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. 2019 Jan 25;9(1):e026684.
doi: 10.1136/bmjopen-2018-026684.

Prevention of child mental health problems in Southeastern Europe: a multicentre sequential study to adapt, optimise and test the parenting programme 'Parenting for Lifelong Health for Young Children', protocol for stage 1, the feasibility study

Inga Frantz  1 , Heather M Foran  2 , Jamie M Lachman  3   4 , Elena Jansen  2 , Judy Hutchings  5 , Adriana Băban  6 , Xiangming Fang  7 , Frances Gardner  3 , Galina Lesco  8 , Marija Raleva  9 , Catherine L Ward  10 , Margiad Elen Williams  5 , Nina Heinrichs  1
Affiliations

Prevention of child mental health problems in Southeastern Europe: a multicentre sequential study to adapt, optimise and test the parenting programme 'Parenting for Lifelong Health for Young Children', protocol for stage 1, the feasibility study

Inga Frantz et al. BMJ Open. .

Abstract

Introduction: Families in low-income and middle-income countries (LMICs) face multiple challenges (eg, poverty and adverse childhood experiences) that increase the risk for child mental health problems, while the context may provide them with few resources. Existing prevention-oriented parenting programmes have been shown to be effective in reducing child behaviour problems and associated risk factors. This project has the overall goal of adapting, implementing and testing a parenting intervention in three Southeastern European LMIC and uses the Multiphase Optimisation Strategy and dimensions of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. It is implemented over three phases: (1) preparation, (2) optimisation and (3) evaluation. The preparation phase, the subject of this paper, involves the adaptation and feasibility piloting of the parenting programme.

Methods and analysis: This protocol describes the assessment of an evidence-informed indicated prevention programme for families with children aged 2-9 years (Parenting for Lifelong Health for Young Children) for implementation in FYR of Macedonia, Republic of Moldova and Romania. In this phase, officials, experts, parents and practitioners are interviewed to explore their views of suitability and needs for further adaptation. In addition, a small pre-post pilot study will test the feasibility of the programme and its implementation as well as the evaluation measures in the three countries with 40 families per country site (n=120). Quantitative data analysis will comprise a psychometric analysis of measures, testing pre-post differences using ANCOVA, χ2 tests and regression analysis. For qualitative data analysis, a thematic approach within an experiential framework will be applied.

Ethics and dissemination: The ethics review board of the Alpen-Adria University Klagenfurt and ethical review boards in the three LMIC sites have approved the study.

Trial registration number: NCT03552250.

Keywords: child protection; clinical trials; community child health; mental health.

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Conflict of interest statement

Competing interests: AB, XF, HMF, EJ, GL, MR, and MEW have nothing to disclose. IF reports personal fees from Hamburg University, and other institutions offering education for psychotherapy in Germany outside the submitted work; IF is a certified trainer of the Triple P program. FG is a co-developer of PLH for Young Children, which is licensed under a Creative Commons 4.0 Non-commercial No Derivatives license, and one of the co-founders of the Parenting for Lifelong Health initiative. FG has participated (and is participating) in a number of research studies involving the program, as an investigator, and the University of Oxford receives research funding for these. LML reports personal fees from Clowns Without Borders South Africa, grants from University of Oxford, and other from Parenting for Lifelong Health, outside the submitted work; NH reports grants and non-financial support from Technische Universität Braunschweig, during the conduct of the study; personal fees from other academic institutions offering continued education for psychotherapy education in Germany, outside the submitted work; and NH serves as an international advisory board member for the Triple P program. JH is a co-developer of PLH for Young Children, which is licensed under a Creative Commons 4.0 Non-commercial No Derivatives license, and one of the co-founders of the Parenting for Lifelong Health initiative. She is the director of the Children’s Early Intervention Trust, a non-profit institution responsible for the dissemination of the program in Europe. She receives occasional fees for providing training and supervision to facilitators and coaches. JH has participated (and is participating) in a number of research studies involving the program, as an investigator, and Bangor University receives research funding for these. JH contributed to the initial trial in South Africa, the trial in the Philippines and led the evaluation of the program in a pre-post trial in Montenegro. CLW reports grants from World Childhood Foundation, and grants from UBS Optimus Foundation via the Philippine Ambulatory Pediatric Association, outside the submitted work; CLW is a co-developer of PLH for Young Children, which is licensed under a Creative Commons 4.0 Non-commercial No Derivatives license, and one of the co-founders of the Parenting for Lifelong Health initiative. CLW has participated (and is participating) in a number of research studies involving the program, as an investigator, and the University of Cape Town receives research funding for these. She receives no direct personal income from this work.

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