Integrating Evidence-based Approaches to Prevent Child Maltreatment in Kyrgyzstan

The University of Texas at Arlington396 enrolled

Overview

The goal of this clinical trial is to learn if a family-based prevention program works to prevent child maltreatment risk and other adverse childhood experiences (ACEs) among families in Kyrgyzstan. It will also learn about the safety, feasibility, and acceptability of the program. The main questions it aims to answer are: (1) Does the integrated family and economic empowerment program improve children's self-regulation, behavioral adjustment, and school adaptation? (2) Is the program feasible and acceptable for families and schools in Kyrgyzstan? Researchers will compare the integrated prevention program to bolstered standard school services to see if the program improves child and family outcomes. Participants will: (a) Be randomly assigned to either the prevention program or bolstered standard school services; (b) Attend weekly group sessions for 16 weeks (if assigned to the prevention program); (c) Complete surveys at baseline, immediately after the 16-week program, and at the end of the school year; and (d) Provide information about child behavior, (co)parenting, family relationships, and financial well-being. Results from this pilot study will inform a future larger trial.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

396

Conditions

Parent-Child Relationships Child Maltreatment

Interventions

Integrated Family and Economic Empowerment ProgramBEHAVIORAL

This intervention uniquely integrates three evidence-based approaches (strengthening families, coparenting and father involvement, and economic empowerment) into a single coordinated prevention model. Unlike stand-alone parenting or couples programs, it simultaneously targets family processes (communication, co-parenting, stress regulation), child self-regulation and school adaptation, and structural economic stressors through asset-building and financial literacy components. The program is culturally adapted for Kyrgyzstani families using stakeholder-guided methods and delivered within school settings by trained social pedagogues. The integration of behavioral family intervention with economic strengthening distinguishes it from traditional parenting-only or school-only prevention programs.

Eligibility

Sex: ALLMin age: 6 YearsMax age: 74 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Two adult caregivers (≥18 years old) who identify as co-parents or primary caregivers of a target child * Target child aged 6-9 years enrolled in one of the participating schools in Bishkek, Kyrgyzstan * Both caregivers identify each other as family members responsible for the care of the child (e.g., parents, grandparents, or other adult caregivers) * Both caregivers report feeling safe participating together in a family-based program * Both caregivers are fluent in either Russian or Kyrgyz * Both caregivers are able and willing to provide informed consent * Child is able to provide assent and participate in age-appropriate assessments. * Family is willing to participate in study procedures, including random assignment and completion of assessments at baseline, post-intervention (16 weeks), and end-of-school-year follow-up. Exclusion Criteria: * Report of severe physical or sexual intimate partner violence between caregivers within the past 12 months, as assessed during screening * Either caregiver is unable to provide informed consent * Either caregiver has a cognitive impairment or a severe mental health condition that would preclude participation in group sessions * Family plans to relocate outside the study area during the intervention period * Child has a severe developmental or medical condition that would prevent participation in assessments * Inability to communicate in Russian or Kyrgyz.

Outcomes

Primary Outcomes

Strengths and Difficulties Questionnaire (SDQ) Parent Report

Child behavioral and emotional adjustment will be assessed using the Strengths and Difficulties Questionnaire (SDQ) Parent Report, a 25-item caregiver-report measure assessing emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Each item is scored on a 3-point scale (0-2). The Total Difficulties Score ranges from 0 to 40, with higher scores indicating greater behavioral and emotional difficulties (poorer adjustment). The Prosocial Behavior subscale ranges from 0 to 10, with higher scores indicating greater prosocial behavior.

Time frame: Up to 1.5 years after baseline

Strengths and Difficulties Questionnaire (SDQ) Self-Report (Youth version)

Child self-regulation will be assessed using the Strengths and Difficulties Questionnaire (SDQ) Self-Report (Youth Version), a 25-item self-report measure completed by children and adolescents that assesses emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Each item is rated on a 3-point scale (0 = Not True, 1 = Somewhat True, 2 = Certainly True). The Total Difficulties Score ranges from 0 to 40, with higher scores indicating greater emotional and behavioral dysregulation (poorer self-regulation). The Prosocial Behavior subscale ranges from 0 to 10, with higher scores indicating greater prosocial behavior and social competence.

Time frame: Baseline through 1.5 years after baseline

Strengths and Difficulties Questionnaire (SDQ) Teacher Report

Child school adaptation will be assessed using the Strengths and Difficulties Questionnaire (SDQ) Teacher Report, a 25-item teacher-completed measure assessing emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Items are rated on a 3-point scale (0 = Not True, 1 = Somewhat True, 2 = Certainly True). The Total Difficulties Score ranges from 0 to 40, with higher scores indicating greater emotional and behavioral difficulties (poorer functioning). The Prosocial Behavior subscale ranges from 0 to 10, with higher scores indicating greater prosocial behavior.