TY - JOUR

T1 - 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

AU - Ward, Catherine

AU - Wessels, Inge

AU - Lachman, Jamie M.

AU - Hutchings, Judy

AU - Cluver, Lucie

AU - Kassanjee, Reshma

AU - Nhapi, Raymond

AU - Little, Francesca

AU - Gardner, Frances

N1 - © 2019 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

PY - 2020/4

Y1 - 2020/4

N2 - 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 t 0 , and at 4-5 months (t 1 ) and 17 months (t 2 ) 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 t 1 , 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 t 2, 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 t 1 , 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 t 1 . 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.

AB - 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 t 0 , and at 4-5 months (t 1 ) and 17 months (t 2 ) 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 t 1 , 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 t 2, 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 t 1 , 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 t 1 . 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.

KW - Parenting

KW - Parenting for Lifelong Health

KW - low- and middle-income countries

KW - prevention

KW - violence against children

U2 - 10.1111/jcpp.13129

DO - 10.1111/jcpp.13129

M3 - Article

C2 - 31535371

VL - 61

SP - 503

EP - 512

JO - Journal of Child Psychology and Psychiatry

JF - Journal of Child Psychology and Psychiatry

SN - 0021-9630

IS - 4

ER -