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Rose AL, Jack HE, Wan C, Toloza E, Bhattiprolu K, Ragunathan M, Schwartz KT, Magidson JF. Implementing Task-Shared Child and Adolescent Psychological Interventions in Low- and Middle-Income Countries: A Scoping Review. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022:1-16. [PMID: 36507739 PMCID: PMC10258230 DOI: 10.1080/15374416.2022.2151450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Effective "task shared," or nonspecialist delivered, psychological interventions for children and adolescents have been developed or adapted in low- and middle-income countries with the aim of closing the global treatment gap for youth mental health care. Yet, delivery remains limited, in part due to the lack of knowledge of associated implementation, or process, outcomes. This scoping review aims to describe, examine the quality of, and synthesize findings on implementation outcomes of child and adolescent psychological interventions in low-and middle-income countries. METHODS PubMed, Web of Science, and PsycInfo were searched for studies on child and adolescent psychological interventions in low- and middle-income countries reporting on implementation outcomes. After abstract and full-text review, data were extracted and summarized on implementation outcomes and quality of implementation outcomes reporting. Implementation barriers and recommendations for addressing barriers were also charted and narratively synthesized. RESULTS Out of 5,207 manuscripts, 86 met inclusion criteria. Younger children were underrepresented. Studies largely reported feasibility and acceptability and did not state hypotheses or use conceptual models. Barriers primarily related to interventions being too complex, not an acceptable fit with participant cultures, and facilitators lacking time for or experiencing distress delivering interventions. Recommendations focused on increasing intervention fit and flexibility, training and support for facilitators, and linkages with existing systems. CONCLUSIONS Rigorous, broader implementation outcomes research is needed within child and adolescent psychological intervention research in low-and middle-income countries. Current evidence suggests the importance of the further developing strategies to increase acceptability to participants and better support facilitators.
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Affiliation(s)
- Alexandra L. Rose
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Helen E. Jack
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Christine Wan
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Emilia Toloza
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Kavya Bhattiprolu
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Meera Ragunathan
- Department of Psychology, University of Maryland, College Park, MD, USA
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Allen K, Hansford L, Hayes R, Longdon B, Allwood M, Price A, Byford S, Norwich B, Ford T. Teachers' views on the acceptability and implementation of the Incredible Years ® Teacher Classroom Management programme in English (UK) primary schools from the STARS trial. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2022; 92:1160-1177. [PMID: 35274747 PMCID: PMC9544510 DOI: 10.1111/bjep.12493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/12/2022] [Indexed: 11/29/2022]
Abstract
Background The Incredible Years® (IY) Teacher Classroom Management (TCM) programme may reduce disruptive behaviour in the classroom and improve child and teacher mental health; however, few studies have considered how acceptable TCM is to teachers or what facilitators and barriers there are to its implementation. Aims In this paper we examine the acceptability of the full 6‐day TCM programme and teachers’ perceived barriers and facilitators to implementation in the English (UK) primary school context. Sample Forty‐four English (UK) primary school teachers who attended the TCM programme as part of the STARS trial. Methods We completed focus groups and telephone interviews with participating teachers 2 months after they completed the TCM programme. Thematic analysis was used to examine the data, and a framework approach was applied to organize and summarize themes. Results Teachers liked the structure of the course, the peer group learning environment, delivery methods, and the opportunity to reflect outside the classroom on their practice. They reported that the video clips used lacked cultural relevance and highlighted the importance of group leadership style. Perceived facilitators to implementation included an understanding of the theory underpinning TCM and adaptability of the TCM strategies. Barriers included perceived gaps in the course content in relation to challenging behaviour, applying strategies with older children and the school context within which teachers were working. Conclusion Our findings suggest high levels of acceptability to TCM overall, but also highlight the need for a whole school approach to combat potential barriers to implementation.
