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Strategies to Increase Uptake of Parent Education Programs in Preschool and School Settings to Improve Child Outcomes: A Delphi Study.

ABSTRACT: Parent education programs, offered via family-school partnerships, offer an effective means for promoting the mental health and educational functioning of children and adolescents at a whole-school level. However, these programs often have a low uptake. This study aimed to identify strategies for increasing the uptake of parent education programs within preschool and school settings. A three-round Delphi procedure was employed to obtain expert consensus on strategies that are important and feasible in educational settings. First, thirty experts rated statements identified from the literature and a stakeholder forum. Next, experts re-appraised statements, including new statements generated from the first round. Ninety statements were endorsed by ≥80% of the experts. Primary themes include strategies for program selection; strategies for increasing the accessibility of programs and the understanding of educational staff on parent engagement and child mental health; strategies for program development, promotion and delivery; as well as strategies for increasing parent and community engagement. This study offers a set of consensus strategies for improving the uptake of parent education programs within family-school partnership.

SUBMITTER: Sim WH

PROVIDER: S-EPMC8036819 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Strategies to Increase Uptake of Parent Education Programs in Preschool and School Settings to Improve Child Outcomes: A Delphi Study.

Sim Wan Hua WH Toumbourou John W JW Clancy Elizabeth M EM Westrupp Elizabeth M EM Benstead Michelle L ML Yap Marie B H MBH

International journal of environmental research and public health 20210329 7

Parent education programs, offered via family-school partnerships, offer an effective means for promoting the mental health and educational functioning of children and adolescents at a whole-school level. However, these programs often have a low uptake. This study aimed to identify strategies for increasing the uptake of parent education programs within preschool and school settings. A three-round Delphi procedure was employed to obtain expert consensus on strategies that are important and feasi ...[more]

PMID: 33805327

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Project description:BackgroundThe 'New Forest Parenting Package' (NFPP), an 8-week home-based intervention for parents of preschoolers with attention-deficit/hyperactivity disorder (ADHD), fosters constructive parenting to target ADHD-related dysfunctions in attention and impulse control. Although NFPP has improved parent and laboratory measures of ADHD in community samples of children with ADHD-like problems, its efficacy in a clinical sample, and relative to an active treatment comparator, is unknown. The aims are to evaluate the short- and long-term efficacy and generalization effects of NFPP compared to an established clinic-based parenting intervention for treating noncompliant behavior ['Helping the Noncompliant Child' (HNC)] in young children with ADHD.MethodsA randomized controlled trial with three parallel arms was the design for this study. A total of 164 3-4-year-olds, 73.8% male, meeting DSM-IV ADHD diagnostic criteria were randomized to NFPP (N = 67), HNC (N = 63), or wait-list control (WL, N = 34). All participants were assessed at post-treatment. NFPP and HNC participants were assessed at follow-up in the next school year. Primary outcomes were ADHD ratings by teachers blind to and uninvolved in treatment, and by parents. Secondary ADHD outcomes included clinician assessments, and laboratory measures of on-task behavior and delay of gratification. Other outcomes included parent and teacher ratings of oppositional behavior, and parenting measures. (Trial name: Home-Based Parent Training in ADHD Preschoolers; Registry: ClinicalTrials.gov Identifier: NCT01320098; URL: http://www/clinicaltrials.gov/ct2/show/NCT01320098).ResultsIn both treatment groups, children's ADHD and ODD behaviors, as well as aspects of parenting, were rated improved by parents at the end of treatment compared to controls. Most of these gains in the children's behavior and in some parenting practices were sustained at follow-up. However, these parent-reported improvements were not corroborated by teacher ratings or objective observations. NFPP was not significantly better, and on a few outcomes significantly less effective, than HNC.ConclusionsThe results do not support the claim that NFPP addresses putative dysfunctions underlying ADHD, bringing about generalized change in ADHD, and its underpinning self-regulatory processes. The findings support documented difficulties in achieving generalization across nontargeted settings, and the importance of using blinded measures to provide meaningful assessments of treatment effects.

