scholarly journals 8.L. Workshop: The children and parents in focus: Challenges in evaluating a public health approach to parenting

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Intervention Program ◽  
Controlled Trial ◽  
Large Population ◽  
Population Level ◽  
Cluster Randomised Controlled Trial ◽  
Parenting Programs ◽  
Public Health Approach ◽  
Children And Parents ◽  
Externalising Problems

Abstract Parenting programs have strong evidence in promoting positive changes in both parents and children and are considered as evidence-based treatments for children with externalising problems such as conduct problems and ADHD. It is expected that a public health approach to parenting - i.e., the availability of parenting programs to all parents regardless of their risk status - will reduce the number of children with externalising problems at the population level. However, the evidence on the effectiveness of this approach is inconclusive. This is largely due to difficulties in conducting the needed large population trials of universal parenting programs. The objective of the workshop is to facilitate a discussion on planning and conducting research projects to successfully evaluate the effectiveness of psychological interventions such as parenting programs when they are offered universally to everyone. We will describe three main challenges in evaluating a public health approach to parenting: difficulties in collecting data from the whole population (and not only those exposed to the intervention), lack of validated instruments to measure population-level impact, and low program exposure. To illustrate our points, we use a population-based cluster randomised controlled trial as an example. The aim of the project - Children and Parents in Focus - was to test the effectiveness of a universally offered parenting program in addressing emotional and behavioural problems in preschool children. The project was carried out for four years in a municipality with 200 000 inhabitants in Sweden. Data were collected from mothers, fathers and teachers of over 7 000 children aged 3 to 5 years. The workshop will include a brief introduction and three presentations. In the first presentation, we focus on recruitment of parents into the study. We discuss the rational for recruiting parents of all children aged 3-5 into the study through child health centres and the steps that we took to increase the number of parents who participated in the study. In the second presentation, we describe the primary outcome measure in the study i.e., the Strengths and Difficulties Questionnaires (SDQ) collected from fathers, mothers and preschool teachers. We discuss how we validated the SDQ for all the three informants and developed a guideline for using the SDQ during routine health check-ups. In the third presentation, we explain our challenges in recruiting parents to the intervention, particularly the restrictions imposed on us by the trial design and describe how we addressed low program participation. After each presentation, the participants will be invited to share their experiences, thoughts and ideas. Their comments will be first collected through a digital interactive platform and then discussed in the room. Key messages Successful evaluation of a public health interventions at the population-level requires ample attention to the recruitment of participants into research and intervention. Program uptake can be increased using simple low cost direct-to-consumer marketing strategies; however, it does take time to build demand for the program.

Using a simple direct-to-consumer marketing strategy to increase participation in parenting programs

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Salari ◽  
A Dahlberg ◽  
A Sarkadi ◽  
K Fängström
Keyword(s):  
Marketing Strategy ◽  
Large Population ◽  
Population Level ◽  
Small Sample ◽  
Parenting Programs ◽  
Routine Practice ◽  
Mothers And Fathers ◽  
Direct To Consumer ◽  
Child Behavioural Problems ◽  
Consumer Marketing

Abstract Low participation in evidence-based parenting programs not only presents a major challenge for population trials where a minimum level of intervention exposure is necessary to detect population-level impact, but also undermines the incorporation of these programs into routine practice settings. As part of a large population trial, we aimed to increase participation in a series of parenting seminars by using a simple direct-to-consumer marketing strategy, i.e., redesigning the program flyer. We captured parents' attention by affirming that “parenting is not always easy”, highlighted the potential benefits of participation, clarified what participation entailed, and addressed some of the common barriers such as the stigma associated with participation in parenting programs. Because fathers and mothers were shown to have different needs, we tailored the flyers to mothers and fathers separately. Testing the flyers on a small sample of parents showed that both mothers and fathers perceived the flyers as relevant. As expected, mothers were more likely to express interest in the program when they saw the flyer which focused on benefits related to dealing with child behavioural problems and featured a mother-child dyad, while fathers preferred the flyer which highlighted the benefits related to dealing with emotional problems, and featured a father-child dyad. Next, following the same procedure that was used to deliver the original flyers over the first 18 months of the project, we used the new flyers to inform parents about the upcoming seminars over the next 24 months. The preliminary results showed that although the average number of parents participating in each seminar had initially decreased from about seven to four, after the introduction of the new flyers, the number increased consistently and reached an average of nine parents during the last 6-month period. The results shows that program uptake can be increased using simple direct-to-consumer marketing strategies.