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Affiliation(s)
- Kate Allen
- College of Medicine and Health, University of Exeter, UK
| | | | - Rachel Hayes
- College of Medicine and Health, University of Exeter, UK
| | - Bryony Longdon
- College of Medicine and Health, University of Exeter, UK
| | - Matthew Allwood
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Anna Price
- College of Medicine and Health, University of Exeter, UK
| | - Sarah Byford
- King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Brahm Norwich
- Graduate School of Education, University of Exeter, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, UK
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"It's Embedded in What We Do for Every Child": A Qualitative Exploration of Early Childhood Educators' Perspectives on Supporting Children's Social and Emotional Learning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041530. [PMID: 33562768 PMCID: PMC7914528 DOI: 10.3390/ijerph18041530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 11/16/2022]
Abstract
Early childhood educators play an important role in supporting children's social and emotional development. While a growing body of research has examined the impact of curriculum-based social and emotional learning (SEL) programs on child outcomes, the approaches educators use to strengthen children's social and emotional functioning through their everyday practices are less defined. This study explored Australian early childhood educators' perspectives on children's social and emotional development, the approaches educators use to encourage children's social and emotional skills, the enablers and barriers to SEL within the preschool environment, and the additional support needed. Thirty Early Childhood Education and Care professionals participated in semi-structured interviews and focus group discussions. Findings suggest children's social-emotional development is at the forefront of educator planning, practice, and reflection. Participants described utilising various approaches to support children's social and emotional skills, embedded within interactions and relationships with children and families. Specifically, strategies could be grouped into four broad categories: a nurturing and responsive educator-child relationship; supporting SEL through everyday interactions and practice; utilising the physical environment to encourage SEL; and working in partnership with caregivers. There was, however, inconsistency in the variety and type of approaches identified. Time constraints, group size, educator confidence and capability, high staff turnover, and limited guidance regarding high-quality social and emotional pedagogy were identified as key barriers. Participants sought practical strategies that could be embedded into daily practice to build upon current knowledge.
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Francis T, Baker-Henningham H. Design and Implementation of the Irie Homes Toolbox: A Violence Prevention, Early Childhood, Parenting Program. Front Public Health 2020; 8:582961. [PMID: 33304875 PMCID: PMC7701241 DOI: 10.3389/fpubh.2020.582961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/06/2020] [Indexed: 11/23/2022] Open
Abstract
This paper describes the development of the Irie Homes Toolbox, a violence prevention program targeting parents of children aged two to six years. The intervention was designed to complement an existing, teacher-training, violence prevention program, the Irie Classroom Toolbox, thus promoting an integrated approach across home and school settings. The Irie Homes Toolbox was developed through a four-stage process by integrating data from theory, formative research, and practice to ensure the intervention is acceptable, feasible, relevant, and effective in the context. The perspectives of Jamaican preschool teachers and parents of preschool children, who are the end users, were integrated into the design of the intervention throughout the development process. Stage one involved integrating theory and formative research to inform the initial intervention design. Stages two and three involved iterative cycles of design, implementation and evaluation of the intervention content, process of delivery, structure and materials. Stage four involved a further cycle of learning through a process evaluation conducted as part of a cluster-randomized controlled trial. Data from each of these four stages was used to inform the design and ongoing revisions of the toolbox with the aim of developing a low-cost, scalable and sustainable intervention for the Jamaican context. The resulting program is theory-informed and uses empirically derived content and behavior change principles operationalized for the context in which it will be delivered. The Irie Homes Toolbox is suitable for integration into the existing preschool provision in Jamaica, thus utilizing an existing service and existing staff and increasing the likelihood for wide-scale dissemination.
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Affiliation(s)
- Taja Francis
- Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Helen Baker-Henningham
- Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
- School of Psychology, Bangor University, Bangor, United Kingdom
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Evaluation of a Violence-Prevention Programme with Jamaican Primary School Teachers: A Cluster Randomised Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152797. [PMID: 31390743 PMCID: PMC6696405 DOI: 10.3390/ijerph16152797] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/01/2019] [Accepted: 08/03/2019] [Indexed: 12/16/2022]
Abstract
This study investigated the effect of a school-based violence prevention programme implemented in Grade 1 classrooms in Jamaican primary schools. Fourteen primary schools were randomly assigned to receive training in classroom behaviour management (n = 7 schools, 27 teachers/classrooms) or to a control group (n = 7 schools, 28 teachers/classrooms). Four children from each class were randomly selected to participate in the evaluation (n = 220 children). Teachers were trained through a combination of workshop and in-class support sessions, and received a mean of 11.5 h of training (range = 3–20) over 8 months. The primary outcomes were observations of (1) teachers’ use of violence against children and (2) class-wide child aggression. Teachers in intervention schools used significantly less violence against children (effect size (ES) = −0.73); benefits to class-wide child aggression were not significant (ES = −0.20). Intervention teachers also provided a more emotionally supportive classroom environment (ES = 1.22). No benefits were found to class-wide prosocial behaviour, teacher wellbeing, or child mental health. The intervention benefited children’s early learning skills, especially oral language and self-regulation skills (ES = 0.25), although no benefits were found to achievement in maths calculation, reading and spelling. A relatively brief teacher-training programme reduced violence against children by teachers and increased the quality of the classroom environment.
