Families First Positive Discipline for Everyday Parenting With Home Visiting Program in Indonesia

Aims and objectives The primary objective of this study is to compare, among caregivers of children aged 0-7 years in Cianjur district, Indonesia, the effectiveness of the Families First Program in reducing rates of violent discipline episodes in the home in comparison to rates observed under the standard community health and social service provision. The study will also identify unintended positive and negative effects of this program; determine facilitators and barriers to its implementation in this context; and assess facilitators, mentors, and families' satisfaction with the program.

Site eligibility Data will be collected across 20 villages or clusters that represent the general population in four sub-districts (Campaka, Ciranjang, Karang tengah, and Naringgul) in Cianjur district, West Java Province, Indonesia. Selected villages will consist of (a) rural and urban/peri-urban communities; (b) not been exposed to the Families First Program; (c) reachable within a 1-hour driving distance of the sub-district office and 1-8 hours driving distance of the district capital; (d) located at ample distance from other clusters; and (e) local political leaders provide approval for the intervention and the evaluation.

Randomization Stratified randomization will be used to select 20 clusters among the eligible 38 study clusters in rural and urban settings in the four sub-districts in a 1:1 ratio for the intervention and the control arms. Clusters will be randomized to avoid the resentment or contamination that might occur as a result of delivering the intervention to some families but not others in the community. Randomization will be done in a Random Allocation Ceremony led by the research team and attended by the chiefs from all participating villages as well as staff from the implementing agency. The ceremony will follow a step-by-step lottery and documentation procedure that includes the use of 20 sequentially numbered, opaque, sealed and stapled envelopes independently prepared by the lead investigator. Aluminium foil inside the envelope will render the envelope impermeable to intense light. The ceremony will be video-recorded. Eligible families will be identified before randomly assigning villages.

Measurement strategy The outcome measures for this study are given in the measurement section of the registration document. The original measurement strategy was to use full measures that have already been applied in this field. Piloting of the original plan indicated that this would not be feasible as there were too many items, many of which would not be appropriate or relevant to the context. Instead, the measurement strategy was to use outcome indicators: single items; indices by cumulating responses over several related items; or full measures/subscales with total scores validated using Rasch analysis.

Socio-demographic covariates Socio-demographic characteristics that will be documented include: a) Child: age, gender, orphanhood status, siblings, physical health, and school status; (b) Mother/caretaker: age, gender, marital status, education level, physical and mental health, ethnicity and cultural background, school/employment status; (c) Family: urban/rural location & type of residence, household structure, family structure, economy, and functioning.