental health problems through parenting interventions in Southeastern Europe (RISE): Protocol for a multi-country cluster randomized factorial study. Contemp Clin Trials 2019; 86:105855. [PMID: 31669446 DOI: 10.1016/j.cct.2019.105855] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/12/2019] [Accepted: 10/12/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Child mental health problems continue to be a major global concern, especially in low- and middle-income countries (LMICs). Parenting interventions have been shown to be effective for reducing child behavior problems in high-income countries, with emerging evidence supporting similar effects in LMICs. However, there remain substantial barriers to scaling up evidence-based interventions due to limited human and financial resources in such countries. METHODS This protocol is for a multi-center cluster randomized factorial trial of an evidence-based parenting intervention, Parenting for Lifelong Health for Young Children, for families with children ages 2-9 years with subclinical levels of behavior problems in three Southeastern European countries, Republic of Moldova, North Macedonia, and Romania (8 conditions, 48 clusters, 864 families, 108 per condition). The trial will test three intervention components: length (5 vs. 10 sessions), engagement (basic vs. enhanced package), and fidelity (on-demand vs. structured supervision). Primary outcomes are child aggressive behavior, dysfunctional parenting, and positive parenting. Analyses will examine the main effect and cost-effectiveness of each component, as well as potential interaction effects between components, in order to identify the most optimal combination of program components. DISCUSSION This study is the first factorial experiment of a parenting program in LMICs. Findings will inform the subsequent testing of the optimized program in a multisite randomized controlled trial in 2021. TRIAL REGISTRATION NCT03865485 registered in ClinicalTrials.gov on March 5, 2019.
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Affiliation(s)
- 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
| | - Elena Jansen
- Institute for Psychology, Alpen-Adria-University Klagenfurt, Klagenfurt, Austria
| | - Antonia Brühl
- Department of Psychology, Clinical Psychology, and Psychotherapy, University of Bremen, Bremen, Germany
| | - Diana Taut
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Xiangming Fang
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Judy Hutchings
- Centre for Evidence Based Early Intervention, School of Psychology, Bangor University, Bangor, UK
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Margiad Elen Williams
- Centre for Evidence Based Early Intervention, School of Psychology, Bangor University, Bangor, UK
| | - Marija Raleva
- Institute for Marriage, Family and Systemic Practice - ALTERNATIVA, Skopje, North Macedonia
| | - Adriana Båban
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Galina Lesco
- Health for Youth Association, Chișinău, Republic of Moldova
| | - Heather M Foran
- Institute for Psychology, Alpen-Adria-University Klagenfurt, Klagenfurt, Austria
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Evans RE, Craig P, Hoddinott P, Littlecott H, Moore L, Murphy S, O'Cathain A, Pfadenhauer L, Rehfuess E, Segrott J, Moore G. When and how do 'effective' interventions need to be adapted and/or re-evaluated in new contexts? The need for guidance. J Epidemiol Community Health 2019; 73:481-482. [PMID: 30787038 PMCID: PMC6581090 DOI: 10.1136/jech-2018-210840] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Rhiannon E Evans
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professions Research Unit (NMAHP RU), University of Stirling, Stirling, UK
| | - Hannah Littlecott
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - Laurence Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Simon Murphy
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - Alicia O'Cathain
- Medical Care Research Unit, School of Health and Related Research (SHARR), University of Sheffield, Sheffield, UK
| | - Lisa Pfadenhauer
- Institute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
| | - Eva Rehfuess
- Institute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
| | - Jeremy Segrott
- DECIPHer, Centre for Trials Research (CTU), Cardiff University, Cardiff, UK
| | - Graham Moore
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
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Haslam D, Mejia A, Thomson D, Betancourt T. Self-Regulation in Low- and Middle-Income Countries: Challenges and Future Directions. Clin Child Fam Psychol Rev 2019; 22:104-117. [PMID: 30725308 DOI: 10.1007/s10567-019-00278-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Self-regulation is developed early in life through family and parenting interactions. There has been considerable debate on how to best conceptualize and enhance self-regulation. Many consider self-regulation as the socio-emotional competencies required for healthy and productive living, including the flexibility to regulate emotions, control anger, maintain calm under pressure, and respond adaptively to a variety of situations. Its enhancement is the focus of many child and family interventions. An important limitation of the self-regulation field is that most empirical and conceptual research comes from high-income countries (HICs). Less is known about the manifestation, measurement and role of self-regulation in many collectivistic, rural, or less-developed contexts such as low- and middle-income countries (LMICs). This position paper aims to present an initial review of the existing literature on self-regulation in LMICs, with a focus on parenting, and to describe challenges in terms of measurement and implementation of self-regulation components into existing interventions for parents, children and adolescents in these settings. We conclude by establishing steps or recommendations for conducting basic research to understand how self-regulation expresses itself in vulnerable and low-resource settings and for incorporating components of self-regulation into services in LMICs.