The public health approach to suicide prevention in Ireland

2021 ◽  
pp. 1-6
Author(s):  
S. Rochford ◽  
P. Dodd ◽  
C. Austin
Keyword(s):  
Public Health ◽  
Suicide Prevention ◽  
Population Level ◽  
Prevention Strategy ◽  
Public Health Approach ◽  
National Strategy ◽  
Extended Phase ◽  
The Public ◽  
National Implementation

Abstract This article provides an overview of the public health approach to suicide in Ireland. The authors provide detail on the current suicide prevention strategy in Ireland, Connecting for Life, which is a whole-of-government, systemic, multicomponent national strategy. As the strategy enters its final extended phase of implementation over the period 2020–2024, the public health elements of Connecting for Life are presented, including the population level and more targeted approaches. The findings of an interim review of the strategy are discussed, in addition to the local and national implementation structures which are in place to assist implementation and monitoring of the strategy.

scholarly journals Protocol for the mWellcare trial: a multicentre, cluster randomised, 12-month, controlled trial to compare the effectiveness of mWellcare, an mHealth system for an integrated management of patients with hypertension and diabetes, versus enhanced usual care in India

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e014851 ◽  
Author(s):  
Dilip Jha ◽  
Priti Gupta ◽  
Vamadevan S Ajay ◽  
Devraj Jindal ◽  
Pablo Perel ◽  
...  
Keyword(s):  
Public Health ◽  
Cost Effectiveness ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
London School ◽  
Clinical Trial Registry ◽  
Link Type ◽  
Adherence To Medication ◽  
Cluster Randomised ◽  
Registration Number

IntroductionRising burden of cardiovascular disease (CVD) and diabetes is a major challenge to the health system in India. Innovative approaches such as mobile phone technology (mHealth) for electronic decision support in delivering evidence-based and integrated care for hypertension, diabetes and comorbid depression have potential to transform the primary healthcare system.Methods and analysismWellcare trial is a multicentre, cluster randomised controlled trial evaluating the clinical and cost-effectiveness of a mHealth system and nurse managed care for people with hypertension and diabetes in rural India. mWellcare system is an Android-based mobile application designed to generate algorithm-based clinical management prompts for treating hypertension and diabetes and also capable of storing health records, sending alerts and reminders for follow-up and adherence to medication. We recruited a total of 3702 participants from 40 Community Health Centres (CHCs), with ≥90 at each of the CHCs in the intervention and control (enhanced care) arms. The primary outcome is the difference in mean change (from baseline to 1 year) in systolic blood pressure and glycated haemoglobin (HbA1c) between the two treatment arms. The secondary outcomes are difference in mean change from baseline to 1 year in fasting plasma glucose, total cholesterol, predicted 10-year risk of CVD, depression, smoking behaviour, body mass index and alcohol use between the two treatment arms and cost-effectiveness.Ethics and disseminationThe study has been approved by the institutional Ethics Committees at Public Health Foundation of India and the London School of Hygiene and Tropical Medicine. Findings will be disseminated widely through peer-reviewed publications, conference presentations and other mechanisms.Trial registrationmWellcare trial is registered with Clinicaltrial.gov (Registration numberNCT02480062; Pre-results) and Clinical Trial Registry of India (Registration number CTRI/2016/02/006641). The current version of the protocol is Version 2 dated 19 October 2015 and the study sponsor is Public Health Foundation of India, Gurgaon, India (www.phfi.org).

