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Background: There is a growing need for interventions that reduce both violence against children and intimate partner violence in low- and middle-income countries. However, few parenting interventions deliberately address this link. We tested the feasibility of a 16-session group-based parenting programme, Parenting for Respectability, in semi-rural Ugandan communities., Methods: This was a pre-post study with parents and their children (N = 484 parents; 212 children)., Results: Pre-post comparisons found large effects for parent-reported reduced harsh parenting (Cohen's f2 = 0.41 overall; f2 = 0.47 (among session attendees); with an overall reduction of 26% for harsh parenting. Session attendees reported higher reductions than non-attendees (p = 0.014), and male caregivers reported higher reductions than female caregivers (p<0.001). Children also reported reduced harsh parenting by attending fathers (f2 = 0.64 overall; f2 = 0.60) and attending mothers (f2 = 0.56 overall; f2 = 0.51); with reduction in harsh parenting ranging between 27% to 29% in the various categories. Overall, spousal violence reduced by 27% (f2 = 0.19 overall; f2 = 0.26 (among session attendees). Both parents and children reported reduced dysfunctional parent relationships; parents: f2 = 0.19 overall; f2 = 0.26 (among session attendees); and children: f2 = 0.35 overall; f2 = 0.32 (for attending parents); with reductions ranging between 22% to 28%. Parents who attended more than 50% of the program reported greater effects on reduced dysfunctional relationships than those who attended less than half of the program (B = -0.74, p = 0.013). All secondary outcomes were improved with f2 ranging between 0.08 and 0.39; and improvements ranging between 6% and 28%., Conclusion: Results suggest the importance of more rigorous testing to determine program effectiveness., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Siu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Parenting programmes may reduce the risk of violence against children and improve child well-being. However, additional economic support may be necessary in highly deprived rural communities in sub-Saharan Africa. Furthermore, delivering programmes within farmer groups may increase male caregiver recruitment and engagement., Methods: A parallel cluster randomised controlled trial examined the combined and separate effects of parenting and economic strengthening programmes on reducing violence against children aged 0-18 years in farming communities in Tanzania (n=248 families; 63% male caregivers). Eight villages were randomly assigned to four conditions (2:2:2:2): (1) 12-session parenting programme (n=60); (2) agribusiness training (n=56); (3) parenting and agribusiness combined (n=72); (4) control (n=60). Parent-report, child-report and early childhood observation assessments were conducted at baseline, mid-treatment and post-treatment. Primary outcomes were child maltreatment and parenting behaviour. Secondary outcomes included corporal punishment endorsement, parenting stress, parent/child depression, child behaviour, economic well-being and child development., Results: At post-treatment, parents and children receiving the combined interventions reported less maltreatment (parents: incidence rate ratio (IRR=0.40, 95% CI 0.24 to 0.65; children: IRR=0.40, 95% CI 0.17 to 0.92). Parents reported reduced endorsement of corporal punishment ( D w =-0.43, 95% CI -0.79 to 0.07) and fewer child behaviour problems ( D w =-0.41, 95% CI -0.77 to 0.05). Parents in parenting-only villages reported less abuse (IRR=0.36, 95% CI 0.21 to 0.63) and fewer child behaviour problems ( D w =-0.47, 95% CI -0.84 to 0.11). Parents in agribusiness-only villages reported fewer child behaviour problems ( D w =-0.43, 95% CI -0.77 to 0.08) and greater household wealth ( D w =0.57, 95% CI 0.08 to 1.06). However, children in agribusiness-only villages reported increased physical abuse (IRR=2.26, 95% CI 1.00 to 5.12) and less positive parenting ( D w =-0.50, 95% CI -0.91 to 0.10). There were no other adverse effects., Conclusion: Parent training may be the active ingredient in reducing maltreatment in farmer groups with majority male caregivers, while agribusiness training programmes may have unintended negative consequences on children when delivered alone. Locating parenting support in