Using the Behaviour Change Wheel (BCW) to Characterise Parenting Interventions to Prevent Intergenerational Child Abuse

Research shows that parents with a history of child abuse are at risk of perpetuating the cycle of abuse; however, exploration of intervention content is still a neglected area. This qualitative study identifies intervention components and corresponding mechanisms of change of parenting interventions to prevent intergenerational child abuse. Interviews with ten heads of interventions from the UK and USA were coded using deductive framework analysis. The Behaviour Change Technique (BCT) Taxonomy and Behaviour Change Wheel were used to code intervention components including BCTs and intervention functions. Mechanisms of change were coded using the Theoretical Domains Framework. Twelve BCTs and eight intervention functions were identified including education, enablement and training delivered through BCTs of instruction on how to perform a behaviour, restructuring the environment and social support. Corresponding mechanisms of change include behaviour regulation, knowledge and social influences, among others. This study offers insight into targeting and tailoring services to improve outcomes for parents with a history of child abuse. Findings suggest that there are possible mechanisms through which vulnerable parents can be helped to break the cycle of abuse including promoting social support, regulating parents’ behaviour through trauma-informed approaches and enhancing knowledge, self-esteem and confidence in parenting.

Parenting interventions for families with refugee backgrounds: a randomized factorial, mixed-methods design study protocol

Background Raising children in new social and cultural contexts can be challenging for parents. In order to help parents address these challenges, the Norwegian government has instituted a policy of mandatory parent training for families who settle in Norway as refugees. The Incredible Years (IY) and The International Child Development Programme (ICDP) have been widely adopted throughout Norway. They have similar aims: to improve parenting through positive parenting practices and development of attachment behaviors. We will evaluate the use of these programs and a measurement feedback system (MFS) to give regular feedback to interventionists about parents’ progress during the course of the parenting intervention. Methods The study is a mixed method, randomized factorial design aimed at evaluating the effect of parenting interventions and the use of feedback to address parental stress, child behavior, resilience, and parents’ mental health. Factor 1 is based on random assignment to one of the parenting interventions IY or ICDP. The parenting interventions are delivered over 15 weeks (IY) or 12 weeks (ICDP) in group-based settings. Factor 2 is based on random assignment of the parenting groups to the (a) with MFS or (b) without MFS condition. The MFS is answered weekly via a phone app, MittEcho, and results are sent to group leaders in the MFS condition. Additionally, the study explores the experiences of families settling in a new cultural context and participating with parenting programs via qualitative interviews. Participants will be recruited from a population of parents with children between the age of 6 and 12 years who settled in Norway as refugees within the previous 9 years. The target sample size is N = 360; n (IY) = 180, n (ICDP) = 180 families. This study is a collaboration between first-line, municipal services; their national governing agencies; family representatives; and a national network of research organizations. Discussion This study endeavors to provide information about what helps families with refugee background integrate successfully into new cultural contexts with different laws, norms, and expectations. Whether or not these interventions can help to normalize this experience, reduce stress, and provide parents with new tools to improve their parenting and the lives of their children are important questions which we address. These findings can lead to the further establishment of evidence-based practices in Norway. Trial registration ISRCTN35008070. Registered on February 24, 2020

A systematic review of parenting interventions used by social workers to support vulnerable children

This paper reports on the findings from a systematic review of parenting interventions used by social workers to support vulnerable children in the United Kingdom. The study focused on children from birth to 11 years and 11 months based on Munro's rationale for early intervention. From the 423 papers initially identified, twelve met the inclusion criteria for this review. Four common themes were identified: developing relationships, the effectiveness of parenting interventions, societal impact on families and health and psychological concerns. The importance of effective relationships between parents and social workers was identified as key to effective parental interventions but there was limited evidence of improved outcomes for children despite this. A common factor in the studies was the level of parental deprivation which in many cases was associated with a range of mental health issues frequently seen in association with drug and alcohol abuse and domestic violence. The review identified a number of successful outcomes across a range of parenting interventions. However, what was surprising was the limited input from the children themselves within this review. Applying our findings to practice, the authors recommend a number of ways to contribute to the development of parenting interventions.

Evaluating the effectiveness and cost effectiveness of the ‘strengthening families, strengthening communities’ group-based parenting programme: study protocol and initial insights

Background Up to 20% of UK children experience socio-emotional difficulties which can have serious implications for themselves, their families and society. Stark socioeconomic and ethnic inequalities in children’s well-being exist. Supporting parents to develop effective parenting skills is an important preventive strategy in reducing inequalities. Parenting interventions have been developed, which aim to reduce the severity and impact of these difficulties. However, most parenting interventions in the UK focus on early childhood (0–10 years) and often fail to engage families from ethnic minority groups and those living in poverty. Strengthening Families, Strengthening Communities (SFSC) is a parenting programme designed by the Race Equality Foundation, which aims to address this gap. Evidence from preliminary studies is encouraging, but no randomised controlled trials have been undertaken so far. Methods/design The TOGETHER study is a multi-centre, waiting list controlled, randomised trial, which aims to test the effectiveness of SFSC in families with children aged 3–18 across seven urban areas in England with ethnically and socially diverse populations. The primary outcome is parental mental well-being (assessed by the Warwick-Edinburgh Mental Well-Being Scale). Secondary outcomes include child socio-emotional well-being, parenting practices, family relationships, self-efficacy, quality of life, and community engagement. Outcomes are assessed at baseline, post intervention, three- and six-months post intervention. Cost effectiveness will be estimated using a cost-utility analysis and cost-consequences analysis. The study is conducted in two stages. Stage 1 comprised a 6-month internal pilot to determine the feasibility of the trial. A set of progression criteria were developed to determine whether the stage 2 main trial should proceed. An embedded process evaluation will assess the fidelity and acceptability of the intervention. Discussion In this paper we provide details of the study protocol for this trial. We also describe challenges to implementing the protocol and how these were addressed. Once completed, if beneficial effects on both parental and child outcomes are found, the impact, both immediate and longer term, are potentially significant. As the intervention focuses on supporting families living in poverty and those from minority ethnic communities, the intervention should also ultimately have a beneficial impact on reducing health inequalities. Trial registration Prospectively registered Randomised Controlled Trial ISRCTN15194500.