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Allen K, Hansford L, Hayes R, Allwood M, Byford S, Longdon B, Price A, Ford T. Teachers' perceptions of the impact of the Incredible Years ® Teacher Classroom Management programme on their practice and on the social and emotional development of their pupils. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2019; 90 Suppl 1:75-90. [PMID: 31297801 DOI: 10.1111/bjep.12306] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/17/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Incredible Years® (IY) Teacher Classroom Management (TCM) programme may be an effective way to reduce teacher stress levels, improve child behaviour, and promote positive socio-emotional development. However, few studies have considered what teachers think of the course and how it might work. AIMS In this paper, we examine teachers' perceptions of the impact of the TCM programme and how it might work in the classroom. SAMPLE(S) Forty-four UK primary school teachers who attended the TCM programme as part of the STARS trial (Ford et al., 2018, Psychol. Med., 49, 828). METHODS Focus groups and interviews were held with teachers two months after completing the TCM programme. Thematic analysis (Braun & Clarke, 2006, Qual. Res. Psychol., 3, 77) was employed to explore the subsequent data. RESULTS Three main themes were identified: impact on the teacher; on children; and on parent-teacher relationships. Impact on the teacher included a positive change in their ethos. Teachers reported being more able to see things from the child's perspective; placing a greater focus on building positive relationships; thinking before responding; feeling calmer, more confident, and in control; and employing strategies to create positive interactions with children. Teachers felt this had had a positive impact on their pupils' development and relationships with parents. Feedback on whether or not TCM was effective in tackling particularly challenging behaviour was more mixed. CONCLUSIONS Our findings suggest that teachers experience the TCM programme as beneficial. This is discussed alongside other qualitative and quantitative studies in this field.
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Affiliation(s)
- Kate Allen
- College of Health and Medicine, University of Exeter, UK
| | | | - Rachel Hayes
- College of Health and Medicine, University of Exeter, UK
| | | | - Sarah Byford
- Institute of Psychiatry, Psychology & Neuroscience, King's Health Economics, King's College London, UK
| | - Bryony Longdon
- College of Health and Medicine, University of Exeter, UK
| | - Anna Price
- College of Health and Medicine, University of Exeter, UK
| | - Tamsin Ford
- College of Health and Medicine, University of Exeter, UK
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Baker-Henningham H, Francis T. Parents' use of harsh punishment and young children's behaviour and achievement: a longitudinal study of Jamaican children with conduct problems. Glob Ment Health (Camb) 2018; 5:e32. [PMID: 30455967 PMCID: PMC6236219 DOI: 10.1017/gmh.2018.21] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 05/01/2018] [Accepted: 06/13/2018] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Harsh punishment by parents is common in low- and middle-income countries (LMIC), yet there is limited evidence from LMIC of the effects of harsh punishment on child outcomes. METHODS A longitudinal, prospective study was conducted with children with conduct problems to examine the associations between parents' use of harsh punishment during the preschool years on child behaviour and school achievement in grade one of primary school. As part of an efficacy trial in 24 preschools, 225 children with the highest level of teacher-reported conduct problems were evaluated and their parents reported on how often they used harsh punishment. Outcome measures in grade one included child conduct problems by independent observation, teacher and parent report, child social skills by teacher and parent report, direct tests of children's academic achievement and language skills, and tester ratings of child attention and impulse control. RESULTS Children had a mean age of 6.92 years and 61% were boys. All parents reported using harsh punishment. After controlling for child age and sex, socio-economic status, parents' involvement with child and maternal education, frequency of harsh punishment was associated with growth in child conduct problems by independent classroom observations (p = 0.037), parent (p = 0.018) and teacher (p = 0.044) report, a reduction in child social skills by teacher (p = 0.024) and parent (p = 0.014) report and poorer attention during the test session (p = 0.049). CONCLUSION The associations between frequency of parents' use of harsh punishment with their preschoolers with conduct problems and later child behaviour indicate a need to train parents in non-violent behaviour management.