Project description:Background: Existing efforts to understand school-based child sexual abuse (CSA) prevention programs mainly focus on the effectiveness of these programs in increasing participants' CSA knowledge and self-protective skills. There are currently no reviews addressing the underpinning pathways leading to these outcomes. In order to increase our understanding about the underpinning causal and contextual factors and inform the further development of school-based CSA prevention programs, a realist review was conducted to synthesize existing evidence from a broad range of data. Methods: An iterative search of electronic databases and grey literature was conducted, supplemented with citation tracking to locate relevant literature. For quantitative evidence, we considered evaluation studies that focused on students aged 5-18 years, who were enrolled in primary or secondary schools; for other types/formats of studies/documents, no population restrictions were applied. We included school-based CSA prevention programs that focused on improving knowledge of CSA or self-protective skills. Outcomes of interest included knowledge of CSA or self-protective skills. We did not apply methodological filters in terms of the types of studies to be included. Thematic content analysis was conducted to synthesize data. Results: Sixty-two studies were included. Five themes and five overarching Context-Strategy-Mechanism-Outcome configurations (CSMOs) that contributed to the success of school-based CSA interventions were identified, including tailoring programs to participants' cognitive developmental levels, repeated exposure of key concepts and skills, utilization of interactive delivery methods and positive feedback, delivery of positive information and application of the 'train-the-trainer' model. Implications: Findings from this realist review provide insights into the underlying program theory of school-based CSA prevention programs, which can aid in the development and implementation of these programs in the future.

Project description:ImportanceAlthough different aspects of socioeconomic status (SES) may represent distinct risk factors for poor mental health in children, knowledge of their differential and synergistic associations with the brain is limited.ObjectiveTo examine the independent associations between distinct SES factors and child brain structure.Design, setting, and participantsWe used baseline data from participants aged 9 to 10 years in the Adolescent Brain Cognitive Development (ABCD) study. These data were collected from 21 US sites between September 2017 and August 2018. Study participants were recruited from schools to create a participant sample that closely reflects the US population.ExposuresNeighborhood disadvantage was measured using the area deprivation index. We also used data on total parent or caregiver educational attainment (in years) and household income-to-needs ratio.Main outcomes and measuresT1-weighted magnetic resonance imaging was used to assess measures of cortical thickness, surface area, and subcortical volume.ResultsData from 8862 ABCD participants aged 9 to 10 years were analyzed. The mean (SD) age was 119.1 (7.5) months; there were 4243 girls (47.9%) and 4619 boys (52.1%). Data on race or ethnicity were available for 8857 of 8862 participants: 173 (2.0%) were Asian, 1099 (12.4%) were Black or African American, 1688 (19.1%) were Hispanic, 4967 (56.1%) were White, and 930 (10.5%) reported multiple races or ethnicities. Using 10-fold, within-sample split-half replication, we found that neighborhood disadvantage was associated with lower cortical thickness in the following brain regions (η2 = 0.004-0.009): cuneus (B [SE] = -0.099 [0.013]; P < .001), lateral occipital (B [SE] = -0.088 [0.011]; P < .001), lateral orbitofrontal (B [SE] = -0.072 [0.012]; P < .001), lingual (B [SE] = -0.104 [0.012]; P < .001), paracentral (B [SE] = -0.086 [0.012]; P < .001), pericalcarine (B [SE] = -0.077 [0.012]; P < .001), postcentral (B [SE] = -0.069 [0.012]; P < .001), precentral (B [SE] = -0.059 [0.011]; P < .001), rostral middle frontal (B [SE] = -0.076 [0.011]; P < .001), and superior parietal (B [SE] = -0.060 [0.011]; P < .001). Exploratory analyses showed that the associations of low educational attainment or neighborhood disadvantage and low cortical thickness were attenuated in the presence of a high income-to-needs ratio (η2 = 0.003-0.007).Conclusions and relevanceThe findings of this cross-sectional study suggest that different SES indicators have distinct associations with children's brain structure. A high income-to-needs ratio may play a protective role in the context of neighborhood disadvantage and low parent or caregiver educational attainment. This study highlights the importance of considering the joint associations of different SES indicators in future work.

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Strategies to Increase Uptake of Parent Education Programs in Preschool and School Settings to Improve Child Outcomes: A Delphi Study.

Publications

Strategies to Increase Uptake of Parent Education Programs in Preschool and School Settings to Improve Child Outcomes: A Delphi Study.

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