Multisite randomized trial of a parenting intervention in Liberia for caregivers of young children. Two main objectives of the "Parents Make the Difference" program are to teach parents (a) skills for decreasing harsh punishments and replacing those with positive ways to manage children's behavior and (b) skills for having more positive interactions with their children, including interactions that encourage learning. As a result of positive changes in parenting, the investigators expect that, over time, children's behavioral and cognitive well-being will improve and that future abuse and poor developmental outcomes will be prevented in the long-term.
This is a multisite randomized trial of a parenting intervention in Liberia for caregivers of young children. The "Parents Make the Difference" program is designed to teach parents (a) skills for decreasing harsh punishments and replacing those with positive ways to manage children's behavior and (b) skills for having more positive interactions with their children. As a result of positive changes in parenting, the investigators expect that, over time, children's behavioral and cognitive well-being will improve and that the intervention will prevent future abuse and poor developmental outcomes in the long-term. This study will randomize 816 caregivers of children ages 3 or 4 years to 1 of 3 study arms: standard group program, group program plus home visits, waitlist control.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
201
10 parent training sessions delivered to groups of caregivers
10 parent training sessions delivered to groups of caregivers, with 3 home visits
International Rescue Committee
Monrovia, Liberia
Caregiver use of harsh discipline practices; assessed using Discipline Interview, Locally-derived items
Extent to which caregivers engage in harsh discipline practices
Time frame: 1 month post treatment
Parent-Child Interactions (Parental Acceptance-Rejection Questionnaire; Locally-derived items assessing positive interactions)
Quality of parent-child relationships and interactions
Time frame: 1 month post treatment
Caregiver use of harsh discipline practices; assessed using Discipline Interview, Locally-derived items
Use of harsh discipline practices, including physical and verbal strategies
Time frame: 12 months post treatment
Parent-Child Interactions (Parental Acceptance-Rejection Questionnaire; Locally-derived items assessing positive interactions)
Quality of parent-child relationships and interactions
Time frame: 12 months post treatment
Child social-emotional development and functioning: Ages and Stages Questionnaire; Strengths and Difficulties Questionnaire: emotion problems and peer problems subscales
Indicators of child emotional problems and problems in peer relationships
Time frame: 1 and 12 months post treatment
Child behavior: Locally-derived measure of disruptive/non-compliant behaviors; Strengths and Difficulties Questionnaire (conduct problems subscale)
Frequency of disruptive behaviors / SDQ items related to behavioral problems
Time frame: 1 and 12 months post treatment
Parental Stress: Parental Stress Scale
Level of caregiver parenting-related stress
Time frame: 1 and 12 months post treatment
Parental knowledge of child development: Locally-derived scale
Locally relevant indicators of parental knowledge about child development
Time frame: 1 and 12 months post treatment
Marital relationship quality: selected items from Conflict Tactics Scale and locally-derived scale of marital relationship quality
Indicators of quality of marital interactions, including relationship violence
Time frame: 1 and 12 months post treatment
Caregiver mental health: General Health Questionnaire (subscale A), Patient Health Questionnaire-9
Indicators of caregiver mental health symptoms
Time frame: 1 and 12 months post treatment
Handwashing Behavior Indicators (e.g., access to hand washing station)
Basic indicators of hand washing behavior and resources
Time frame: 1 and 12 months post treatment
Child cognitive skills (verbal ability); assessed with a story comprehension task and instruction-following task
Child verbal abilities (brief assessment)
Time frame: 1 and 12 months post treatment
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