Intensified partner notification and repeat testing can improve the effectiveness of screening in reducing Chlamydia trachomatis prevalence: a mathematical modelling study

2021 ◽  
pp. sextrans-2021-055220
Author(s):  
Ben B Hui ◽  
Jane S Hocking ◽  
Sabine Braat ◽  
Basil Donovan ◽  
Christopher K Fairley ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Controlled Trial ◽  
Partner Notification ◽  
Population Level ◽  
Cluster Randomised Controlled Trial ◽  
Base Case ◽  
Relative Reduction ◽  
Treatment Rate ◽  
Chlamydia Testing ◽  
Randomised Controlled

BackgroundThe Australian Chlamydia Control Effectiveness Pilot (ACCEPt) was a cluster randomised controlled trial designed to assess the effectiveness of annual chlamydia testing through general practice in Australia. The trial showed that testing rates increased among sexually active men and women aged 16–29 years, but after 3 years the estimated chlamydia prevalence did not differ between intervention and control communities. We developed a mathematical model to estimate the potential longer-term impact of chlamydia testing on prevalence in the general population.MethodsWe developed an individual-based model to simulate the transmission of Chlamydia trachomatis in a heterosexual population, calibrated to ACCEPt data. A proportion of the modelled population were tested for chlamydia and treated annually at coverage achieved in the control and intervention arms of ACCEPt. We estimated the reduction in chlamydia prevalence achieved by increasing retesting and by treating the partners of infected individuals up to 9 years after introduction of the intervention.ResultsIncreasing the testing coverage in the general Australian heterosexual population to the level achieved in the ACCEPt intervention arm resulted in reduction in the population-level prevalence of chlamydia from 4.6% to 2.7% in those aged 16–29 years old after 10 years (a relative reduction of 41%). The prevalence reduces to 2.2% if the proportion retested within 4 months of treatment is doubled from the rate achieved in the ACCEPt intervention arm (a relative reduction of 52%), and to 1.9% if the partner treatment rate is increased from 30%, as assumed in the base case, to 50% (a relative reduction of 59%).ConclusionA reduction in C. trachomatis prevalence could be achieved if the level of testing as observed in the ACCEPt intervention arm can be maintained at a population level. More substantial reductions can be achieved with intensified case management comprising retesting of those treated and treatment of partners of infected individuals.

scholarly journals Epidemiology, public health and the problem of personality disorder

2003 ◽  
Vol 182 (S44) ◽  
pp. s3-s10 ◽  
Author(s):  
Jeremy Coid
Keyword(s):  
Public Health ◽  
Problem Solving ◽  
Personality Disorder ◽  
Public Health Problem ◽  
Population Level ◽  
Case Definition ◽  
Public Health Approach ◽  
Preventive Interventions ◽  
The Public ◽  
Comprehensive Method

BackgroundThe public health problem-solving paradigm is a comprehensive method not previously applied to preventive interventions for personality disorder.AimsTo present an overview for clinical psychiatrists.MethodReview of epidemiological research into DSM–IV Axis II disorders and application to the paradigm.ResultsPersonality disorder affects a substantial proportion of the population. Burdens on health care, social and criminal justice agencies have yet to be accurately quantified. Debates continue over case definition, but there is increasing information on prevalence using ‘broad’ definitions and aetiology. A conceptual framework, based on development, suggests preventive interventions should be targeted in childhood. The public health approach also requires monitoring of risk factors operating at the population level.ConclusionsServices in England and Wales for persons with personality disorder are currently inadequate. The problem-solving paradigm suggests new preventive interventions. Psychiatrists should renegotiate their relationship with policy-makers and reconsider their preventive role.

scholarly journals Measuring the scientific effectiveness of contact tracing: Evidence from a natural experiment

