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Parents make the difference: a randomized-controlled trial of a parenting intervention in Liberia

  • E. S. Puffer (a1) (a2), E. P. Green (a2), R. M. Chase (a3), A. L. Sim (a4), J. Zayzay (a5), E. Friis (a1), E. Garcia-Rolland (a4) and L. Boone (a4)...
Abstract
Background.

The objective of this study was to evaluate the impact of a brief parenting intervention, ‘Parents Make the Difference‘(PMD), on parenting behaviors, quality of parent-child interactions, children's cognitive, emotional, and behavioral wellbeing, and malaria prevention behaviors in rural, post-conflict Liberia.

Methods.

A sample of 270 caregivers of children ages 3–7 were randomized into an immediate treatment group that received a 10-session parent training intervention or a wait-list control condition (1:1 allocation). Interviewers administered baseline and 1-month post-intervention surveys and conducted child-caregiver observations. Intent-to-treat estimates of the average treatment effects were calculated using ordinary least squares regression. This study was pre-registered at ClinicalTrials.gov (NCT01829815).

Results.

The program led to a 55.5% reduction in caregiver-reported use of harsh punishment practices (p < 0.001). The program also increased the use of positive behavior management strategies and improved caregiver–child interactions. The average caregiver in the treatment group reported a 4.4% increase in positive interactions (p < 0.05), while the average child of a caregiver assigned to the treatment group reported a 17.5% increase (p < 0.01). The program did not have a measurable impact on child wellbeing, cognitive skills, or household adoption of malaria prevention behaviors.

Conclusions.

PMD is a promising approach for preventing child abuse and promoting positive parent-child relationships in low-resource settings.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
* Address for correspondence: E. S. Puffer, Department of Psychology and Neuroscience, Duke University, Box 90086, 417 Chapel Drive, Durham, NC, USA and Duke Global Health Institute, Box 90519, Durham, NC, USA. (Email: eve.puffer@duke.edu)
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