The impact of a parenting guidance programme for mothers with an ethnic minority background

The current mixed-method study investigates the effects of a culturally adapted version of the International Child Development Programme (ICDP) with 135 mothers – 29 ethnic Pakistani mothers residing in Norway attending Urdu-language groups and a comparison group of 105 Norwegian mothers attending Norwegian-language groups. All mothers completed questionnaires on parenting and psychosocial health before and after attending the ICDP programme. In-depth interviews with a subgroup of 12 ethnic Pakistani mothers and 8 ethnic Norwegian mothers were analysed using thematic analysis. Before the ICDP programme, the Urdu-speaking mothers spent more time with the child, scored higher on distant child management and reported poorer mental health. Most changes over time were similar but significant for the Norwegian-speaking group only, which might imply that the minority mothers were in the process of change. In the interviews, the Urdu-speaking mothers’ emphasized enhanced communication and regulation, enhanced family relationships and life quality, whereas the Norwegian-speaking group told about increased consciousness and empowerment, and a more positive focus.Funded by the Norwegian Ministry of Children, Equality, and Social Inclusion

Professional caregivers' participation in the International Caregiver Development Programme: A qualitative study of psychosocial care in nursing homes

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Mothers and Fathers Attending the International Child Development Programme in Norway

Fathers are understudied in parent training studies. This study investigates whether mothers and fathers benefit equally from participating in the International Child Development Programme (ICDP) implemented as a community-wide programme in Norway in their parenting behaviour, perceived child difficulties and their psychosocial health. The questionnaire study used a pre-post design comparing 105 mothers and 36 fathers who attended a regular ICDP course. Results showed that the mothers and fathers differed on parenting behaviours prior to the course but showed similar changes, including on emotional and regulative aspects of parenting and autonomy supportive behaviours. However, only the mothers perceived a decrease in their child’s difficulties after the course while the fathers showed a greater increase in behaviours assumed to support the child’s meaning-making and in self-efficacy, and a greater decrease in anxiety after the course. ICDP courses appear to be a useful tool for supporting both mothers and fathers in their parenting role

Evaluation of Follow-Up Effects of the International Child Development Programme on Caregivers in Mozambique

This is a non-final version of an article published in final form in Infants & Young Children, 27(2), 120-135. doi:10.1097/iyc.0000000000000006.Parenting programs have been used to good effect in many settings, yet few are systematically introduced and evaluated in developing countries. This study explores the relative long-term effect of participation in the International Child Development Programme (ICDP) in a group of caregivers in Mozambique. A quasi-experimental design was used to compare caregivers who had completed an ICDP course (n = 75) with a sociogeographically matched comparison group participants (n = 62) who had not followed any parenting program. Both groups completed a questionnaire about parenting, attitudes toward the child and the child’s behavior, self-efficacy, life quality, and mental health. The ICDP group reported better parenting skills, fewer conduct problems in their children, and better child adjustment than the comparison group, as well as a shift in physical punishment away from hitting. The ICDP group had higher self-efficacy scores, better health and life quality, and lower scores on mental health difficulties. The follow-up differences between caregivers who had and had not attended the ICDP course indicate that course attendance may result in observable benefits in parenting and mental health scores. The data are cross-sectional and the caregivers were interviewed postintervention only, and more research is therefore needed

Child and Caregiver Reporting on Child Maltreatment and Mental Health in the Philippines Before and After an International Child Development Program (ICDP) Parenting Intervention