2021 ◽  
Vol 118 (33) ◽  
pp. e2100814118
Author(s):  
Thiemo Fetzer ◽  
Thomas Graeber
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Natural Experiment ◽  
Controlled Trial ◽  
Contact Tracing ◽  
Public Health Approach ◽  
The Public ◽  
Random Breakdown ◽  
Randomized Controlled ◽  
Health Authorities

Contact tracing has for decades been a cornerstone of the public health approach to epidemics, including Ebola, severe acute respiratory syndrome, and now COVID-19. It has not yet been possible, however, to causally assess the method’s effectiveness using a randomized controlled trial of the sort familiar throughout other areas of science. This study provides evidence that comes close to that ideal. It exploits a large-scale natural experiment that occurred by accident in England in late September 2020. Because of a coding error involving spreadsheet data used by the health authorities, a total of 15,841 COVID-19 cases (around 20% of all cases) failed to have timely contact tracing. By chance, some areas of England were much more severely affected than others. This study finds that the random breakdown of contact tracing led to more illness and death. Conservative causal estimates imply that, relative to cases that were initially missed by the contact tracing system, cases subject to proper contact tracing were associated with a reduction in subsequent new infections of 63% and a reduction insubsequent COVID-19–related deaths of 66% across the 6 wk following the data glitch.

scholarly journals Evaluation of health, nutrition and food security programmes in a complex emergency: the case of Congo as an example of a chronic post-conflict situation

2006 ◽  
Vol 9 (5) ◽  
pp. 551-556 ◽  
Author(s):  
Laura Rossi ◽  
Thomas Hoerz ◽  
Veronique Thouvenot ◽  
Gianni Pastore ◽  
Markus Michael
Keyword(s):  
Public Health ◽  
Food Security ◽  
Nutritional Status ◽  
Access To Health Care ◽  
Large Population ◽  
Intervention Strategy ◽  
Public Health Intervention ◽  
Population Level ◽  
Post Conflict ◽  
Complex Emergency

AbstractObjectiveTo describe the case of Congo as an example of the assessment and appropriateness of donor operational and sectoral strategies in a complex emergency.Design and settingThe paper reports the findings of an external evaluation of operations financed by the European Commission Humanitarian Office in the Democratic Republic of Congo (DRC).ResultsThe Congolese health system is suffering from severe deterioration. What is functioning in the public health context is donor-dependent with high costs and limited coverage. Despite a relatively favourable agro-climatic situation, food shortage and famine severely affect the nutritional status of large population groups. In this context, humanitarian programmes have generally improved access to health care and the nutritional status of beneficiaries. The reduction of malnutrition in project areas is often demonstrated even though the context did not permit consolidation of these results. Malnutrition continues to claim a massive cost of lives owing to the effect of widespread food insecurity that follows a circular cause-and-effect pattern of very low food production and extreme poverty.ConclusionsThe current context in DRC does not correspond yet to ‘post-crisis’: neither at population level with regard to indicators of poverty, malnutrition, disease and death, nor at institutional level, with regard to state support to institutions. In these situations, the international community is often called upon to replace the state as service provider. Integrated humanitarian actions should be the future of relief projects in DRC. Health, nutrition and food security components should be considered a standard public health intervention strategy representing the most sensible approach to address the needs of the affected population.

Parental programs for preventing behavioural and emotional problems in children

2010 ◽  
pp. 399-406 ◽  
Author(s):  
Matthew Sanders ◽  
James Kirby
Keyword(s):  
Public Health ◽  
Emotional Problems ◽  
Parenting Programs ◽  
Public Health Approach ◽  
Triple P ◽  
Evidence Based ◽  
Emotional Outcomes ◽  
Agents Of Change ◽  
Multi Level ◽  
Behavioural And Emotional Problems

Chapter 42 focuses on parents as agents of change. This chapter describes the role parenting programs can play in improving behavioural and emotional outcomes in children. Using the Triple P program as an example they emphasise the importance of an evidence-based integrated, multi-level public health approach to prevention that is tailored to the needs of a family.

Sign in / Sign up

Export Citation Format

Share Document