Parents Make the Difference II: Trial of a Parenting Intervention

Parents Make the Difference II: A Randomized Experiment of a Parent Training Program for Caregivers of Young Children Designed to Reduce the Use of Harsh Punishment and Improve Child-caregiver Relationships

Multisite randomized trial of a parenting intervention in Liberia for caregivers of young children. Two main objectives of the "Parents Make the Difference" program are to teach parents (a) skills for decreasing harsh punishments and replacing those with positive ways to manage children's behavior and (b) skills for having more positive interactions with their children, including interactions that encourage learning. As a result of positive changes in parenting, the investigators expect that, over time, children's behavioral and cognitive well-being will improve and that future abuse and poor developmental outcomes will be prevented in the long-term.

Study Overview

• Status: Completed
• Conditions: Child Abuse; Parenting
• Intervention / Treatment: Behavioral: Parents Make the Difference; Behavioral: Parents Make the Difference Plus

Detailed Description

This is a multisite randomized trial of a parenting intervention in Liberia for caregivers of young children. The "Parents Make the Difference" program is designed to teach parents (a) skills for decreasing harsh punishments and replacing those with positive ways to manage children's behavior and (b) skills for having more positive interactions with their children. As a result of positive changes in parenting, the investigators expect that, over time, children's behavioral and cognitive well-being will improve and that the intervention will prevent future abuse and poor developmental outcomes in the long-term. This study will randomize 816 caregivers of children ages 3 or 4 years to 1 of 3 study arms: standard group program, group program plus home visits, waitlist control.

• Study Type: Interventional
• Enrollment (Actual): 201
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Liberia
  • Monrovia, Liberia
    • International Rescue Committee

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• caregiver of child ages 3 or 4
• live within catchment area of each study site
• caregiver is at least 18 years old

Exclusion Criteria:

• does not live with child

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Parents Make the Difference; Parents Make the Difference (Caregivers attend 10 group parent training sessions)	Behavioral: Parents Make the Difference; 10 parent training sessions delivered to groups of caregivers
Experimental: Parents Make the Difference Plus; Parents Make the Difference Plus (Caregivers attend 10 group parent training sessions and receive 3 home visits)	Behavioral: Parents Make the Difference Plus; 10 parent training sessions delivered to groups of caregivers, with 3 home visits
No Intervention: Waitlist Control; No parenting intervention until the end of the study period

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Caregiver use of harsh discipline practices; assessed using Discipline Interview, Locally-derived items	Extent to which caregivers engage in harsh discipline practices	1 month post treatment
Parent-Child Interactions (Parental Acceptance-Rejection Questionnaire; Locally-derived items assessing positive interactions)	Quality of parent-child relationships and interactions	1 month post treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Caregiver use of harsh discipline practices; assessed using Discipline Interview, Locally-derived items	Use of harsh discipline practices, including physical and verbal strategies	12 months post treatment
Parent-Child Interactions (Parental Acceptance-Rejection Questionnaire; Locally-derived items assessing positive interactions)	Quality of parent-child relationships and interactions	12 months post treatment
Child social-emotional development and functioning: Ages and Stages Questionnaire; Strengths and Difficulties Questionnaire: emotion problems and peer problems subscales	Indicators of child emotional problems and problems in peer relationships	1 and 12 months post treatment
Child behavior: Locally-derived measure of disruptive/non-compliant behaviors; Strengths and Difficulties Questionnaire (conduct problems subscale)	Frequency of disruptive behaviors / SDQ items related to behavioral problems	1 and 12 months post treatment
Parental Stress: Parental Stress Scale	Level of caregiver parenting-related stress	1 and 12 months post treatment
Parental knowledge of child development: Locally-derived scale	Locally relevant indicators of parental knowledge about child development	1 and 12 months post treatment
Marital relationship quality: selected items from Conflict Tactics Scale and locally-derived scale of marital relationship quality	Indicators of quality of marital interactions, including relationship violence	1 and 12 months post treatment
Caregiver mental health: General Health Questionnaire (subscale A), Patient Health Questionnaire-9	Indicators of caregiver mental health symptoms	1 and 12 months post treatment
Handwashing Behavior Indicators (e.g., access to hand washing station)	Basic indicators of hand washing behavior and resources	1 and 12 months post treatment
Child cognitive skills (verbal ability); assessed with a story comprehension task and instruction-following task	Child verbal abilities (brief assessment)	1 and 12 months post treatment

Collaborators and Investigators

• Sponsor: Duke University
• Collaborators: International Rescue Committee
• Investigators: Principal Investigator: Eve Puffer, PhD, Duke University

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2016
• Primary Completion (Actual): December 1, 2016
• Study Completion (Actual): December 1, 2016

Study Registration Dates

• First Submitted: March 7, 2016
• First Submitted That Met QC Criteria: July 28, 2016
• First Posted (Estimated): August 2, 2016

Study Record Updates

• Last Update Posted (Estimated): February 21, 2024
• Last Update Submitted That Met QC Criteria: February 19, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Other Study ID Numbers: pmd2

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: following anonymization and publication

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No