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  • Annemarie Lodder
    University College London
  • Anita Mehay
    University College London
  • Hana Pavlickova
  • Zoe Hoare
  • Leandra Box
    Race Equality Foundation
  • Jabeer Butt
    Race Equality Foundation
  • Tim Weaver
    Middlesex University
  • M. Crawford
    Imperial College London
  • Donna Clutterbuck
    Race Equality Foundation
  • Nicola Westbrook
    University College London
  • Karlet Manning
  • Saffron Karlsen
    Bristol University
  • Steve Morris
    Cambridge University
  • Andrew Brand
  • Paul G. Ramchandani
    Cambridge University
  • Yvonne Kelly
    University College London
  • Anja Heilmann
    University College London
  • Richard G. Watt
    University College London
Background
Up to 20% of UK children experience socio-emotional difficulties which can have serious implications for themselves, their families and society. Stark socioeconomic and ethnic inequalities in children’s well-being exist. Supporting parents to develop effective parenting skills is an important preventive strategy in reducing inequalities. Parenting interventions have been developed, which aim to reduce the severity and impact of these difficulties. However, most parenting interventions in the UK focus on early childhood (0–10 years) and often fail to engage families from ethnic minority groups and those living in poverty. Strengthening Families, Strengthening Communities (SFSC) is a parenting programme designed by the Race Equality Foundation, which aims to address this gap. Evidence from preliminary studies is encouraging, but no randomised controlled trials have been undertaken so far.

Methods/design
The TOGETHER study is a multi-centre, waiting list controlled, randomised trial, which aims to test the effectiveness of SFSC in families with children aged 3–18 across seven urban areas in England with ethnically and socially diverse populations. The primary outcome is parental mental well-being (assessed by the Warwick-Edinburgh Mental Well-Being Scale). Secondary outcomes include child socio-emotional well-being, parenting practices, family relationships, self-efficacy, quality of life, and community engagement. Outcomes are assessed at baseline, post intervention, three- and six-months post intervention. Cost effectiveness will be estimated using a cost-utility analysis and cost-consequences analysis. The study is conducted in two stages. Stage 1 comprised a 6-month internal pilot to determine the feasibility of the trial. A set of progression criteria were developed to determine whether the stage 2 main trial should proceed. An embedded process evaluation will assess the fidelity and acceptability of the intervention.

Discussion
In this paper we provide details of the study protocol for this trial. We also describe challenges to implementing the protocol and how these were addressed. Once completed, if beneficial effects on both parental and child outcomes are found, the impact, both immediate and longer term, are potentially significant. As the intervention focuses on supporting families living in poverty and those from minority ethnic communities, the intervention should also ultimately have a beneficial impact on reducing health inequalities.

Trial registration
Prospectively registered Randomised Controlled Trial ISRCTN15194500.

Background

Keywords

  • Parenting, child outcomes, Parental well-being, Health inequalities, Randomised controlled trial, Parenting Programme, Child well-being, Intervention
Original languageEnglish
Article number1887
JournalBMC Public Health
Volume21
Issue number1
DOIs
Publication statusPublished - 19 Oct 2021

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