Preventing child maltreatment and child conduct problems in LMIC: A randomised controlled trial of parenting for lifelong health (PLH) for parents of children aged 2-9

Introduction: Child maltreatment can be prevented through early intervention with parent skills training. However, very few parenting programmes have been developed for or evaluated in low- and middle-income countries. The... [ view full abstract ]

Introduction: Child maltreatment can be prevented through early intervention with parent skills training. However, very few parenting programmes have been developed for or evaluated in low- and middle-income countries. The Parenting for Lifelong Health Programme (for parents of children aged 2-9) was developed to address this gap.
Objectives: To test a novel, evidence-informed, low-cost parenting programme in South Africa, to assess whether it: (1) reduces harsh parenting; (2) increases positive parenting; (3) reduces child conduct problems, which can trigger harsh parenting.
Methods: 296 parents were recruited from peri-urban townships near Cape Town, South Africa. Half were randomly assigned to receive the 12-session parenting programme, and half to the control group. Harsh parenting was assessed using the ISPCAN Child Abuse Screening Tool (the ICAST-P); positive parenting using two subscales of the Parenting Young Children measure (Supporting Positive Behaviour and Setting Limits), and child behaviour using the Eyberg Child Behavior Inventory. Parenting and child behaviour were also assessed through observation, using a modified version of the Dyadic Parent-Child Interaction System. These were assessed at baseline, post-test (immediately after the intervention group had completed the 12-week programme), and one year after the post-test (with follow-up rates over 90% at both post-test and one-year follow-up). A strict intent-to-treat analysis was conducted, as well as a per-protocol analysis.
Results and Conclusions: Parent self-report data at post-test suggests that the intervention increased positive parenting, and that there were decreases in harsh parenting and in child conduct problems, in both experimental and control groups. The intervention significantly reduced the intensity of child conduct problems at post-test, compared with the control group. Further results from the observational data and one-year follow-up will also be presented. The Parenting for Lifelong Health Programme may potentially be useful for improving positive parenting in low- and middle-income settings.