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. 2019 May 2;20(1):253.
doi: 10.1186/s13063-019-3356-x.

The effects of two early parenting interventions on child aggression and risk for violence in Brazil (The PIÁ Trial): protocol for a randomised controlled trial

Joseph Murray  1 , Iná S Santos  2 , Andréa D Bertoldi  2 , Lynne Murray  3   4 , Adriane Arteche  5 , Luciana Tovo-Rodrigues  2 , Suélen Cruz  2 , Luciana Anselmi  2 , Rafaela Martins  2 , Elisa Altafim  6 , Tâmara Biolo Soares  7 , Maria Gabriela Andriotti  7 , Andrea Gonzalez  8 , Isabel Oliveira  2 , Mariângela Freitas da Silveira  2 , Peter Cooper  3   4
Affiliations

The effects of two early parenting interventions on child aggression and risk for violence in Brazil (The PIÁ Trial): protocol for a randomised controlled trial

Joseph Murray et al. Trials. .

Abstract

Background: Children in many low- and middle-income countries (LMICs) are at high risk for exposure to violence and later violent behaviour. The World Health Organization has declared an urgent need for the evaluation and implementation of low-cost parenting interventions in LMICs to prevent violence. Two areas of significant early risk are harsh parenting and poor child cognitive and socio-emotional development. Parenting interventions suitable for LMIC contexts have been developed targeting these risk factors and have been shown to have promising effects. However, their impact on child aggression, a key precursor of violence, has yet to be determined. The Pelotas Trial of Parenting Interventions for Aggression (PIÁ) has been designed to address this issue.

Methods: We are conducting a randomised controlled trial to evaluate two early parenting interventions for mothers of children aged between 30 and 42 months in a Brazilian city. The first of these, dialogic book-sharing (DBS), aims to promote child cognitive and socio-emotional development; and the second, the ACT Raising Safe Kids Program (ACT), is designed to reduce harsh parenting. These interventions are being compared with a control group receiving neither intervention. Three hundred and sixty-nine families in a birth cohort are being randomly allocated to one of the three groups (DBS, ACT, Control). Facilitators deliver the interventions to groups of five to 10 mothers at weekly sessions for 8 weeks in DBS and 9 weeks in ACT. Independent assessments of parenting and child development are being made before the interventions, shortly afterwards, and at follow-up 6 months later. The primary outcome is child aggression, and the two main secondary outcomes are: (1) child cognitive and socio-emotional development and (2) harsh parenting. Longer-term outcomes will be investigated as the birth cohort is followed into late childhood, adolescence, and adulthood.

Discussion: The Pelotas Trial of Parenting Interventions for Aggression (PIÁ) aims to evaluate the impact of two early parenting interventions on child aggression and several other key risk factors for the development of violence, including aspects of parenting and child cognition and socio-emotional functioning. The study is being carried out in a LMIC context where violence constitutes a major social and health burden. Since the two interventions are brief and, with modest levels of training, readily deliverable in LMIC settings, a demonstration that they benefit parenting and reduce risk factors for violence would be of major significance.

Trial registration: Brazilian Ministry of Health Register of Clinical Trials, ID: RBR-2kwfsk . Registered on 6 June 2018.

Keywords: Child aggression; Child development; Parenting interventions; Violence prevention.

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Conflict of interest statement

Ethics approval and consent to participate

The study protocol has received ethical approval from the Ethics Committee of the Faculty of Medicine, Federal University of Pelotas (2.602.769). Any modifications to the study protocol will be communicated to the Ethics Committee and updated on the trial registry. Participation in The PIÁ Trial is dependent on the informed consent of the primary caregiver of the child. A consent form is delivered in writing, and is read to the mothers in order to explain the objectives and procedures of the study. In addition, potential participants are communicated data confidentiality procedures, the fact that participation is entirely voluntary, and the possibility of leaving the study at any time and without justification. The mothers are being invited to sign the consent form a copy of which they keep. The signed form is filed at the Federal University of Pelotas.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Schedule of enrolment, interventions, and assessments
See this image and copyright information in PMC

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