Effectiveness of a Positive Parental Practices Training Program for Chilean Preschoolers’ Families: A Randomized Controlled Trial

Abstract

Background: Evidence for the effectiveness of parental training as a strategy for promotion of positive parental practices and prevention of child behavior problems in low and middle income countries is not conclusive. This study aims to assess the effectiveness of a universal positive parental training program designed for this context, “Día a Día” UdeC © (“Day by Day” University of Concepción), in Chilean preschoolers’ families (3–6 years old children).Methods: A cluster randomized controlled trial (cRCT) was carried out in 19 preschool education centers. There were two treatment arms: 10 centers (including 178 families) were randomly assigned to the intervention group and nine centers (including 154 families) were assigned to the waiting list control condition. Intervention groups received Day by Day UdeC, a six group sessions program for parents, including two group sessions for preschool educators, focused in affective communication; daily and child-directed play; directed attention; routines and transitions; reinforcement and incentive programs; planned inattention-ignore and time out; and logical consequences. Parental practices, parental satisfaction, and presence of children behavioral problems were examined at two-time points: T1 (4 weeks before intervention) and T2 (5–6 weeks after intervention).Results: Intention-to-treat analysis shows a reduction in physical punishment and an increase in parental involvement, as well as a reduction in children behavioral problems. A per-protocol analysis revealed an additional effect: increase in observed parental practices.Conclusion: This cRCT provided evidence for the effectiveness of a parental training program for the promotion of positive parental practices in low and middle income countries. The observed effects of the program in decreasing physical punishment and children’s behavioral problems make it a promising strategy for prevention purposes.Trial Registration: This study was registered under ISRCTN.com (ISRCTN90762146; https://doi.org/10.1186/ISRCTN90762146).

Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis

“…Second, our review focused on parenting interventions for children during the first 3 years of life. As a result, other relevant parenting interventions with preschool-aged children [67,68] or those covering a broader age range of children (e.g., 2-to 6-year-olds) [69,70] were excluded, which limits the generalizability of our results. Third, the reporting of the psychometric properties of measures (e.g., reliability and validity evidence, adaptation procedures) was highly variable across studies, with many studies not reporting any such details.…”

Randomized cluster trial of a parenting program in Chile: Key mediators in the decrease in behavior problems in preschool children

“…The following theoretical and methodological components, identified as fundamental parts of the most effective programs, were incorporated in the Day by Day program: a foundation in social learning theories, the development of positive interaction skills of parents with their children, and the use of several strategies to enhance adherence (Gardner et al, 2009; Kaminski, Valle, Filene, & Boyle, 2008). A more detailed description of this program, as well as the method of this cluster randomized clinical trial and its overall effectiveness, appears elsewhere (Rincon et al, 2018). The primary outcomes of this trial were the frequency of disruptive behaviors and the concern they cause for the mother or the father.…”

Programas de fortalecimiento de prácticas parentales: un aporte a la prevención de conductas externalizantes en preescolares

“…En este tipo de intervención -de carácter grupal-los elementos centrales de los programas de entrenamiento parental efectivos se focalizan en el desarrollo de capacidades para incrementar en los participantes interacciones positivas con los niños a su cuidado y la inclusión de habilidades para favorecer entre todos ellos la comunicación emocional 14,35,36 . Los programas de entrenamiento parental, son una de las estrategias más investigadas en la intervención con conductas externalizantes, ya sea como componente exclusivo o en el marco de estrategias multicomponentes 6,7,37,38 . El meta-análisis de Furlong et al (2012) de programas de entrenamiento parental mostró que estos disminuían las conductas problemáticas de niños y niñas así como las prácticas parentales "rudas" hacia ellos y ellas mejorando al mismo tiempo las competencias parentales, el bienestar y salud mental de las personas participantes 7 .…”

“…En Chile existe un programa de carácter promocional y preventivo de tipo universal que fue probado en un ensayo clínico aleatorizado por conglomerados con muy buenos resultados: Día a Día UdeC 6,44 (tabla 1). El éxito en términos de disminución de conductas externalizantes de preescolares y de mejoras en prácticas de crianza van en la misma línea de los programas reconocidos por Blueprints con óp-timos niveles de efectividad, altos estándares de calidad y reducción potencial de maltrato infantil 6,[40][41][42][43][44] .…”

“…Se ha demostrado que los programas de intervención dirigidos a madres y padres, tanto en prevención como en tratamiento, son cruciales en la modificación de conductas externalizantes en niños, siendo el entrenamiento en habilidades parentales una de las estrategias más estudiadas y con mejores resultados 6,7 . Los padres y/o cuidadores/as de niños que presentan conductas externalizantes muestran frecuentemente un estilo de crianza negativo y coercitivo 8 , que a partir de dichos programas puede ser modificado, beneficiando la evolución del diagnóstico.…”