The effects and costs of the universal parent group program – all children in focus: a study protocol for a randomized wait-list controlled trial

BMC Public Health

Pia Enebrink³  Anna Månsdotter²  Kajsa Lönn Rhodin¹  Maria Lalouni¹  Eva Skärstrand³  Camilla Jalling³  Malin Ulfsdotter³  Lene Lindberg² 

[1] Family and social welfare, Stockholm, Sweden;Department of public health sciences, Karolinska institutet, Stockholm, Sweden;Department of clinical neuroscience, Karolinska institutet, Stockholm, Sweden

关键词: Universal;    Health promotion;    Development;    Child health;    Parental self-efficacy;    Parenting programs;   

Others  :  1161994
DOI  :  10.1186/1471-2458-13-688

 received in 2013-07-01, accepted in 2013-07-26,  发布年份 2013

【 摘 要 】

Background

In recent decades, parents have been involved in programs that aim to improve parenting style and reduce child behavior problems. Research of preventive parenting programs has shown that these interventions generally have a positive influence on both parents and children. However, to our knowledge there is a gap in the scientific literature when it comes to randomized controlled trials of brief, manual-based structured programs which address general parenting among the population, and focus on promoting health. A four-session universal health promotion parent group program named All Children in Focus was developed. It aims at promoting parental competence and children’s positive development with the parent–child relationship as the target. There is currently no randomized controlled trial existing of the program.

Methods/Design

A prospective multicenter randomized wait-list controlled trial is being conducted. Approximately 600 parents with children ranging in age from 3–12 years have been recruited in eleven municipalities and city districts in the County of Stockholm, Sweden. Parents are randomized at baseline to an intervention group, which receives the program directly, or to a waiting-list control group, which participates in the program six months later. Changes in parenting and child health and development are assessed with measures immediately post-intervention and six months after the baseline. Observations of a minor group of parents and children are conducted to explore possible relations between parental reports and observed behaviors, as well as changes in the interaction between parent and child. Further, data collected within the evaluation will also be applied to evaluate the possible cost-effectiveness of the program.

Discussion

This paper describes a study protocol of a randomized controlled trial. Except for the quantitative outcome measures to evaluate the effectiveness of All Children in Focus, this protocol also describes health economic and qualitative analyses to deepen the knowledge of the program. We further discuss some issues regarding the implementation of the program in municipalities and city districts.