existing farmer groups can engage much higher proportions of fathers than stand-alone programmes.ClinicalTrials.gov: NCT02633319., Competing Interests: Competing interests: The authors declare the following competing interests: JL reports grants from UBS Optimus Foundation, grants from Netherlands Ministry of Foreign Affairs, grants from Complexity in Health Improvement Programme of the Medical Research Council MRC UK, during the conduct of the study; grants from UNICEF Thailand, grants from UNICEF Philippines, personal fees from Maestral International, grants from EU Horizon 2020, personal fees from Oxford Policy Management, personal fees from Clowns Without Borders South Africa, grants from Oak Foundation, outside the submitted work; and JL is the codeveloper of a non-profit parenting program with the WHO ‘Parenting for Lifelong Health’, under a creative commons license, and receives fees as a trainer for this. JW reports grants from UBS Optimus foundation during the conduct of the study. TS reports personal fees from International Catholic Relief Services, personal fees from Department of Education, University of Oxford, personal fees and other from Journal of Child and Adolescent Mental Health outside the submitted work. JM reports grants from UBS Optimus Foundation, grants from Netherlands Ministry of Foreign Affairs, from Complexity in Health Improvement Programme of the Medical Research Council MRC UK during the conduct of the study. DW reports grants from UBS Optimus Foundation, grants from Netherlands Ministry of Foreign Affairs, from Complexity in Health Improvement Programme of the Medical Research Council MRC UK, during the conduct of the study; and DW has devoted considerable time to developing a parenting programme in Uganda (Parenting for Respectability) which might be perceived to create a bias towards interpreting parenting interventions as effective. FG reports grants from NIHR, during the conduct of the study; grants from UNICEF, grants from EU Horizon 2020, grants from UBS Optimus Foundation, grants from John Fell Oxford University Press Research Fund, personal fees from Blueprints for Health Youth Development, University of Colorado, Boulder, personal fees from Trygfonden Foundation, Denmark, outside the submitted work. FG is also a codeveloper of a non-profit parenting programme with WHO, ‘Parenting for Lifelong Health’, and receives no fees for this., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)

Background: Growing evidence suggests that experiences in the early years play a major role in children's development in terms of health, wellbeing and educational attainment. The Trial of healthy relationship initiatives for the very early years (THRIVE) aims to evaluate two antenatal group interventions, Enhanced Triple P for Baby and Mellow Bumps, designed for those with additional health or social care needs in pregnancy. As both interventions aim to improve maternal mental health and parenting skills, we hypothesise that in the longer term, participation may lead to an improvement in children's life trajectories., Methods: THRIVE is a three-arm, longitudinal, randomised controlled trial aiming to recruit 500 pregnant women with additional health or social care needs. Participants will be referred by health and social care professionals, predominately midwives. Consenting participants will be block randomised to one of the three arms: Enhanced Triple P for Baby plus care as usual, Mellow Bumps plus care as usual or care as usual. Groups will commence when participants are between 20 and 34 weeks pregnant., Discussion: The population we aim to recruit are traditionally referred to as "hard to reach", therefore we will monitor referrals received from maternity and social care pathways and will be open to innovation to boost referral rates. We will set geographically acceptable group locations for participants, to limit challenges we foresee for group participation and retention. We anticipate the results of the trial will help inform policy and practice in supporting women with additional health and social care needs during antenatal and early postnatal periods. This is currently a high priority for the Scottish and UK Governments., Trial Registration: International Standard Randomised Controlled Trials Number (ISRCTN) Registry, ISRCTN:21656568 . Registered on 28 February 2014 (registered retrospectively (by 3 months)).