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Affiliation(s)
- H. Baker-Henningham
- School of Psychology, Bangor University, Bangor, LL57 2AS, UK
- Caribbean Institute for Health Research, University of the West Indies, Kingston 7, Jamaica
| | - T. Francis
- Caribbean Institute for Health Research, University of the West Indies, Kingston 7, Jamaica
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Baker-Henningham H. The Irie Classroom Toolbox: developing a violence prevention, preschool teacher training program using evidence, theory, and practice. Ann N Y Acad Sci 2018; 1419:179-200. [DOI: 10.1111/nyas.13713] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 03/09/2018] [Accepted: 03/16/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Helen Baker-Henningham
- School of Psychology; Bangor University; Bangor Gwynedd UK
- Caribbean Institute for Health Research; University of the West Indies; Mona Jamaica
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Effect of transporting an evidence-based, violence prevention intervention to Jamaican preschools on teacher and class-wide child behaviour: a cluster randomised trial. Glob Ment Health (Camb) 2018; 5:e7. [PMID: 29507743 PMCID: PMC5827422 DOI: 10.1017/gmh.2017.29] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 10/07/2017] [Accepted: 10/18/2017] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Based on extensive piloting work, we adapted the Incredible Years (IY) teacher-training programme to the Jamaican preschool setting and evaluated this adapted version through a cluster-randomised trial. METHODS Twenty-four community preschools in Kingston, Jamaica were randomly assigned to intervention (12 schools, 37 teachers) or control (12 schools, 36 teachers). The intervention involved training teachers in classroom management through eight full-day training workshops and four individual 1-h in-class support sessions. Outcome measurements included direct observation of teachers' positive and negative behaviours to the whole class and to high-risk children and four observer ratings: two measures of class-wide child behaviour and two measures of classroom atmosphere. Measures were repeated at a six-month follow-up. RESULTS Significant benefits of intervention were found for teachers' positive [effect size (ES) = 3.35] and negative (ES = 1.29) behaviours to the whole class and to high-risk children (positive: ES = 0.83; negative: ES = 0.50) and for observer ratings of class-wide child behaviour (ES = 0.73), child interest and enthusiasm (ES = 0.98), teacher warmth (ES = 2.03) and opportunities provided to share and help (ES = 5.72). At 6-month follow-up, significant benefits of intervention were sustained: positive behaviours (ES = 2.70), negative behaviours (ES = 0.98), child behaviour (ES = 0.50), child interest and enthusiasm (ES = 0.78), teacher warmth (ES = 0.91), opportunities to share and help (ES = 1.42). CONCLUSIONS The adapted IY teacher-training programme produced large benefits to teacher's behaviour and to class-wide measures of children's behaviour, which were sustained at 6-month follow-up. Benefits were of a similar magnitude to those found in a pilot study of the minimally adapted version that required significantly more in-class support for teachers.
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Schneider DR, Pereira APD, Cruz JI, Strelow M, Chan G, Kurki A, Sanchez ZM. Evaluation of the Implementation of a Preventive Program for Children in Brazilian Schools. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2016. [DOI: 10.1590/1982-3703000592016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract The article discusses the pilot implementation of the evidence-based preventive program Good Behavior Game (GBG) in public schools in four Brazilian cities. GBG is a method for classroom behavior management by teachers, which aims at developing sociability among elementary school students between 6 and 10 years old. The objective of this study was to evaluate the program implementation process, focusing on the acceptability and perceived results by the professionals involved. Mixed methods were used, and data analysis was conducted using triangulation, including questionnaires and semi-structured interviews with 28 teachers, 9 school administrators, and 6 coaches. Data analysis was performed through descriptive and inferential statistics and content analysis, according to the nature of data. GBG had a high acceptance among teachers and school administrators. Professionals highlighted the importance of stimulating teamwork, the systematic use of rewards, and the objectivity of classroom rules. Acceptability was attributed, in large part, to the effectiveness of the strategy for classroom management. Nevertheless, this study highlighted the need of adaptations to better reflect the Brazilian societal and economic context.
