A mixed methods evaluation of the large-scale implementation of a school- and community-based parenting program to reduce violence against children in Tanzania: a study protocol

Abstract

Background Despite the rapid dissemination of parenting programs aiming to reduce and prevent violence against children (VAC) worldwide, there is limited knowledge about and evidence of the implementation of these programs at scale. This study addresses this gap by assessing the quality of delivery and impact of an evidence-based parenting program for parents/caregivers and their adolescent girls aged 9 to 14—Parenting for Lifelong Health Teens (PLH-Teens), known locally as Furaha Teens—on reducing VAC at scale in Tanzania. The study will explore participating family and staff perspectives on program implementation and examine factors associated with implementation and how implementation quality is associated with intervention outcomes when the program is delivered to approximately 50,000 parent-child dyads (N = 100,000) in schools and community centers across eight districts of Tanzania. Methods This mixed-methods study will answer the following research questions: (1) what is the implementation quality and fidelity of PLH-Teens at scale in Tanzania; (2) what factors are associated with the quality of delivery and implementation fidelity of PLH-Teens; (3) how are implementation quality and fidelity associated with intervention outcomes; (4) what are participant and implementing staff perspectives on the acceptability, appropriateness, feasibility, benefits, and challenges of delivering PLH-Teens in their schools and communities; (5) what is the impact of PLH-Teens on VAC and participant well-being; and (6) how much does it cost to deliver PLH-Teens at scale? Qualitative and quantitative data will be collected directly from implementers, parents/caregivers, and adolescents using pre-post questionnaires, observational assessments, cost surveys, focus groups, and interviews. Qualitative data will be analyzed thematically with the aid of NVIVO software. Quantitative data will be cleaned and analyzed using methods such as correlation, regression, and structural equation models using Stata and R. COREQ and TREND guidelines will be used, where appropriate. Discussion Findings will provide vital insights into some of the factors related to quality implementation at scale. Lessons learned regarding the implementation of PLH-Teens at scale will be applied in Tanzania, and also in the delivery of PLH parenting programs globally.

A hybrid digital parenting programme to prevent abuse of adolescents in Tanzania: study protocol for a pragmatic cluster-randomised controlled trial

“…The in-person PLH Teens programme (locally known in Tanzania as Furaha Teens ) was successfully delivered to 75,061 Tanzanian caregivers and children with promising positive impact in a large-scale pre-post evaluation, including reduced child maltreatment, improved family relationships, promoted child development, and reduced IPV perpetration and experience [ 39 ]. The Tanzanian-adapted version of PLH Teens also demonstrated high cultural acceptability and programme fidelity when delivered at scale.…”

The development, reliability, and validity of the Facilitator Assessment Tool: An implementation fidelity measure used in Parenting for Lifelong Health for Young Children

“…These studies found improved positive parenting and child behaviour, while reducing family violence. Further information about PLH and its growing evidence base is available in numerous published papers, protocols, and resources (e.g., Martin, Lachman, et al, 2021 ; Shenderovich et al, 2020 ; World Health Organisation [WHO], 2020 ). As the evidence supporting parenting programmes such as PLH is positive and substantial, studying their implementation fidelity represents an important way to explore which programme elements are correlated with outcomes and how to improve delivery.…”

Reflections on Networking Dynamics to Address Violence Against Children in Tanzania

“…Recently, investigators have examined the prevalence, context, and health outcomes of VAC (Vagi et al, 2016), its impact (Hillis et al, 2017), possible remedies (Lachman et al, 2020;Martin et al, 2021), and existing interventions (Reuben et al, 2022;Wangamati et al, 2022). Although some research has been carried out on community-based child protection mechanisms in Tanzania (e.g., Reuben et al, 2022), there is still limited understanding of the dynamics of civil society networks and connections at different levels as well as the advantages of networks, and the challenges they face, in regard to VAC prevention and response.…”