The Pelotas Trial of Parenting Interventions for Aggressio
- Conditions
- AggressionF00-F99
- Registration Number
- RBR-2kwfsk
- Lead Sponsor
- Programa de Pós-Graduação em Epidemiologia
- Brief Summary
Background: Violence is a major public health problem globally, with the highest rates in low- and middle-income countries (LMICs) in the Americas and southern Africa. Parenting programmes in high-income countries can diminish risk for violence, by reducing risk factors such as child aggression and harsh parenting, and increasing protective factors such as child cognitive development and school readiness. However, there is a critical need to identify low-cost programmes with replicable benefits in real-world LMICs contexts. Methods: A three-arm, randomised, single-blind trial evaluated effects of two low-cost group-based parenting programmes recommended for LMICs (ACT: Raising Safe Kids; DBS: dialogic book-sharing) on child aggression (primary outcome), child development, parenting, maltreatment, and stress. Participants were 369 children with medium-high levels of aggression (mean age 3.1 years at baseline) in poor households. Interventions were implemented in city health and education services in southern Brazil. Maternal reports, filmed observations, child tasks, and hair cortisol were assessed at baseline, one-month post intervention, and eight-month follow-up. Intention-to-treat analyses compared each of ACT and DBS with a control group. Results: 368 (99.7%) participants completed follow-up assessments eight-months after the interventions. There was no effect of ACT (standardised mean difference, SMD 0.11, 95%CI -0.05, 0.27) or DBS (SMD 0.05, 95%CI -0.11, 0.21) on the primary outcome of child aggression. ACT reduced harsh parenting behaviour post intervention (SMD -0.23; 95%CI -0.46, -0.01), but not at follow-up. DBS improved book-sharing practices at both time points (e.g., maternal sensitivity at follow-up SMD 0.33; 95%CI: 0.08, 0.57). There were no benefits of either programme for other parenting, child development, or stress outcomes. Conclusion: Two parenting programmes in Brazil had small effects on parenting practices, but did not reduce child aggression or several other important risk/protective factors for violence. Effective early interventions that reduce violence in real-world LMIC settings are highly desirable but may be a challenge to achieve.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Recruitment completed
- Sex
- Not specified
- Target Recruitment
- Not specified
child born in 2015 in Pelotas city; mother lives in the household; mother consents to participate in the study; mother is the primary caregiver of the child; mother lives in the child’s house at least 4 nights per week; family income is in bottom 30% at child age 2-years
child with low aggression score at age 2-years old; child with serious developmental delay at age 2-years; child with other medical condition preventing participating in activities targeted by interventions; mother has a medical condition preventing participating in intervention activities
Study & Design
- Study Type
- Intervention
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Expected outcome 6. Evaluate the reduction in child aggression at 6-month follow-up, when children are approximately aged 4-years; assessed by questionnaires (Child Behavior Checklist, ELDEQ study questionnaire) and observational tasks (LABTAB, Don’t Touch, and Clean up), with an independent statistician calculating the final latent variable(s) of aggression for analysis; reduced aggression will be identified based on a statistically significant lower level of child aggression in the intervention groups compared with the control group, adjusting for baseline variables
- Secondary Outcome Measures
Name Time Method