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Affiliation(s)
| | | | | | | | - Gail Chan
- American Institutes for Research, Estados Unidos da América
| | - Anja Kurki
- American Institutes for Research, Estados Unidos da América
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Baker-Henningham H, Vera-Hernández M, Alderman H, Walker S. Irie Classroom Toolbox: a study protocol for a cluster-randomised trial of a universal violence prevention programme in Jamaican preschools. BMJ Open 2016; 6:e012166. [PMID: 27165651 PMCID: PMC4874121 DOI: 10.1136/bmjopen-2016-012166] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION We aim to determine the effectiveness of a school-based violence prevention programme implemented in Jamaican preschools, on reducing the levels of aggression among children at school, and violence against children by teachers. METHODS AND ANALYSIS This is a 2-arm, single-blind, cluster-randomised controlled trial with parallel assignment. Clusters are 76 preschools in Kingston, and all teachers and classrooms in the selected schools are included in the study. In addition, a random sample of up to 12 children in the 4-year-old classes have been selected for evaluation of child-level outcomes. The intervention involves training teachers in classroom behaviour management and in strategies to promote children's social-emotional competence. Training is delivered through five full-day workshops, monthly in-class coaching over 2 school terms, and weekly text messages. The primary outcome measures are: (1) observed levels of child aggression and (2) observed violence against children by teachers. Secondary outcomes include observations of the levels of children's prosocial behaviour and the quality of the classroom environment, teachers' reports of their mental health, teacher-reported child mental health, direct tests of children's self-regulation and child attendance. ETHICS AND DISSEMINATION If this intervention were effective at improving the caregiving environment of young children in school, this would have significant implications for the prevention of child mental health problems, and prevention of violence against children in low and middle-income countries where services are often limited. The intervention is integrated into the school system and involves training existing staff, and thus, represents an appropriate strategy for large-scale implementation and benefits at the population level. Ethical consent for the study was given by the School of Psychology Ethics and Research Committee, Bangor University (ref: 2014-14167), and by the University of the West Indies Ethics Committee (ref: ECP 50,14/15). TRIAL REGISTRATION NUMBER ISRCTN11968472; Pre-results.
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Affiliation(s)
- Helen Baker-Henningham
- School of Psychology, Bangor University, Bangor, Gwynedd, UK
- Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica
| | - Marcos Vera-Hernández
- Centre for the Evaluation of Development Policies, Institute of Fiscal Studies, London, UK
| | - Harold Alderman
- International Food Policy Research Institute, Washington DC, USA
| | - Susan Walker
- Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica
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Gardner F, Montgomery P, Knerr W. Transporting Evidence-Based Parenting Programs for Child Problem Behavior (Age 3-10) Between Countries: Systematic Review and Meta-Analysis. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 45:749-762. [PMID: 25785902 DOI: 10.1080/15374416.2015.1015134] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There has been rapid global dissemination of parenting interventions, yet little is known about their effectiveness when transported to countries different from where they originated, or about factors influencing success. This is the first systematic attempt to address this issue, focusing on interventions for reducing child behavior problems. Stage 1 identified evidence-based parenting interventions showing robust effects in systematic reviews; Stage 2 identified trials of these interventions in a new country. Systematic review/meta-analysis of transported programs was followed by subgroup analyses by trial- and country-level cultural, resource, and policy factors. We found 17 transported trials of 4 interventions, originating in United States or Australia, tested in 10 countries in 5 regions, (n = 1,558 children). Effects on child behavior were substantial (SMD -.71) in the (14) randomized trials, but nonsignificant in the (3) nonrandomized trials. Subgroup analyses of randomized trials found no association between effect size and participant or intervention factors (e.g., program brand, staffing). Interventions transported to "western" countries showed comparable effects to trials in origin countries; however, effects were stronger when interventions were transported to culturally more distant regions. Effects were higher in countries with survival-focused family/childrearing values than those ranked more individualistic. There were no differences in effects by country-level policy or resource factors. Contrary to common belief, parenting interventions appear to be at least as effective when transported to countries that are more different culturally, and in service provision, than those in which they were developed. Extensive adaptation did not appear necessary for successful transportation.