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Affiliation(s)
- Divna Haslam
- Parenting & Family Support Centre, The University of Queensland, Brisbane, Australia.
| | | | - Dana Thomson
- Boston College School of Social Work, Chestnut Hill, MA, USA
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Leijten P, Gardner F, Melendez-Torres GJ, van Aar J, Hutchings J, Schulz S, Knerr W, Overbeek G. Meta-Analyses: Key Parenting Program Components for Disruptive Child Behavior. J Am Acad Child Adolesc Psychiatry 2019; 58:180-190. [PMID: 30738545 DOI: 10.1016/j.jaac.2018.07.900] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/21/2018] [Accepted: 08/15/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Parenting programs are the recommended strategy for the prevention and treatment of disruptive child behavior. Similar to most psychosocial interventions, it is unknown which components of parenting programs (ie, parenting techniques taught) actually contribute to program effects. Identifying what parents need to be taught to reduce disruptive child behavior can optimize intervention strategies, and refine theories on how parenting shapes disruptive child behavior. METHOD In two meta-analyses, we updated the evidence-base for effectiveness of parenting programs delivered at various levels of prevention and treatment of disruptive behavior. We searched six databases (eg, PsycINFO, MEDLINE) for randomized trials and coded the parenting techniques taught in each program. We identified the techniques associated with program effects in general, and for prevention versus treatment, and immediate versus longer-term effects, specifically. RESULTS Parenting program effects on disruptive behavior gradually increased per level of prevention (universal d = -0.21, selective d = -0.27, indicated d = -0.55) and treatment (d = -0.69) (Meta-Analysis 1: 154 trials, 398 effect sizes). Three of 26 parenting techniques were associated with stronger program effects: positive reinforcement, praise in particular, and natural/logical consequences. Several additional techniques (eg, relationship building and parental self-management) were associated with stronger effects in treatment but weaker effects in prevention. No techniques were associated with stronger longer-term effects (Meta-Analysis 2: 42 trials, 157 effect sizes). CONCLUSION Positive reinforcement and nonviolent discipline techniques (eg, applying natural/logical consequences) seem to be key parenting program techniques to reduce disruptive child behavior. Additional techniques (eg, parental self-management skills) might improve program effects in treatment, but not in prevention.
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Affiliation(s)
- Patty Leijten
- University of Oxford, UK; University of Amsterdam, The Netherlands.
| | | | | | | | | | - Susanne Schulz
- University of Amsterdam, The Netherlands; Utrecht University, The Netherlands
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Moore GF, Evans RE, Hawkins J, Littlecott H, Melendez-Torres G, Bonell C, Murphy S. From complex social interventions to interventions in complex social systems: Future directions and unresolved questions for intervention development and evaluation. EVALUATION (LONDON, ENGLAND : 1995) 2019; 25:23-45. [PMID: 30705608 PMCID: PMC6330692 DOI: 10.1177/1356389018803219] [Citation(s) in RCA: 182] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Complex systems approaches to social intervention research are increasingly advocated. However, there have been few attempts to consider how models of intervention science, such as the UK's Medical Research Council complex interventions framework, might be reframed through a complex systems lens. This article identifies some key areas in which this framework might be reconceptualized, and a number of priority areas where further development is needed if alignment with a systems perspective is to be achieved. We argue that a complex systems perspective broadens the parameters of 'relevant' evidence and theory for intervention development, before discussing challenges in defining feasibility in dynamic terms. We argue that whole systems evaluations may be neither attainable, nor necessary; acknowledgment of complexity does not mean that evaluations must be complex, or investigate all facets of complexity. However, a systems lens may add value to evaluation design through guiding identification of key uncertainties, and informing decisions such as timings of follow-up assessments.