Background: THRIVE is a three-arm randomised controlled trial (RCT) that aims to evaluate whether antenatal and early postnatal interventions, Enhanced Triple B for Baby (ETPB) plus care as usual (CAU) or Mellow Bumps (MB) plus CAU (versus CAU alone), can: 1) improve the mental health and well-being of pregnant women with complex health and social care needs; 2) improve mother-infant bonding and interaction; 3) reduce child maltreatment; and 4) improve child language acquisition. This paper focuses on THRIVE's realist process evaluation, which is carefully monitoring what is happening in the RCT., Methods: Realistic evaluation provides the theoretical rationale for the process evaluation. We question: 1) how faithfully are MB and ETPB implemented? 2) What are the mechanisms by which they work, if they do, and who do they work for and how? 3) What contextual factors are necessary for the programmes to function, or might prevent them functioning? The mixed-methods design includes quantitative measures, which are pre- and post-training/intervention questionnaires for facilitators and mothers-to-be, and post-session evaluation forms. Qualitative data collection methods include participant observation of facilitator training and the delivery of a series of antenatal sessions in selected intervention groups (n = 3 for ETPB and n = 3 for MB), semi-structured interviews with facilitators, pregnant women, partners, and referring facilitators, and telephone interviews examining the content of the postnatal components of ETPB and MB., Discussion: The findings of this process evaluation will help researchers and decision makers interpret the outcomes of THRIVE. It will provide a greater understanding of: how the interventions work (if they do); the extent and quality of their implementation; contextual factors facilitating and constraining intervention functioning; variations in response within and between subgroups of vulnerable parents; and benefits or unintended consequences of either intervention. Few studies to date have published detailed research protocols illustrating how realist process evaluation is designed and conducted as an integral part of a randomised controlled trial., Trial Registration: ISRCTN, ISRCTN21656568 . Registered on 8 November 2013.

Understanding why parenting programmes work or do not work, and for whom, is crucial for development of more effective parenting interventions. In this paper we focus on a specific component of Mellow Bumps: reflection on one's own childhood/past/life. We explore how this component was implemented, how participants engaged with it, the facilitating and constraining factors shaping this, whether and how it appeared to work, or not, and for whom. The paper analyses data from the Process Evaluation of the Trial of Healthy Relationships Initiatives for the Very Early years, which is evaluating two antenatal interventions delivered to vulnerable women, one of which is Mellow Bumps. Data were collected from January 2014 to June 2018 for 28 groups, 108 participants and 24 facilitators in a comprehensive and rigorous Process Evaluation designed to complement the Outcome Evaluation. Data were gathered at various time points using multiple methods, and were synthesised to triangulate findings. The reflective component was implemented with fidelity and participants engaged with it to varying degrees, dependent largely on the coherence of the group. Patchy attendance compromised the coherence of some groups, with the development of rapport, which is key to delivering reflective exercises, more difficult when group composition varied from week to week. Where there was a coherent group, powerful mechanisms of change, leading to stress reduction, included: relief through unburdening, empowerment through support given and received, reduced isolation through sharing anxieties, and control through self-care advice. A minority of highly vulnerable mothers seemed not to benefit from the reflective exercises and were marginalised within their groups. In order to minimise potential harmful effects of such exercises, allocation of participants to groups should strive to maximise group homogeneity. More research is needed to explore how very vulnerable parents can be supported in attending parenting interventions from start to finish., Competing Interests: The authors have declared that no competing interests exist.

Purpose: Research on predictors of young children's psychosocial well-being currently relies on adult-reported outcomes. This study investigated whether early family circumstances and parenting predict 7-year-olds' subjective well-being., Methods: Information on supportive friendships, liking school and life satisfaction was obtained from 7-year-olds in one Growing Up in Scotland birth cohort in 2012-2013 (N = 2869). Mothers provided information on early childhood factors from 10 to 34 months, parenting (dysfunctional parenting, home learning and protectiveness) from 46 to 70 months, and 7-year-olds' adjustment. Multivariable path models explored associations between early childhood factors, parenting and 7-year-olds' subjective well-being. Supplementary analyses compared findings with those for mother-reported adjustment., Results: In a model of early childhood factors, maternal distress predicted less supportive friendships and lower life satisfaction (coefficients -0.12), poverty predicted less supportive friendships (-0.09) and remote location predicted all outcomes (-0.20 to -0.27). In a model with parenting added, dysfunctional parenting predicted all outcomes (-10 to -0.16), home learning predicted liking school (0.11) and life satisfaction (0.08), and protectiveness predicted life satisfaction (0.08). Effects of maternal distress were fully mediated, largely via dysfunctional parenting, while home learning mediated negative effects of low maternal education. Direct effects of poverty and remote location remained. Findings for mother-reported child adjustment were broadly similar., Conclusions: Unique prospective data show parenting and early childhood impact 7-year-olds' subjective well-being. They underline the benefits for children of targeting parental mental health and dysfunctional parenting, and helping parents develop skills to support children at home and school., Competing Interests: Compliance with ethical standards Ethical standards Each sweep of data collection was subject to medical ethical review by the Scotland ‘A’ MREC committee, in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All parents interviewed gave their informed consent prior to inclusion in the study. Conflict of interest The authors declare that they have no conflict of interest.

