Malezi ne Kilimo Bora (Good Parenting and Farming) - Skilful Parenting and Agribusiness Child Abuse Prevention Study (SPACAPS)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 248
- 试验地点
- 1
- 主要终点
- Change in Child Abuse - Parent Report
研究概览
简要总结
The Malezi ne Kilimo Bora ("Good Parenting and Farming" in Kiswahili) Skilful Parenting and Agribusiness Child Abuse Prevention Study is a collaboration between the University of Oxford, University of Glasgow, and the Tanzania National Medical Research Institute (NIMR). It is pilot cluster randomised controlled trial (cRCT) of a community-based intervention implemented by Investing in Children and Our Societies (ICS), an international non-governmental organization (NGO) with extensive experience operating in rural Tanzania. The overall focus of the project is to evaluate ICS's agribusiness and skilful parenting programmes' impact on the prevention of child maltreatment and improvement of child and family psychosocial and economic wellbeing (n = 8 villages, n = 16 farmer groups, n = 240 families).
详细描述
Background on Child Maltreatment in Tanzania
Child maltreatment and other childhood adversities often occur in many low- and middle-income countries at rates that are higher than in high-income countries - rates that often exceed 50%. In Tanzania, a national survey examining violence against children (VAC) found that almost 73.5% of females and 71.7% of males between the ages of 13 and 24 had experienced physical violence by prior to the age of 18. Furthermore, 23.6% of females and 27.5% of males had experienced emotional violence by an adult during childhood, and 27.9% of females and 13.4% of males had experienced some form of sexual violence before the age of 18 years. In addition, the survey identified an overlap among physical, emotional, and sexual violence against children. Approximately 80% of respondents who experienced sexual violence also experienced physical violence as a child, and nearly all children who experienced physical violence also experienced emotional violence. The VAC study also found that parents and other adult relatives are the most commonly reported perpetrators of physical and emotional violence against children, with corporal punishment considered a social norm.
Recent advances in neuroscience, genomics, developmental psychology, epidemiology, and economics have shed light on the long-term and far-reaching consequences of childhood adversities, many of which, like child maltreatment, are directly related to poor parenting. These consequences include serious physical and mental health problems later in life, as well as difficulties in school, jobs, and relationships. Child maltreatment can have substantial intergenerational effects in which some parents who experienced maltreatment during childhood are more vulnerable to the risk of maltreating their own children. Child maltreatment is also a risk factor for later intimate partner violence, increased risk of HIV-infection, and transactional sex amongst AIDS-affected youth. Furthermore, not only is child maltreatment a serious public health and human rights issue, but it comes at an economic cost due to expenses relating to the treatment of victims' health problems, criminal justice and welfare costs, and lower economic productivity.
The risks factors of child maltreatment can be best understood using an ecological framework. A recent review of 23 quantitative studies in Africa by Meinck et al identified a number of child, family, and social risk factors for child maltreatment. Child factors associated with increased likelihood of physical abuse included younger children, boys, children with disability or chronic illness, child behaviour problems, and school non-attendance and poor performance. Family-level factors include caregiver chronic illness, HIV/AIDS, caregiver mental health problems, caregiver disability, domestic violence, substance abuse, poor family functioning, and inconsistent parenting. Finally, household poverty and low socioeconomic status was found to be a major factor for increased risk of child abuse, as well as indirectly through increased family stress and reduced parental involvement.
Parenting Programmes to Prevent Child Maltreatment
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Prevention
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •for villages (n = 8):
- •Situated within 1 hour driving distance from Shinyanga, Tanzania
- •Provide community consent via community local leader and approval from local authorities
- •Contain registered farmer groups
- •Inclusion criteria for participating farmer groups (n = 16, 2 per village):
- •Situated within participating village
- •Registered with Tanzanian Ministry of Agriculture within the previous 3 years
- •Registered to participate in ICS's Agribusiness and Skilful Parenting programme
- •Provide consent via farmer group leader
- •Inclusion criteria for adults caregivers (n = 240, 30 per village):
- •Age 18 or older
- •Serves as the primary caregiver of a child in the household between the ages of 3 and 17
- •Lives in the house at least 4 nights per week.
- •Is a registered member of the included agricultural farmer group
- •Provides consent to participate in the full study
排除标准
- •for adult participants:
- •Any adult exhibiting severe mental health problems or acute mental disabilities.
- •Any adult that has been referred to social services or child protection services during the course of baseline data collection as a result of reported or observed indications of significant potential psychological harm towards a child.
- •Inclusion criteria for child respondents (n = 240, 30 per village):
- •Age 10 to 17 years at initial assessment
- •Lives in the house at least 4 nights per week
- •Must have an adult primary caregiver who lives in the household, who provides consent, and who participates in the study
- •Provides assent to participate in the full study
- •Exclusion criteria for child respondents:
- •Any child who is either experiencing severe mental health problems, has acute developmental disabilities,
- •If the child participant has been referred to social services during baseline data collection due to reported or observed indications of significant harm.