Child maltreatment is a serious problem affecting millions of children. Research on self-reporting of child maltreatment has shown a difference in reporting between caregivers and children. Increased understanding of this has implications for further evaluations of parenting programmes and assessment of violence and maltreatment. The purpose of this study was to explore caregiver-child reporting discrepancies on child maltreatment and emotional health before and after piloting of the International Child Development Program (ICDP) in the Philippines. Data was collected from caregivers and their children before and after caregiver participation in ICDP. Participants were selected from the Pantawid Pamilyang Pilipino Program in Leyte by Save the Children. Caregivers and children completed a questionnaire with some adapted items from the Conflict Tactics Scale Parent–Child version (CTSPC), some relevant complementary items on psychological aggression and items from the emotional problems subscale from the Strength and Difficulties Questionnaire (SDQ). Matching items, subscales and total count scores were compared using paired t-tests in STATA 14. Forty-six caregivers and 43 children aged from 5–13 years participated at baseline, and 44 caregivers and 42 children at endline. At baseline, children reported significantly more maltreatment than their caregivers. The groups reported similarly at baseline and endline on the items from the subscale on emotional problems. Both children and caregivers had lower scores on our harsh discipline scale at endline, indicating improved parenting strategies after the intervention. These results indicate a difference in reporting of child maltreatment between caregivers and children, with higher rates reported by the children before the intervention, but not after. This is important because it illustrates child and caregiver perspectives on maltreatment, and how they can differ. As such, our findings point towards a positive effect of ICDP on parenting.publishedVersio

‘As soon as they can hold a glass, they begin taking alcohol’: a qualitative study on early childhood substance use in Mbale District, Uganda

Background Globally, substance use is a leading contributor to the burden of disease among young people, with far reaching social, economic and health effects. Following a finding of harmful alcohol use among 5-8-year-old children in Mbale District, Uganda, this study aims to investigate community members’ views on early childhood substance use among children below the age of 10 years. Methods In 2016, we conducted eight focus group discussions with 48 parents and 26 key informant interviews with teachers, health workers, alcohol distributors, traditional healers, religious leaders, community leaders and youth workers. We used thematic content analysis. Four participants and two research assistants reviewed and confirmed the findings. Results Alcohol in everyday life: ‘Even children on laps taste alcohol’: Almost all participants confirmed the existence of and concern for substance use before age 10. They described a context where substance use was widespread in the community, especially intake of local alcoholic brews. Children would access substances in the home or buy it themselves. Those living in poor neighbourhoods or slums and children of brewers were described as particularly exposed. Using substances to cope: ‘We don’t want them to drink’: Participants explained that some used substances to cope with a lack of food and resources for childcare, as well as traumatic experiences. This made children in deprived families and street-connected children especially vulnerable to substance use. Participants believed this was a result of seeing no alternative solution. Conclusions To our knowledge, this is the first study to describe the context and conditions of childhood substance use before age 10 in Mbale District, Uganda. The study shows that community members attributed early childhood substance use to a social context of widespread use in the community, which was exacerbated by conditions of material and emotional deprivation. These social determinants for this practice deserve public health attention and intervention.publishedVersio

The long-term effectiveness of the International Child Development Programme (ICDP) implemented as a community-wide parenting programme

This is an open-access article distributed under the terms of the Creative Commons Attribution Licence http://creativecommons.org/licences/by/3.0/, which permits the unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The moral rights of the named author(s) have been asserted.Short-term effectiveness of the International Child Development Programme (ICDP) for parents in the general population has been studied. The aim of this paper was to investigate the longer term impact of the ICDP programme on parents looking for sustained changes 6–12 months after the programme. For this, a nonclinical caregiver group attending the ICDP programme (N ¼ 79) and a nonattending comparison group (N ¼ 62) completed questionnaires on parenting, psychosocial functioning, and child difficulties before, on completion and 6–12 months after the ICDP programme. Analyses compare changes in scores over time. The results revealed that the ICDP group showed significantly improved scores on parenting measures, less loneliness, and trends towards improved self-efficacy compared to the comparison group 6–12 months after programme completion. The ICDP group also reported that their children spent significantly less time on television and computer games and a trend towards fewer child difficulties. Key positive effects sustained over time but at a somewhat lower level, supporting community-wide implementation of ICDP as a general parenting programme. It is concluded that more intensive training with follow-up sessions should be considered to sustain and boost initial gains.Funded by the Norwegian Ministry of Children, Equality, and Social Inclusion

Paradoxical correlates of a facilitative parenting programme in prison—counter-productive intervention or first signs of responsible parenthood?