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Affiliation(s)
| | | | | | | | | | - Chris Bonell
- London School of Hygiene & Tropical Medicine, UK
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Gardner F, Leijten P, Melendez-Torres GJ, Landau S, Harris V, Mann J, Beecham J, Hutchings J, Scott S. The Earlier the Better? Individual Participant Data and Traditional Meta-analysis of Age Effects of Parenting Interventions. Child Dev 2018; 90:7-19. [PMID: 30216433 DOI: 10.1111/cdev.13138] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Strong arguments have been made for early intervention for child problems, stating that early is more effective than later, as the brain is more malleable, and costs are lower. However, there is scant evidence from trials to support this hypothesis, which we therefore tested in two well-powered, state-of-the-art meta-analyses with complementary strengths: (a) Individual participant data (IPD) meta-analysis of European trials of Incredible Years parenting intervention (k = 13, n = 1696; age = 2-11); (b) Larger, trial-level robust variance estimation meta-analysis of a wider range of parenting programs (k = 156, n = 13,378, Mage = 2-10) for reducing disruptive behavior. Both analyses found no evidence that intervention earlier in childhood was more effective; programs targeted at a narrower age range were no more effective than general ones.
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Burkey MD, Hosein M, Morton I, Purgato M, Adi A, Kurzrok M, Kohrt BA, Tol WA. Psychosocial interventions for disruptive behaviour problems in children in low- and middle-income countries: a systematic review and meta-analysis. J Child Psychol Psychiatry 2018; 59:982-993. [PMID: 29633271 DOI: 10.1111/jcpp.12894] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Most of the evidence for psychosocial interventions for disruptive behaviour problems comes from Western, high-income countries. The transferability of this evidence to culturally diverse, low-resource settings with few mental health specialists is unknown. METHODS We conducted a systematic review with random-effects meta-analysis of randomized controlled trials examining the effects of psychosocial interventions on reducing behaviour problems among children (under 18) living in low- and middle-income countries (LMIC). RESULTS Twenty-six randomized controlled trials (representing 28 psychosocial interventions), evaluating 4,441 subjects, met selection criteria. Fifteen (54%) prevention interventions targeted general or at-risk populations, whereas 13 (46%) treatment interventions targeted children selected for elevated behaviour problems. Most interventions were delivered in group settings (96%) and half (50%) were administered by non-specialist providers. The overall effect (standardized mean difference, SMD) of prevention studies was -0.25 (95% confidence interval (CI): -0.41 to -0.09; I2 : 78%) and of treatment studies was -0.56 (95% CI: -0.51 to -0.24; I2 : 74%). Subgroup analyses demonstrated effectiveness for child-focused (SMD: -0.35; 95% CI: -0.57 to -0.14) and behavioural parenting interventions (SMD: -0.43; 95% CI: -0.66 to -0.20), and that interventions were effective across age ranges. CONCLUSIONS Our meta-analysis supports the use of psychosocial interventions as a feasible and effective way to reduce disruptive behaviour problems among children in LMIC. Our study provides strong evidence for child-focused and behavioural parenting interventions, interventions across age ranges and interventions delivered in groups. Additional research is needed on training and supervision of non-specialists and on implementation of effective interventions in LMIC settings.