Background: Pathways leading to socioeconomic inequalities in young children's body mass index (BMI) are not well understood. This study examined whether parenting related to the physical and social context of children's food consumption helped to explain associations between maternal educational level and child BMI trajectory., Methods: The study used data from 2957 families in a nationally representative birth cohort study surveyed from 2004 to 2011, with child BMI z-score measured 3 times (46, 70 and 94 months). Latent growth curve models examined associations between maternal education and BMI z-score trajectory, exploring mediating effects of parenting (positive mealtime interaction, informal meal setting and child bedroom TV) and unhealthy child diet., Results: After adjusting for maternal BMI, maternal education predicted increased inequality in child BMI z-score trajectory slope over the study period. The slope index of inequality coefficient for maternal education, that is, the change in z-score associated with the lowest relative to the highest maternal education level, was 0.17, p<0.001. Indirect effects of lower maternal education on steeper BMI trajectory via parenting and/or unhealthy diet represented 89% of the total effect. Pathways via parenting and then unhealthy diet accounted for 68% of significant indirect pathways, with the remainder via unhealthy diet only. Bedroom TV was the most important parenting pathway, followed by informal meal setting., Conclusions: Pathways via parenting helped to explain the emergence of inequalities in young children's BMI related to maternal education. Interventions targeting parental provision of child bedroom TV and informal meal setting might reduce these inequalities., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Current theorizing and evidence suggest that parenting stress might be greater among parents from both low and high socioeconomic positions (SEP) compared with those from intermediate levels because of material hardship among parents of low SEP and employment demands among parents of high SEP. However, little is known about how this socioeconomic variation in stress relates to the support that parents receive. This study explored whether variation in maternal parenting stress in a population sample was associated with support deficits. To obtain a clearer understanding of support deficits among mothers of high and low education, we distinguished subgroups according to mothers' migrant and single-parent status. Participants were 5,865 mothers from the Growing Up in Scotland Study, who were interviewed when their children were 10 months old. Parenting stress was greater among mothers with either high or low education than among mothers with intermediate education, although it was highest for those with low education. Support deficits accounted for around 50% of higher stress among high- and low-educated groups. Less frequent grandparent contact mediated parenting stress among both high- and low-educated mothers, particularly migrants. Aside from this common feature, different aspects of support were relevant for high- compared with low-educated mothers. For high-educated mothers, reliance on formal childcare and less frequent support from friends mediated higher stress. Among low-educated mothers, smaller grandparent and friend networks and barriers to professional parent support mediated higher stress. Implications of differing support deficits are discussed., ((c) 2015 APA, all rights reserved).)

This paper explores the structural role of the family and parenting in young people's sexual and reproductive health. The study involved eight weeks of participant observation, 26 in-depth interviews, and 11 group discussions with young people aged 14-24 years, and 20 in-depth interviews and 6 group discussions with parents/carers of children in this age group. At an individual level, parenting and family structure were found to affect young people's sexual behaviour by influencing children's self-confidence and interactional competence, limiting discussion of sexual health and shaping economic provision for children, which in turn affected parental authority and daughters' engagement in risky sexual behaviour. Sexual norms are reproduced both through parents' explicit prohibitions and their own behaviours. Girls are socialised to accept men's superiority, which shapes their negotiation of sexual relationships. Interventions to improve young people's sexual and reproductive health should recognise the structural effects of parenting, both in terms of direct influences on children and the dynamics by which structural barriers such as gendered power relations and cultural norms around sexuality are transmitted across generations.