This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Scandinavian Studies in Criminology and Crime Prevention on 07/04/2014, available online: doi: 10.1080/14043858.2014.898981Purpose. Parenting programmes are rarely part of prisoners’ rehabilitation, and evaluations of such programmes are lacking. Methods. The present mixed-methods study investigates the International Child Development Programme (ICDP) with 25 incarcerated fathers and a comparison group of 36 community fathers through questionnaires administered before and after parenting courses. Interviews with 20 incarcerated fathers were analysed using thematic analysis. Results. Before the course, the prison group self-reported better parenting skills and poorer psychosocial health than the comparison group. Both groups improved on parenting strategies. On several measures the comparison group improved, while the prison group revealed the same or lower scores. The incarcerated fathers described becoming more aware of their paternal role but also saw the course as emotionally challenging. Conclusions. Some of the self-reported scores of the prison participants related to parental skills and psychosocial health decreased from ‘before’ to ‘after’ ICDP sensitization, pointing to the possibility that the ICDP courses may have contributed to overcoming a ‘prisonization process’, where the prisoner identity overshadows the parental identity, by making them more aware of their parental responsibilities. Due to the emerging possibility of counter-productive influences, a randomized controlled study is needed in the future to ascertain the parenting and recidivism-related effects of this programme

Effectiveness of the International Child Development Programme: Results from a randomized controlled trial

This study aimed to evaluate the effectiveness of the International Child Development Programme (ICDP), a group-based parenting programme used internationally and implemented nationally in Norway. We used a cluster randomized controlled trial in which 81 groups were randomly assigned to either the intervention or waitlist control condition after the baseline data collection. A total of 590 parents completed at least one of three questionnaires (administrated before and after ICDP and 4 months after completing the intervention). Primary outcomes included parental self-efficacy, parental emotion sensitivity and positive involvement with their child. Secondary outcomes included parents' perceptions of their relationship with the child, child-rearing conflicts and the child's psychosocial health. We found significant effects favouring the intervention arm following the intervention and at follow-up on two primary outcomes (parental self-efficacy and emotion sensitivity). For the secondary outcomes, we found a significant reduction in child-rearing conflict at the 4-month follow-up, increased closeness to the child, reduced child internalizing difficulties and increased prosocial behaviour immediately following the intervention. However, ICDP seems to have limited effects on parent-reported changes in children. We conclude that ICDP as a universal preventive programme offered to parents in groups can be effective in strengthening parental self-efficacy and improving parental emotion sensitivity.publishedVersio

Leveraging implementation science to reduce inequities in children’s mental health care: Highlights from a multidisciplinary international colloquium

Background and purposeAccess to evidence-based mental health care for children is an international priority. However, there are significant challenges to advancing this public health priority in an efficient and equitable manner. The purpose of this international colloquium was to convene a multidisciplinary group of health researchers to build an agenda for addressing disparities in mental health care access and treatment for children and families through collaboration among scholars from the United States and Europe engaged in innovative implementation science and mental health services research.Key highlightsGuided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework, presentations related to inner, outer, and bridging context factors that impact the accessibility and quality of mental health evidence-based practices (EBPs) for children and families. Three common topics emerged from the presentations and discussions from colloquium participants, which included: 1) the impact of inner and outer context factors that limit accessibility to EBPs across countries, 2) strategies to adapt EBPs to improve their fit in different settings, 3) the potential for implementation science to address emerging clinical and public health concerns.ImplicationsThe common topics discussed underscored that disparities in access to evidence-based mental health care are prevalent across countries. Opportunities for cross-country and cross-discipline learnings and collaborations can help drive solutions to address these inequities, which relate to the availability of a trained and culturally appropriate workforce, insurance reimbursement policies, and designing interventions and implementation strategies to support sustained use of evidence-based practices