Prevention of child mental health problems in Southeastern Europe: a multicentre sequential study to adapt, optimise and test the parenting programme ‘Parenting for Lifelong Health for Young Children’, protocol for stage 1, the feasibility study

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Abstract

Introduction

Families in low-income and middle-income countries (LMICs) face multiple challenges (eg, poverty and adverse childhood experiences) that increase the risk for child mental health problems, while the context may provide them with few resources. Existing prevention-oriented parenting programmes have been shown to be effective in reducing child behaviour problems and associated risk factors. This project has the overall goal of adapting, implementing and testing a parenting intervention in three Southeastern European LMIC and uses the Multiphase Optimisation Strategy and dimensions of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. It is implemented over three phases: (1) preparation, (2) optimisation and (3) evaluation. The preparation phase, the subject of this paper, involves the adaptation and feasibility piloting of the parenting programme.

Methods and analysis

This protocol describes the assessment of an evidence-informed indicated prevention programme for families with children aged 2–9 years (Parenting for Lifelong Health for Young Children) for implementation in FYR of Macedonia, Republic of Moldova and Romania. In this phase, officials, experts, parents and practitioners are interviewed to explore their views of suitability and needs for further adaptation. In addition, a small pre–post pilot study will test the feasibility of the programme and its implementation as well as the evaluation measures in the three countries with 40 families per country site (n=120). Quantitative data analysis will comprise a psychometric analysis of measures, testing pre–post differences using ANCOVA, χ ² tests and regression analysis. For qualitative data analysis, a thematic approach within an experiential framework will be applied.

Ethics and dissemination

The ethics review board of the Alpen-Adria University Klagenfurt and ethical review boards in the three LMIC sites have approved the study.

Trial registration number

NCT03552250.

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Most cited references 12

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Design and analysis of pilot studies: recommendations for good practice.

Susanna Dodd, G Lancaster, Paula Williamson … (2004)

Pilot studies play an important role in health research, but they can be misused, mistreated and misrepresented. In this paper we focus on pilot studies that are used specifically to plan a randomized controlled trial (RCT). Citing examples from the literature, we provide a methodological framework in which to work, and discuss reasons why a pilot study might be undertaken. A well-conducted pilot study, giving a clear list of aims and objectives within a formal framework will encourage methodological rigour, ensure that the work is scientifically valid and publishable, and will lead to higher quality RCTs. It will also safeguard against pilot studies being conducted simply because of small numbers of available patients.

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Is Open Access

Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries

Mark Bellis, Karen Hughes, Nicola Leckenby … (2014)

Abstract Objective To evaluate the association between adverse childhood experiences – e.g. abuse, neglect, domestic violence and parental separation, substance use, mental illness or incarceration – and the health of young adults in eight eastern European countries. Methods Between 2010 and 2013, adverse childhood experience surveys were undertaken in Albania, Latvia, Lithuania, Montenegro, Romania, the Russian Federation, The former Yugoslav Republic of Macedonia and Turkey. There were 10 696 respondents – 59.7% female – aged 18–25 years. Multivariate modelling was used to investigate the relationships between adverse childhood experiences and health-harming behaviours in early adulthood including substance use, physical inactivity and attempted suicide. Findings Over half of the respondents reported at least one adverse childhood experience. Having one adverse childhood experience increased the probability of having other adverse childhood experiences. The number of adverse childhood experiences was positively correlated with subsequent reports of health-harming behaviours. Compared with those who reported no adverse experiences, respondents who reported at least four adverse childhood experiences were at significantly increased risk of many health-harming behaviours, with odds ratios varying from 1.68 (95% confidence interval, CI: 1.32–2.15) – for physical inactivity – to 48.53 (95% CI: 31.98–76.65) – for attempted suicide. Modelling indicated that prevention of adverse childhood experiences would substantially reduce the occurrence of many health-harming behaviours within the study population. Conclusion Our results indicate that individuals who do not develop health-harming behaviours are more likely to have experienced safe, nurturing childhoods. Evidence-based programmes to improve parenting and support child development need large-scale deployment in eastern European.

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A systematic review and meta-analysis of quantitative interviewing tools to investigate self-reported HIV and STI associated behaviours in low- and middle-income countries.

G. Gomez, Scott E. Phillips, G Garnett … (2010)

Studies identifying risks and evaluating interventions for human immunodeficiency virus (HIV) and other sexually transmitted infections often rely on self-reported measures of sensitive behaviours. Such self-reports can be subject to social desirability bias. Concerns over the accuracy of these measures have prompted efforts to improve the level of privacy and anonymity of the interview setting. This study aims to determine whether such novel tools minimize misreporting of sensitive information. Systematic review and meta-analysis of studies in low- and middle-income countries comparing traditional face-to-face interview (FTFI) with innovative tools for reporting HIV risk behaviour. Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Cochran's chi-squared test of heterogeneity was performed to explore differences between estimates. Pooled estimates were determined by gender, region, education, setting and question time frame using a random effects model. We found and included 15 data sets in the meta-analysis. Most studies compared audio computer-assisted self interview (ACASI) with FTFI. There was significant heterogeneity across studies for three outcomes of interest: 'ever had sex' (I(2) = 93.4%, P 60% had secondary education) and a shorter question time frame. Contrary to expectation, differences between FTFI and non-interviewer-administered interview methods for the reported sensitive behaviour investigated were not uniform. However, we observed trends and variations in the level of reporting according to the outcome, study and population characteristics. FTFI may not always be inferior to innovative interview tools depending on the sensitivity of the question as well as the population assessed.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2019

Publication date (Electronic): 25 January 2019

Volume: 9

Issue: 1

Electronic Location Identifier: e026684

Affiliations

[1 ] departmentInstitute for Psychology , Technische Universität Braunschweig , Braunschweig, Germany

[2 ] departmentInstitute for Psychology , Alpen-Adria-University Klagenfurt , Klagenfurt, Austria

[3 ] departmentDepartment of Social Policy and Intervention , University of Oxford , Oxford, UK

[4 ] departmentMRC/CSO Social and Public Health Sciences Unit , University of Glasgow , Glasgow, UK

[5 ] departmentSchool of Psychology , Bangor University , Bangor, UK

[6 ] departmentDepartment of Psychology , Babeș-Bolyai University , Cluj-Napoca, Romania

[7 ] departmentSchool of Public Health , Georgia State University , Atlanta, Georgia, USA

[8 ] Health for Youth Association , Chișinău, Republic of Moldova

[9 ] Institute for Marriage, Family and Systemic Practice – ALTERNATIVA , Skopje, