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Parenting for Lifelong Health: a pragmatic cluster randomised controlled trial of a non-commercialised parenting programme for adolescents and their families in South Africa.
Cluver, Lucie D; Meinck, Franziska; Steinert, Janina I; Shenderovich, Yulia; Doubt, Jenny; Herrero Romero, Rocio; Lombard, Carl J; Redfern, Alice; Ward, Catherine L; Tsoanyane, Sibongile; Nzima, Divane; Sibanda, Nkosiyapha; Wittesaele, Camille; De Stone, Sachin; Boyes, Mark E; Catanho, Ricardo; Lachman, Jamie McLaren; Salah, Nasteha; Nocuza, Mzuvukile; Gardner, Frances.
Afiliação
  • Cluver LD; Centre for Evidence-Based Interventions, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
  • Meinck F; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
  • Steinert JI; Centre for Evidence-Based Interventions, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
  • Shenderovich Y; OPTENTIA Research Focus Group, School of Behavioural Sciences, North-West University, Vanderbijlpark, South Africa.
  • Doubt J; Centre for Evidence-Based Interventions, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
  • Herrero Romero R; Centre for Evidence-Based Interventions, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
  • Lombard CJ; Institute of Criminology, University of Cambridge, Cambridge, UK.
  • Redfern A; Centre for Evidence-Based Interventions, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
  • Ward CL; UNICEF Innocenti Office of Research, Florence, Italy.
  • Tsoanyane S; Centre for Evidence-Based Interventions, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
  • Nzima D; Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa.
  • Sibanda N; School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
  • Wittesaele C; Centre for Evidence-Based Interventions, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
  • De Stone S; Department of Psychology and Safety and Violence Initiative, University of Cape Town, Cape Town, South Africa.
  • Boyes ME; Clowns Without Borders South Africa, Durban, South Africa.
  • Catanho R; Department of Sociology & Anthropology, University of Fort Hare, Alice, South Africa.
  • Lachman JM; Ali-Douglas Research Network, Bulawayo, Zimbabwe.
  • Salah N; Department of International Development, London School of Economics and Political Science, London, UK.
  • Nocuza M; Centre for Evidence-Based Interventions, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
  • Gardner F; Warwick Medical School, Warwick, UK.
BMJ Glob Health ; 3(1): e000539, 2018.
Article em En | MEDLINE | ID: mdl-29564157
ABSTRACT

OBJECTIVE:

To assess the impact of 'Parenting for Lifelong Health Sinovuyo Teen', a parenting programme for adolescents in low-income and middle-income countries, on abuse and parenting practices.

DESIGN:

Pragmatic cluster randomised controlled trial.

SETTING:

40 villages/urban sites (clusters) in the Eastern Cape province, South Africa.

PARTICIPANTS:

552 families reporting conflict with their adolescents (aged 10-18). INTERVENTION Intervention clusters (n=20) received a 14-session parent and adolescent programme delivered by trained community members. Control clusters (n=20) received a hygiene and hand-washing promotion programme. MAIN OUTCOME

MEASURES:

Primary

outcomes:

abuse and parenting practices at 1 and 5-9 months postintervention. Secondary

outcomes:

caregiver and adolescent mental health and substance use, adolescent behavioural problems, social support, exposure to community violence and family financial well-being at 5-9 months postintervention. Blinding was not possible.

RESULTS:

At 5-9 months postintervention, the intervention was associated with lower abuse (caregiver report incidence rate ratio (IRR) 0.55 (95% CI 0.40 to 0.75, P<0.001); corporal punishment (caregiver report IRR=0.55 (95% CI 0.37 to 0.83, P=0.004)); improved positive parenting (caregiver report d=0.25 (95% CI 0.03 to 0.47, P=0.024)), involved parenting (caregiver report d=0.86 (95% CI 0.64 to 1.08, P<0.001); adolescent report d=0.28 (95% CI 0.08 to 0.48, P=0.006)) and less poor supervision (caregiver report d=-0.50 (95% CI -0.70 to -0.29, P<0.001); adolescent report d=-0.34 (95% CI -0.55 to -0.12, P=0.002)), but not decreased neglect (caregiver report IRR 0.31 (95% CI 0.09 to 1.08, P=0.066); adolescent report IRR 1.46 (95% CI 0.75 to 2.85, P=0.264)), inconsistent discipline (caregiver report d=-0.14 (95% CI -0.36 to 0.09, P=0.229); adolescent report d=0.03 (95% CI -0.20 to 0.26, P=0.804)), or adolescent report of abuse IRR=0.90 (95% CI 0.66 to 1.24, P=0.508) and corporal punishment IRR=1.05 (95% CI 0.70 to 1.57, P=0.819). Secondary outcomes showed reductions in caregiver corporal punishment endorsement, mental health problems, parenting stress, substance use and increased social support (all caregiver report). Intervention adolescents reported no differences in mental health, behaviour or community violence, but had lower substance use (all adolescent report). Intervention families had improved economic welfare, financial management and more violence avoidance planning (in caregiver and adolescent report). No adverse effects were detected.

CONCLUSIONS:

This parenting programme shows promise for reducing violence, improving parenting and family functioning in low-resource settings. TRIAL REGISTRATION NUMBER Pan-African Clinical Trials Registry PACTR201507001119966.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2018
Texto completo
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PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2018