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Affiliation(s)
- Frances Gardner
- a Centre for Evidence-Based Intervention, Department of Social Policy andIntervention , University of Oxford
| | - Paul Montgomery
- a Centre for Evidence-Based Intervention, Department of Social Policy andIntervention , University of Oxford
| | - Wendy Knerr
- a Centre for Evidence-Based Intervention, Department of Social Policy andIntervention , University of Oxford
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Pryjmachuk S, Elvey R, Kirk S, Kendal S, Bower P, Catchpole R. Developing a model of mental health self-care support for children and young people through an integrated evaluation of available types of provision involving systematic review, meta-analysis and case study. HEALTH SERVICES AND DELIVERY RESEARCH 2014. [DOI: 10.3310/hsdr02180] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundThe mental health of children and young people (CYP) is a major UK public health concern. Recent policy reviews have identified that service provision for CYP with mental health needs is not as effective, responsive, accessible or child-centred as it could be. Following on from a previous National Institute for Health Research (NIHR) study into self-care support for CYP with long-term physical health needs, this study explored self-care support’s potential in CYP’s mental health.ObjectivesTo identify and evaluate the types of mental health self-care support used by, and available to, CYP and their parents, and to establish how such support interfaces with statutory and non-statutory service provision.DesignTwo inter-related systematic literature reviews (an effectiveness review with meta-analysis and a perceptions review), together with a service mapping exercise and case study.SettingGlobal (systematic reviews); England and Wales (mapping exercise and case study).Participants (case study)Fifty-two individuals (17 CYP, 16 family members and 19 staff) were interviewed across six sites.Main outcome measures (meta-analysis)A measure of CYP’s mental health symptomatology.Data sources (literature reviews)MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, All Evidence-Based Medicine (EBM) Reviews, Applied Social Sciences Index and Abstracts (ASSIA) and Education Resources Information Center (ERIC).Review methodsTitles and abstracts of papers were screened for relevance then grouped into studies. Two independent reviewers extracted data from studies meeting the inclusion criteria. A descriptive analysis and meta-analysis were conducted for the effectiveness review; descriptive analyses were conducted for the perceptions review. These analyses were integrated to elicit a mixed-methods review.ResultsSixty-five of 71 included studies were meta-analysable. These 65 studies elicited 71 comparisons which, when meta-analysed, suggested that self-care support interventions were effective at 6-month [standardised mean difference (SMD) = −0.20; 95% confidence interval (CI) −0.28 to −0.11] and 12-month (SMD = −0.12; 95% CI −0.17 to −0.06) follow-ups. However, judged against Cochrane criteria, the studies were mostly low quality. Key elements of self-care support identified in the perceptions review were the acquisition of knowledge and skills, peer support and the relationship with the self-care support agent; CYP also had different perceptions from adults about what is important in self-care support. The mapping exercise identified 27 providers of 33 self-care support services. According to the case study data, effective self-care support services are predicated on flexibility; straightforward access; non-judgemental, welcoming organisations and staff; the provision of time and attention; opportunities to learn and practise skills relevant to self-care; and systems of peer support.ConclusionsMental health self-care support interventions for CYP are modestly effective in the short to medium term. Self-care support can be conceptualised as a process which has overlap with ‘recovery’. CYP and their families want choice and flexibility in the provision of such interventions and a continued relationship with services after the nominal therapy period. Those delivering self-care support need to have specific child-centred attributes.Future workFuture work should focus on under-represented conditions (e.g. psychosis, eating disorders, self-harm); the role of technology, leadership and readiness in self-care support; satisfaction in self-care support; the conceptualisation of self-care support in CYP’s mental health; and efficacy and cost-effectiveness.Study registrationPROSPERO number (for the effectiveness review) CRD42012001981.FundingThe NIHR Health Services and Delivery Research programme.
