RT Journal Article
SR Electronic
T1 Parenting for Lifelong Health: a pragmatic cluster randomised controlled trial of a non-commercialised parenting programme for adolescents and their families in South Africa
JF BMJ Global Health
FD BMJ Publishing Group Ltd
SP e000539
DO 10.1136/bmjgh-2017-000539
VO 3
IS 1
A1 Lucie D Cluver
A1 Franziska Meinck
A1 Janina I Steinert
A1 Yulia Shenderovich
A1 Jenny Doubt
A1 Rocio Herrero Romero
A1 Carl J Lombard
A1 Alice Redfern
A1 Catherine L Ward
A1 Sibongile Tsoanyane
A1 Divane Nzima
A1 Nkosiyapha Sibanda
A1 Camille Wittesaele
A1 Sachin De Stone
A1 Mark E Boyes
A1 Ricardo Catanho
A1 Jamie McLaren Lachman
A1 Nasteha Salah
A1 Mzuvukile Nocuza
A1 Frances Gardner
YR 2018
UL http://gh.bmj.com/content/3/1/e000539.abstract
AB Objective To assess the impact of ‘Parenting for Lifelong Health: Sinovuyo Teen’, a parenting programme for adolescents in low-income and middle-income countries, on abuse and parenting practices.Design Pragmatic cluster randomised controlled trial.Setting 40 villages/urban sites (clusters) in the Eastern Cape province, South Africa.Participants 552 families reporting conflict with their adolescents (aged 10–18).Intervention Intervention clusters (n=20) received a 14-session parent and adolescent programme delivered by trained community members. Control clusters (n=20) received a hygiene and hand-washing promotion programme.Main outcome measures Primary outcomes: abuse and parenting practices at 1 and 5–9 months postintervention. Secondary outcomes: caregiver and adolescent mental health and substance use, adolescent behavioural problems, social support, exposure to community violence and family financial well-being at 5–9 months postintervention. Blinding was not possible.Results At 5–9 months postintervention, the intervention was associated with lower abuse (caregiver report incidence rate ratio (IRR) 0.55 (95% CI 0.40 to 0.75, P<0.001); corporal punishment (caregiver report IRR=0.55 (95% CI 0.37 to 0.83, P=0.004)); improved positive parenting (caregiver report d=0.25 (95% CI 0.03 to 0.47, P=0.024)), involved parenting (caregiver report d=0.86 (95% CI 0.64 to 1.08, P<0.001); adolescent report d=0.28 (95% CI 0.08 to 0.48, P=0.006)) and less poor supervision (caregiver report d=−0.50 (95% CI −0.70 to −0.29, P<0.001); adolescent report d=−0.34 (95% CI −0.55 to −0.12, P=0.002)), but not decreased neglect (caregiver report IRR 0.31 (95% CI 0.09 to 1.08, P=0.066); adolescent report IRR 1.46 (95% CI 0.75 to 2.85, P=0.264)), inconsistent discipline (caregiver report d=−0.14 (95% CI −0.36 to 0.09, P=0.229); adolescent report d=0.03 (95% CI −0.20 to 0.26, P=0.804)), or adolescent report of abuse IRR=0.90 (95% CI 0.66 to 1.24, P=0.508) and corporal punishment IRR=1.05 (95% CI 0.70 to 1.57, P=0.819). Secondary outcomes showed reductions in caregiver corporal punishment endorsement, mental health problems, parenting stress, substance use and increased social support (all caregiver report). Intervention adolescents reported no differences in mental health, behaviour or community violence, but had lower substance use (all adolescent report). Intervention families had improved economic welfare, financial management and more violence avoidance planning (in caregiver and adolescent report). No adverse effects were detected.Conclusions This parenting programme shows promise for reducing violence, improving parenting and family functioning in low-resource settings.Trial registration number Pan-African Clinical Trials Registry PACTR201507001119966.