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Three-year-old outcomes of a brief universal parenting intervention to prevent behaviour problems: randomised controlled trial.
- Source :
-
Archives of disease in childhood [Arch Dis Child] 2010 Mar; Vol. 95 (3), pp. 187-92. Date of Electronic Publication: 2009 Oct 21. - Publication Year :
- 2010
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Abstract
- Objective: To determine whether a structured programme of parent anticipatory guidance 'Toddlers Without Tears,' delivered in universal primary care, can prevent preschool child behaviour problems.<br />Design: Cluster randomised controlled trial.<br />Setting/participants: 40 primary care nursing centres (clusters) in metropolitan Melbourne, Australia. 733 English-speaking mothers of 6- to 7-month-old infants consecutively recruited from well-child appointments; 589 (80%) retained at age 3 years.<br />Intervention: Parenting programme from age 8 to 15 months, with two group sessions co-led by well-child providers and a parenting expert. The programme addressed normal behaviour development and offered strategies to increase desired and reduce unwanted behaviour. While 93% of intervention parents received at least some of the programme, only 49% completed all components. Control Usual primary care.<br />Main Outcome Measures: Maternal report of child externalising behaviour (Child Behaviour Checklist), parenting (Parent Behaviour Checklist) and maternal mental health (Depression Anxiety Stress Scales) when children were aged 3 years.<br />Results: Behaviour scores in the intervention and control groups were similar (mean (SD)) 11.4 (7.1) versus 12.4 (7.6); adjusted mean difference -0.8, 95% CI -2.2 to 0.6, p=0.26). On the parenting subscale scores, intervention parents reported fewer unreasonable expectations of child development (37.3 (10.9) vs 39.9 (10.2), adjusted mean difference -3.1, 95% CI -4.9 to -1.4, p=0.001). The mean scores for harsh/abusive and nurturing parenting, and maternal mental health, were similar between the two groups.<br />Conclusions: A brief universal parenting programme in primary care is insufficient to prevent development of preschool externalising problems. A new population trial targeting more intensive prevention to distressed parents with toddler behaviour problems is now under way, aiming to prevent externalising and internalising problems before school entry.<br />Trial Registration Number: ISRCTN77531789.
Details
- Language :
- English
- ISSN :
- 1468-2044
- Volume :
- 95
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Archives of disease in childhood
- Publication Type :
- Academic Journal
- Accession number :
- 19847011
- Full Text :
- https://doi.org/10.1136/adc.2009.168302