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Affiliation(s)
- Steven Pryjmachuk
- School of Nursing, Midwifery and Social Work, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Rebecca Elvey
- School of Nursing, Midwifery and Social Work, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Susan Kirk
- School of Nursing, Midwifery and Social Work, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Sarah Kendal
- School of Nursing, Midwifery and Social Work, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Peter Bower
- Institute of Population Health, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
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Baker-Henningham H. The role of early childhood education programmes in the promotion of child and adolescent mental health in low- and middle-income countries. Int J Epidemiol 2013; 43:407-33. [DOI: 10.1093/ije/dyt226] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Baker-Henningham H, Scott S, Jones K, Walker S. Reducing child conduct problems and promoting social skills in a middle-income country: cluster randomised controlled trial. Br J Psychiatry 2012; 201:101-8. [PMID: 22500015 PMCID: PMC3409425 DOI: 10.1192/bjp.bp.111.096834] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is an urgent need for effective, affordable interventions to prevent child mental health problems in low- and middle-income countries. AIMS To determine the effects of a universal pre-school-based intervention on child conduct problems and social skills at school and at home. METHOD In a cluster randomised design, 24 community pre-schools in inner-city areas of Kingston, Jamaica, were randomly assigned to receive the Incredible Years Teacher Training intervention (n = 12) or to a control group (n = 12). Three children from each class with the highest levels of teacher-reported conduct problems were selected for evaluation, giving 225 children aged 3-6 years. The primary outcome was observed child behaviour at school. Secondary outcomes were child behaviour by parent and teacher report, child attendance and parents' attitude to school. The study is registered as ISRCTN35476268. RESULTS Children in intervention schools showed significantly reduced conduct problems (effect size (ES) = 0.42) and increased friendship skills (ES = 0.74) through observation, significant reductions to teacher-reported (ES = 0.47) and parent-reported (ES = 0.22) behaviour difficulties and increases in teacher-reported social skills (ES = 0.59) and child attendance (ES = 0.30). Benefits to parents' attitude to school were not significant. CONCLUSIONS A low-cost, school-based intervention in a middle-income country substantially reduces child conduct problems and increases child social skills at home and at school.
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Affiliation(s)
- Helen Baker-Henningham
- Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica.
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Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, Rohde LA, Srinath S, Ulkuer N, Rahman A. Child and adolescent mental health worldwide: evidence for action. Lancet 2011; 378:1515-25. [PMID: 22008427 DOI: 10.1016/s0140-6736(11)60827-1] [Citation(s) in RCA: 1203] [Impact Index Per Article: 92.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Mental health problems affect 10-20% of children and adolescents worldwide. Despite their relevance as a leading cause of health-related disability in this age group and their longlasting effects throughout life, the mental health needs of children and adolescents are neglected, especially in low-income and middle-income countries. In this report we review the evidence and the gaps in the published work in terms of prevalence, risk and protective factors, and interventions to prevent and treat childhood and adolescent mental health problems. We also discuss barriers to, and approaches for, the implementation of such strategies in low-resource settings. Action is imperative to reduce the burden of mental health problems in future generations and to allow for the full development of vulnerable children and adolescents worldwide.
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Affiliation(s)
- Christian Kieling
- Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
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Baker-Henningham H. Transporting evidence-based interventions across cultures: using focus groups with teachers and parents of pre-school children to inform the implementation of the Incredible Years Teacher Training Programme in Jamaica. Child Care Health Dev 2011; 37:649-61. [PMID: 21392051 DOI: 10.1111/j.1365-2214.2011.01208.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Evidence-based programmes to prevent and treat conduct problems in young children are available, but there is limited information on the extent to which they can be effectively transported to developing countries. This study used focus group discussions with parents and teachers of pre-school children to investigate whether an evidence-based programme - the Incredible Years (IY) Teacher Training Programme - could be transported to the Jamaican pre-school setting. METHODS Ten focus group discussions were held with 50 pre-school teachers and 47 parents of pre-school children. For each focus group, a semi-structured questioning guide was used to explore parents' and teachers' perceptions of the dimensions and causes of problem behaviour in young children and strategies used to manage child behaviour. All focus group discussions were audiotaped and transcribed, and thematic analysis was used to analyse the data. RESULTS Parents and teachers shared similar views of what constitutes good behaviour and poor behaviour, and both parents and teachers believed that the major influences on children's behaviour are factors in the home. Many appropriate and useful strategies for managing child behaviour were used including showing children affection, spending time with children, using praise, incentives and rewards and withdrawing privileges and using timeout as consequences for misbehaviour. Some inappropriate strategies were also used, especially corporal punishment, although there was a general consensus within all groups that this is not desirable or effective. CONCLUSIONS Through the focus groups, it was clear that parents and teachers were familiar with many of the strategies and principles introduced through the IY Teacher Training Programme, and the programme was largely compatible with their values and beliefs. However, some topics require additional emphasis thus lengthening the time required for training. It was also evident that there is a strong perceived need for training in child behaviour management for parents.
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Affiliation(s)
- H Baker-Henningham
- Department of Educational Studies, University of the West Indies, Mona, Kingston 7, Jamaica.
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Carlson JS, Tiret HB, Bender SL, Benson L. The Influence of Group Training in the Incredible Years Teacher Classroom Management Program on Preschool Teachers’ Classroom Management Strategies. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2011. [DOI: 10.1080/15377903.2011.565277] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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