Sexual content in teenagers' media diets is known to predict early sexual behaviour. Research on sexual content has not allowed for the social context of media use, which may affect selection and processing of content. This study investigated whether sexual media content and/or contextual factors (co-viewing, parental media restrictions) were associated with early sexual behaviour using 2251 14-15 year-olds from Scotland, UK. A third (n = 733) reported sexual intercourse. In multivariable analysis the likelihood of intercourse was lower with parental restriction of sexual media and same-sex peer co-viewing; but higher with mixed-sex peer co-viewing. Parental co-viewing, other parental restrictions on media and sexual film content exposure were not associated with intercourse. Findings suggest the context of media use may influence early sexual behaviour. Specific parental restrictions on sexual media may offer more protection against early sex than other restrictions or parental co-viewing. Further research is required to establish causal mechanisms., (Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Approximately one in four incarcerated male young offenders in the UK is an actual or expectant father. This paper reviews evidence on the effectiveness of parenting interventions for male young offenders. We conducted systematic searches across 20 databases and consulted experts. Twelve relevant evaluations were identified: 10 from the UK, of programmes for incarcerated young offenders, and two from the US, of programmes for young parolees. None used experimental methods or included a comparison group. They suggest that participants like the courses, find them useful, and the interventions may improve knowledge about, and attitudes to, parenting. Future interventions should incorporate elements of promising parenting interventions with young fathers in the community, for example, and/or with older incarcerated parents. Young offender fathers have specific developmental, rehabilitative, and contextual needs. Future evaluations should collect longer-term behavioural parent and child outcome data and should use comparison groups and, ideally, randomization., (Copyright © 2011 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Context: Extensive research has explored the relationship between parenting and teenagers' sexual risk-taking. Whether parenting is associated with wider aspects of teenagers' capacity to form satisfying sexual relationships is unknown., Methods: Self-reported data were collected in 2007 from 1,854 students, whose average age was 15.5 years, in central Scotland. Multivariate analyses examined associations between parenting processes and sexual outcomes (delayed first intercourse, condom use and several measures reflecting the context or anticipated context of first sex)., Results: Parental supportiveness was positively associated with all outcomes (betas, 0.1-0.4), and parental values restricting intercourse were positively associated with all outcomes except condom use (0.1-0.5). Parental monitoring was associated only with delayed intercourse (0.2) and condom use (0.2); parental rules about TV content were associated with delayed intercourse (0.7) and expecting sex in a relationship, rather than casually (0.8). Frequency of parental communication about sex and parental values endorsing contraceptive use were negatively associated with teenagers' delayed intercourse (-0.5 and -0.3, respectively), and parents' contraceptive values were negatively associated with teenagers' expecting sex in a relationship (-0.5). Associations were partly mediated by teenagers' attitudes, including value placed on having sex in a relationship., Conclusions: Parents may develop teenagers' capacity for positive and safe early sex by promoting skills and values that build autonomy and encourage sex only within a relationship. Interventions should promote supportive parenting and transmission of values, avoid mixed messages about abstinence and contraception, and acknowledge that teenagers may learn more indirectly than directly from parents about sex., (Copyright © 2011 by the Guttmacher Institute.)

Both family structure and processes have been associated with young people's sexual behaviour, but most studies are cross-sectional and focus on only one outcome: age at first intercourse. This paper uses longitudinal data from a survey of Scottish teenagers (N=5041) to show how low parental monitoring predicts early sexual activity for both sexes (with some reverse causation), and for females it also predicts more sexual partners and less condom use. A lot of spending money also predicts early sexual activity and, for males, having more sexual partners. Comfort talking with parents about sex, however, seems to bear little relationship to sexual behaviour.