. 2018 Jan 31;3(1):e000539.

doi: 10.1136/bmjgh-2017-000539. eCollection 2018.

Parenting for Lifelong Health: a pragmatic cluster randomised controlled trial of a non-commercialised parenting programme for adolescents and their families in South Africa

Lucie D Cluver^{1

2}, Franziska Meinck^{1

3}, Janina I Steinert¹, Yulia Shenderovich^{1

4}, Jenny Doubt^{1

5}, Rocio Herrero Romero¹, Carl J Lombard^{6

7}, Alice Redfern¹, Catherine L Ward⁸, Sibongile Tsoanyane⁹, Divane Nzima^{10

11}, Nkosiyapha Sibanda¹², Camille Wittesaele¹, Sachin De Stone¹³, Mark E Boyes¹⁴, Ricardo Catanho¹, Jamie McLaren Lachman^{1

9}, Nasteha Salah¹⁵, Mzuvukile Nocuza¹, Frances Gardner¹

Affiliations

¹ Centre for Evidence-Based Interventions, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
² Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
³ OPTENTIA Research Focus Group, School of Behavioural Sciences, North-West University, Vanderbijlpark, South Africa.
⁴ Institute of Criminology, University of Cambridge, Cambridge, UK.
⁵ UNICEF Innocenti Office of Research, Florence, Italy.
⁶ Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa.
⁷ School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
⁸ Department of Psychology and Safety and Violence Initiative, University of Cape Town, Cape Town, South Africa.
⁹ Clowns Without Borders South Africa, Durban, South Africa.
¹⁰ Department of Sociology & Anthropology, University of Fort Hare, Alice, South Africa.
¹¹ Ali-Douglas Research Network, Bulawayo, Zimbabwe.
¹² Department of International Development, London School of Economics and Political Science, London, UK.
¹³ Warwick Medical School, Warwick, UK.
¹⁴ Faculty of Health Sciences, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
¹⁵ London School of Hygiene and Tropical Medicine, London, UK.

PMID: 29564157
PMCID: PMC5859808
DOI: 10.1136/bmjgh-2017-000539

Parenting for Lifelong Health: a pragmatic cluster randomised controlled trial of a non-commercialised parenting programme for adolescents and their families in South Africa

Lucie D Cluver et al. BMJ Glob Health. 2018.

. 2018 Jan 31;3(1):e000539.

doi: 10.1136/bmjgh-2017-000539. eCollection 2018.

Authors

Affiliations

¹ Centre for Evidence-Based Interventions, Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
² Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
³ OPTENTIA Research Focus Group, School of Behavioural Sciences, North-West University, Vanderbijlpark, South Africa.
⁴ Institute of Criminology, University of Cambridge, Cambridge, UK.
⁵ UNICEF Innocenti Office of Research, Florence, Italy.
⁶ Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa.
⁷ School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
⁸ Department of Psychology and Safety and Violence Initiative, University of Cape Town, Cape Town, South Africa.
⁹ Clowns Without Borders South Africa, Durban, South Africa.
¹⁰ Department of Sociology & Anthropology, University of Fort Hare, Alice, South Africa.
¹¹ Ali-Douglas Research Network, Bulawayo, Zimbabwe.
¹² Department of International Development, London School of Economics and Political Science, London, UK.
¹³ Warwick Medical School, Warwick, UK.
¹⁴ Faculty of Health Sciences, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
¹⁵ London School of Hygiene and Tropical Medicine, London, UK.

PMID: 29564157
PMCID: PMC5859808
DOI: 10.1136/bmjgh-2017-000539

Abstract

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.

Keywords: RCT; adolescents; child abuse; low-income and middle-income countries; parenting.

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Conflict of interest statement

Competing interests: JD, JML, ST, LDC, CLW and JIS were involved in developing the Sinovuyo Caring Families Programme for Parents and Teens, which is licensed under a Creative Commons 4.0 Non-commercial No Derivatives license. JD, JML and ST work for Clowns Without Borders South Africa, the non-profit institution responsible for the delivery of the intervention that was evaluated in this study. All other authors declare no competing interests.

Figures

**Figure 1**
Trial profile. CG, caregiver; ITT, intention to treat.

See this image and copyright information in PMC

References

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Parenting for Lifelong Health: a pragmatic cluster randomised controlled trial of a non-commercialised parenting programme for adolescents and their families in South Africa

Affiliations

Parenting for Lifelong Health: a pragmatic cluster randomised controlled trial of a non-commercialised parenting programme for adolescents and their families in South Africa

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources