Exploring the potential utility and impact of a universal, multi-component early parenting intervention through a community-based, controlled trial

Hickey, Gráinne; McGilloway, Sinéad; Leckey, Yvonne; Leavy, Shane; Stokes, Ann; O’Connor, Siobhán; Donnelly, Michael; Bywater, Tracey

doi:10.1016/j.childyouth.2020.105458

Cited by 12 publications

(12 citation statements)

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“…Compared to recreational activities, these structured academic activities might give children fewer opportunities to explore feelings in self and others, and thus have smaller effects on subsequent behavioral outcomes. Consistent with previous research [ 36 , 37 ], this study also demonstrates a need to develop comprehensive parenting programs aiming to train parents on multiple aspects of parenting such as guiding them to provide sensitive and responsive care as well as assisting them to establish positive interactions with their children through different activities.…”

Section: Discussionsupporting

confidence: 84%

A Longitudinal Study of the Relation between Childhood Activities and Psychosocial Adjustment in Early Adolescence

Wong

Tung

Rao

et al. 2021

IJERPH

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Background: Although an increasing body of research shows that excessive screen time could impair brain development, whereas non-screen recreational activities can promote the development of adaptive emotion regulation and social skills, there is a lack of comparative research on this topic. Hence, this study examined whether and to what extent the frequency of early-life activities predicted later externalizing and internalizing problems. Methods: In 2012/13, we recruited Kindergarten 3 (K3) students from randomly selected kindergartens in two districts of Hong Kong and collected parent-report data on children’s screen activities and parent–child activities. In 2018/19, we re-surveyed the parents of 323 students (aged 11 to 13 years) with question items regarding their children’s externalizing and internalizing symptoms in early adolescence. Linear regression analyses were conducted to examine the associations between childhood activities and psychosocial problems in early adolescence. Results: Early-life parent–child activities (β = −0.14, p = 0.012) and child-alone screen use duration (β = 0.15, p = 0.007) independently predicted externalizing problems in early adolescence. Their associations with video game exposure (β = 0.19, p = 0.004) and non-screen recreational parent–child activities (β = −0.14, p = 0.004) were particularly strong. Conclusions: Parent–child play time is important for healthy psychosocial development. More efforts should be directed to urge parents and caregivers to replace child-alone screen time with parent–child play time.

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Section: Discussionsupporting

confidence: 84%

A Longitudinal Study of the Relation between Childhood Activities and Psychosocial Adjustment in Early Adolescence

Wong

Tung

Rao

et al. 2021

IJERPH

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“…Although no effectiveness results have been published for these parent and baby programs the Mellow Bumps trial ‘THRIVE’ process evaluation findings suggest that vulnerable families did not benefit and felt marginalized, and that more is needed to support such families in attending the parent programs for the full duration [ 32 ]. However, a controlled trial in Ireland that investigated IY-I as part of a wraparound service (called the ‘Up2Two’) and found parenting efficacy and child cognitive stimulation effects [ 33 ]. Overall, more work is needed to identify effective parenting interventions for families with infants/toddlers.…”

Section: Discussionmentioning

confidence: 99%

A randomized controlled trial of a proportionate universal parenting program delivery model (E-SEE Steps) to enhance child social-emotional wellbeing

et al. 2022

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Background Evidence for parenting programs to improve wellbeing in children under three is inconclusive. We investigated the fidelity, impact, and cost-effectiveness of two parenting programs delivered within a longitudinal proportionate delivery model (‘E-SEE Steps’). Methods Eligible parents with a child ≤ 8 weeks were recruited into a parallel two-arm, assessor blinded, randomized controlled, community-based, trial with embedded economic and process evaluations. Post-baseline randomization applied a 5:1 (intervention-to-control) ratio, stratified by primary (child social-emotional wellbeing (ASQ:SE-2)) and key secondary (maternal depression (PHQ-9)) outcome scores, sex, and site. All intervention parents received the Incredible Years® Baby Book (IY-B), and were offered the targeted Infant (IY-I)/Toddler (IY-T) program if eligible, based on ASQ:SE-2/PHQ-9 scores. Control families received usual services. Fidelity data were analysed descriptively. Primary analysis applied intention to treat. Effectiveness analysis fitted a marginal model to outcome scores. Cost-effectiveness analysis involved Incremental Cost-Effectiveness Ratios (ICERs). Results The target sample (N = 606) was not achieved; 341 mothers were randomized (285:56), 322 (94%) were retained to study end. Of those eligible for the IY-I (n = 101), and IY-T (n = 101) programs, 51 and 21 respectively, attended. Eight (of 14) groups met the 80% self-reported fidelity criteria. No significant differences between arms were found for adjusted mean difference scores; ASQ:SE-2 (3.02, 95% CI: -0.03, 6.08, p = 0.052), PHQ-9 (-0.61; 95% CI: -1.34, 0.12, p = 0.1). E-SEE Steps had higher costs, but improved mothers’ Health-related Quality of Life (0.031 Quality Adjusted Life Year (QALY) gain), ICER of £20,062 per QALY compared to control. Serious adverse events (n = 86) were unrelated to the intervention. Conclusions E-SEE Steps was not effective, but was borderline cost-effective. The model was delivered with varying fidelity, with lower-than-expected IY-T uptake. Changes to delivery systems and the individual programs may be needed prior to future evaluation. Trial registration International Standard Randomized Controlled Trial Number: ISRCTN11079129.

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“…This evaluation was conducted within a larger research programme (Hickey et al 2016) which incorporates a non-randomised effectiveness trial and economic analysis of the PIN intervention (Hickey et al 2020). The overarching aims of the PIN process evaluation are to gain an understanding of the active ingredients of the programme, explore how implementation is progressing and systematically evaluate the processes and conditions which influence programme implementation and effectiveness (Hickey et al 2016).…”

Section: Study Backgroundmentioning

confidence: 99%

Understanding the theoretical underpinnings of preventative early parenting interventions: A theory-based evaluation

Hickey¹,

McGilloway²,

Leckey

et al. 2023

Evaluation

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Early parenting programmes which promote nurturing care for children aged 0–3 years are popular in community-based primary health care settings. However, little research has explored the causal and theoretical assumptions underpinning these programmes. This paper outlines a programme theory evaluation which was conducted to explore the change principles inherent in a complex early parenting intervention, the parent and infant programme, which aims to support parents and infants aged 0–2 years. A documentary analysis and qualitative interviews ( n = 19) with key stakeholders were undertaken to describe programme components, outline intervention objectives and identify the mechanisms assumed to be important to programme success. The interpretation of the findings was informed by the Consolidated Framework for Implementation Research, within which we explore and describe the theoretical perspectives that underpin the programme and guide its operationalisation and delivery. The importance of attending to the causal mechanisms underlying early parenting interventions is outlined.

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Exploring the potential utility and impact of a universal, multi-component early parenting intervention through a community-based, controlled trial

Cited by 12 publications

References 57 publications

A Longitudinal Study of the Relation between Childhood Activities and Psychosocial Adjustment in Early Adolescence

A Longitudinal Study of the Relation between Childhood Activities and Psychosocial Adjustment in Early Adolescence

A randomized controlled trial of a proportionate universal parenting program delivery model (E-SEE Steps) to enhance child social-emotional wellbeing

Understanding the theoretical underpinnings of preventative early parenting interventions: A theory-based evaluation

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