Trial registration

Current Controlled Trials ISRCTN70202532

【 授权许可】

   
2013 Lindberg et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Waylen A, Stewart-Brown S: Factors influencing parenting in early childhood: a prospective longitudinal study focusing on change. Child Care Health Dev 2010, 36(2):198-207.
• [2]Stewart-Brown S: Improving parenting: the why and the how. Arch Dis Child 2008, 93(2):102-104.
• [3]Stewart-Brown SL, Schrader-McMillan A: Parenting for mental health: what does the evidence say we need to do? Report of Workpackage 2 of the DataPrev project. Health Promot Int 2011, 26(Suppl 1):i10-28.
• [4]Webster-Stratton C: Randomized trial of two parent-training programs for families with conduct-disordered children. J Consult Clin Psychol 1984, 52(4):666-678.
• [5]Cunningham CE, Bremner R, Boyle M: Large group community-based parenting programs for families of preschoolers at risk for disruptive behaviuor disorders: utilization, cost effectiveness, and outcome. J Child Psychol Psyc 1995, 36(7):1141-1159.
• [6]Sanders MR: Triple P-positive parenting program: towards an empirically validated multilevel parenting and family support strategy for the prevention of behavior and emotional problems in children. Clin Child Fam Psychol Rev 1999, 2(2):71-90.
• [7]Furlong M, McGilloway S, Bywater T, Hutchings J, Smith SM, Donnelly M: Behavioural and cognitive-behavioural group-based parenting programmes for early-onset conduct problems in children aged 3 to 12 years. Cochrane Database Syst Rev 2012., 2CD008225
• [8]Barlow J, Smailagic N, Ferriter M, Bennett C, Jones H: Group-based parent-training programmes for improving emotional and behavioural adjustment in children from birth to three years old. Cochrane Database Syst Rev 2010., 3CD003680
• [9]Dretzke J, Davenport C, Frew E, Barlow J, Stewart-Brown S, Bayliss S, Taylor RS, Sandercock J, Hyde C: The clinical effectiveness of different parenting programmes for children with conduct problems: a systematic review of randomised controlled trials. Child and adolescent psychiatry and mental health 2009, 3(1):7. BioMed Central Full Text
• [10]Piquero AR, Farrington DP, Welsh BC, Tremblay R, Jennings WG: Effects of early family/parent training programs on antisocial behavior and delinquency. J Exp Criminol 2009, 5(2):83-120.
• [11]Kaminski JW, Valle LA, Filene JH, Boyle CL: A meta-analytic review of components associated with parent training program effectiveness. J Abnorm Child Psychol 2008, 36(4):567-589.
• [12]Lundahl B, Risser HJ, Lovejoy MC: A meta-analysis of parent training: moderators and follow-up effects. Clin Psychol Rev 2006, 26(1):86-104.
• [13]Brosnan R, Carr A: Adolescent conduct problems. In What works with children and adolescents? A critical review of psychological interventions with children, adolescents and their families. Edited by Florence KY. US: Taylor & Frances/Routledge; 2000:131-154.
• [14]Piquero A, Farrington D, Welsh B, Tremblay R, Jennings W: Effects of early family/parent training programs on antisocial behavior and delinquency. J Exp Criminol 2009, 5(2):83-120.
• [15]Kling A, Forster M, Sundell K, Melin L: A randomized controlled effectiveness trial of parent management training with varying degrees of therapist support. Behav Therapy 2010, 41(4):530-542.
• [16]Sanders MR: Triple P-positive parenting program as a public health approach to strengthening parenting. J Fam Psychol 2008, 22(4):506-517.
• [17]Eisner M, Nagin D, Ribeaud D, Malti T: Effects of a universal parenting program for highly adherent parents: a propensity score matching approach. Prev Sci 2012, 13(3):252-266.
• [18]Simkiss DE, Snooks HA, Stallard N, Davies S, Thomas MA, Anthony B, Winstanley S, Wilson L, Stewart-Brown S: Measuring the impact and costs of a universal group based parenting programme: protocol and implementation of a trial. BMC Public Health 2010, 10:364. BioMed Central Full Text
• [19]Bloomfield L, Kendall S: Parenting self-efficacy, parenting stress and child behaviour before and after a parenting programme. Primary health care research & development 2012, 13(4):364-372.
• [20]Reyno SM, McGrath PJ: Predictors of parent training efficacy for child externalizing behavior problems–a meta-analytic review. J Child Psychol Psychiatry 2006, 47(1):99-111.
• [21]Zechmeister I, Kilian R, McDaid D, group tM: Is it worth investing in mental health promotion and prevention of mental illness? A systematic review of the evidence from economic evaluations. BMC Public Health 2008, 8(1):20. BioMed Central Full Text
• [22]Knapp M, McDaid D: Making an economic case for prevention and promotion. International journal of mental health promotion 2009, 11(3):49.
• [23]Killip S, Mahfoud Z, Pearce K: What is an intracluster correlation coefficient? Crucial concepts for primary care researchers. Ann Fam Med 2004, 2(3):204-208.
• [24]Stewart-Brown S, Patterson J, Mockford C, Barlow J, Klimes I, Pyper C: Impact of a general practice based group parenting programme: quantitative and qualitative results from a controlled trial at 12 months. Arch Dis Child 2004, 89(6):519-525.
• [25]Hiscock H, Bayer JK, Price A, Ukoumunne OC, Rogers S, Wake M: Universal parenting programme to prevent early childhood behavioural problems: cluster randomised trial. BMJ 2008, 336(7639):318-321.
• [26]Bandura A: Social learning theory. Englewood Cliffs, NJ: Prentice-Hall; 1977.
• [27]Bowlby J: Attachment and loss: Vol. 1: attachment. New York: Basic Books; 1969.
• [28]Belsky J, Bell B, Bradley RH, Stallard N, Stewart-Brown SL: Socioeconomic risk, parenting during the preschool years and child health age 6 years. Eur J Public Health 2007, 17(5):508-513.
• [29]Bronfenbrenner U: Ecology of the family as a context for human development: reasearch perspectives. 22 1989, 6:723-742.
• [30]Thomas R, Zimmer-Gembeck MJ: Behavioral outcomes of parent–child interaction therapy and triple P-positive parenting program: a review and meta-analysis. J Abnorm Child Psychol 2007, 35(3):475-495.
• [31]Kendall S, Bloomfield L: Developing and validating a tool to measure parenting self-efficacy. J Adv Nurs 2005, 51(2):174-181.
• [32]Ravens-Sieberer U, Gosch A, Abel T, Auquier P, Bellach BM, Bruil J, Dur W, Power M, Rajmil L, European KG: Quality of life in children and adolescents: a European public health perspective. Soz Praventivmed 2001, 46(5):294-302.
• [33]Webster-Stratton C: Preventing conduct problems in Head Start children: strengthening parenting competencies. J Consult Clin Psychol 1998, 66(5):715-730.
• [34]Webster-Stratton C, Reid J, Hammond M: Social skills and problem-solving training for children with early-onset conduct problems: who benefits? J Child Psychol Psychiatry 2001, 42(7):943-952.
• [35]Goldberg DP, Williams P: The User’s guide to the general health questionnaire. Windsor: NFER-Wilson; 1988.
• [36]Sabourin S, Valois P, Lussier Y: Development and validation of a brief version of the dyadic adjustment scale with a nonparametric item analysis model. Psychol Assess 2005, 17(1):15-27.
• [37]Gross JJ, John OP: Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J Pers Soc Psychol 2003, 85(2):348-362.
• [38]Parkin D, Devlin N: Is there a case for using visual analogue scale valuations in cost-utility analysis? Health Econ 2006, 15(7):653-664.
• [39]Tabachnik BG, Fidell LS: Using multivariate statistics. 6th edition. Boston: Allyn and Bacon; 2013.
• [40]Baron RM, Kenny DA: The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 1986, 51(6):1173-1182.
• [41]Drummond MF, Shulpher MJ, Torrance GW, O’Brien BJ, Stoddart GL: Methods for the economic evaluation of health care programmes. 3rd edition. Oxford: Oxford University Press; 2005.
• [42]Friedman LS, Richter ED: Relationship between conflicts of interest and research results. J Gen Intern Med 2004, 19(1):51-56.
• [43]Petrosino A, Soydan H: The impact of program developers as evaluators on criminal recidivism: results from meta-analyses of experimental and quasi-experimental reserach. J Exp Criminol 2005, 1:435-450.
• [44]Hutchings J, Bywater T, Eames C, Martin P: Implementing child mental health interventions in service settings: lessons from three pragmatic randomised controlled trials in Wales. J Child Serv 2008, 3(2):17-27.