- •Inclusion criteria for observed children (n = 240, 30 per village):
- •Age 0 to 3 years at initial assessment
- •Lives in the house at least 4 nights per week
- •Must have an adult primary caregiver who lives in the household, who provides consent, and who participates in the study
- •Inclusion criteria for adult ICS programme facilitators:
- •Age 18 or older
- •Is registered as a facilitator of ICS's Agribusiness or Skilful Parenting programme
- •Provides consent to participate in the full study
研究组 & 干预措施
Parenting Training
Skilful Parenting: 12-week group-based parent intervention delivered by Investing in Children and Our Societies to caregivers who are members of farmer groups in participating villages.
干预措施: Skilful Parenting (Behavioral)
Agricultural Training
Agrics: Initial 3-month agricultural training intervention with ongoing support afterwards.
干预措施: Agrics (Other)
Parenting and Agricultural Training
Village farmer groups receiving both Skilful Parenting and Agrics interventions.
干预措施: Skilful Parenting (Behavioral)
Parenting and Agricultural Training
Village farmer groups receiving both Skilful Parenting and Agrics interventions.
干预措施: Agrics (Other)
Control
6-month wait-list control group
结局指标
主要结局
Change in Child Abuse - Parent Report
时间窗: Baseline; 6-Months Follow-Up; 12-Months Follow-Up
Child abuse will be measured using adapted versions of the ISPCAN Child Abuse Screening Tool-Parent version (ICAST-P), a multi-national and consensus-based survey instrument measuring the incidence and prevalence of child abuse and neglect. This 19-item scale ICAST-P was validated in 6 LMIC and 7 languages (α = 0.77-0.88) and measures four types of abuse: physical, emotional and sexual abuse, as well as neglect. In this study, the response code was adapted to a frequency scale from 0 to more than 8 times as certain behaviour occurred in the past month. In this study, incidence child maltreatment will be scored as dichotomous variables for physical, verbal, and sexual abuse, as well as an overall indication of previous child abuse (0 = no abuse; 1 = previous abuse). The investigators will also assess frequency of overall abuse by summing all of the subscales as well as for each individual subscale.
Change in Child Abuse - Child Report
时间窗: Baseline; 6-Months Follow-Up; 12-Months Follow-Up
Child report of child abuse will be measured using adapted versions of the ISPCAN Child Abuse Screening Tool-Child version (ICAST-C), a multi-national and consensus-based survey instrument measuring the incidence and prevalence of child abuse and neglect. This 32-item scale ICAST-C was validated in 6 LMIC and 7 languages (α = 0.77-0.88) and measures four types of abuse: physical, emotional and sexual abuse, as well as neglect. In this study, the response code was adapted to a frequency scale from 0 to more than 8 times as certain behaviour occurred in the past month. In this study, incidence child maltreatment will be scored as dichotomous variables for physical, verbal, and sexual abuse, as well as an overall indication of previous child abuse (0 = no abuse; 1 = previous abuse). The investigators will also assess frequency of overall abuse by summing all of the subscales as well as for each individual subscale.
Change in Parenting Behaviour - Child Report
时间窗: Baseline; 6-Months Follow-Up; 12-Months Follow-Up
Parent-child interaction, will be measured using the Alabama Parenting Questionnaire - Child Report (42 items). The APQ contains five subscales assessing Positive Parenting (8 items), Parent Involvement (8 items), Inconsistent Discipline (11 items), Poor Supervision (10 items), and Harsh Discipline (5 items). The APQ has been shown to have moderate to strong internal reliability for both parent and child reports (Cronbach's α = 0.50 to 0.89). It has been used widely including in LMIC such as South Africa and Mexico. Children report on the frequency of parenting behaviour based on a 4-point Likert scale (0 = never; 3 = Often, more than 5 times). Items are summed to create total frequency score (range 0 to 126) as well as for each subscale.
Change in Parenting Behaviour - Adult Report
时间窗: Baseline; 6-Months Follow-Up; 12-Months Follow-Up
Parent-child interaction, will be measured using the Alabama Parenting Questionnaire (APQ) - Adult Report (37 items). The APQ contains five subscales assessing Positive Parenting (8 items), Parent Involvement (8 items), Inconsistent Discipline (11 items), Poor Supervision (10 items). The APQ has been shown to have moderate to strong internal reliability for both parent and child reports (Cronbach's α = 0.50 to 0.89). It has been used widely including in LMIC such as South Africa and Mexico. Caregivers report on the frequency of parenting behaviour based on a 4-point Likert scale (0 = never; 3 = Often, more than 5 times). Items are summed to create total frequency score (range 0 to 81) as well as for each subscale.
次要结局
- Change in Caregiver Depression - Adult Report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Household Hunger - Adult Report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Household Hunger - Child Report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Child Sexual Behavior(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Infant/Toddler Weight(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Parenting Stress - Adult Report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change Child Behaviour - Child Report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Intimate partner Violence - Adult Report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Child Labor - Adult Report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Agricultural Assets - Adult Report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Household Assets - Adult Report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Parental Attitudes to Punishment(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change Child Behaviour - Adult Report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Child Development - Adult Report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Infant/Toddler Height(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Child food consumption - Child report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Child labour - Child report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Child Attitudes to Punishment(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Early Childhood Home Environment - Observed and Adult Report(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Child Alcohol Use(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Adult Alcohol Use(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)
- Change in Child Depression(Baseline; 6-Months Follow-Up; 12-Months Follow-Up)