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Affiliation(s)
- Matthew D Burkey
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- University of British Columbia, Vancouver, BC, Canada
| | | | - Isabella Morton
- University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Marianna Purgato
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- University of Verona, Verona, Italy
| | - Ahmad Adi
- Duke University School of Medicine, Durham, NC, USA
| | - Mark Kurzrok
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Wietse A Tol
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Parra-Cardona R, Leijten P, Lachman JM, Mejía A, Baumann AA, Amador Buenabad NG, Cluver L, Doubt J, Gardner F, Hutchings J, Ward CL, Wessels IM, Calam R, Chavira V, Domenech Rodríguez MM. Strengthening a Culture of Prevention in Low- and Middle-Income Countries: Balancing Scientific Expectations and Contextual Realities. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2018; 22:7-17. [PMID: 30058025 DOI: 10.1007/s11121-018-0935-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Relevant initiatives are being implemented in low- and middle-income countries (LMICs) aimed at strengthening a culture of prevention. However, cumulative contextual factors constitute significant barriers for implementing rigorous prevention science in these contexts, as defined by guidelines from high-income countries (HICs). Specifically, disseminating a culture of prevention in LMICs can be impacted by political instability, limited health coverage, insecurity, limited rule of law, and scarcity of specialized professionals. This manuscript offers a contribution focused on strengthening a culture of prevention in LMICs. Specifically, four case studies are presented illustrating the gradual development of contrasting prevention initiatives in northern and central Mexico, Panamá, and Sub-Saharan Africa. The initiatives share the common goal of strengthening a culture of prevention in LMICs through the dissemination of efficacious parenting programs, aimed at reducing child maltreatment and improving parental and child mental health. Together, these initiatives illustrate the following: (a) the relevance of adopting a definition of culture of prevention characterized by national commitments with expected shared contributions by governments and civil society, (b) the need to carefully consider the impact of context when promoting prevention initiatives in LMICs, (c) the iterative, non-linear, and multi-faceted nature of promoting a culture of prevention in LMICs, and (d) the importance of committing to cultural competence and shared leadership with local communities for the advancement of prevention science in LMICs. Implications for expanding a culture of prevention in LMICs are discussed.
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Affiliation(s)
- Rubén Parra-Cardona
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd., Stop, D3500, Austin, TX, 78712, USA.
| | - Patty Leijten
- Research Institute of Child Development and Education & Research Priority Area YIELD, University of Amsterdam, Amsterdam, Netherlands
| | - Jamie M Lachman
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Complexity in Health Improvement, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Anilena Mejía
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología, Panama City, Panama
| | - Ana A Baumann
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, USA
| | | | - Lucie Cluver
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Jenny Doubt
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Judy Hutchings
- Centre for Evidence Based Early Intervention, Department of Psychology, Bangor University, Bangor, UK
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Inge M Wessels
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Rachel Calam
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
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Murray J, Shenderovich Y, Gardner F, Mikton C, Derzon JH, Liu J, Eisner M. Risk Factors for Antisocial Behavior in Low- and Middle-Income Countries: A Systematic Review of Longitudinal Studies. CRIME AND JUSTICE (CHICAGO, ILL.) 2018; 47:255-364. [PMID: 30310248 PMCID: PMC6176906 DOI: 10.1086/696590] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Violent crime is a major cause of social instability, injury, and death in low- and middle-income countries. Longitudinal studies in high-income countries have provided important evidence on developmental precursors of violence and other antisocial behaviors. However, there may be unique influences or different risk factor effects in other social settings. Extensive searches in seven languages and screening of over 60,000 references identified 39 longitudinal studies of antisocial behavior in low- and middle-income countries. Many risk factors have roughly the same average effects as when studied in high-income countries. Stability of aggression over a 3-year period is almost identical across low- and middle-income countries and high-income countries. Dimensions of comorbid psychopathology such as low self-control, hyperactivity, and sensation seeking are associated with antisocial behavior in low- and middle-income countries, but some early physical health factors have consistently weak or null effects.
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Affiliation(s)
- Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | | | - Frances Gardner
- Department of Social Policy and Intervention, Oxford University
| | - Christopher Mikton
- Department of Health and Social Sciences, University of the West of England
| | - James H Derzon
- Center for Advanced Methods Development, Research Triangle Institute
| | - Jianghong Liu
- School of Nursing and Perelman School of Medicine, University of Pennsylvania
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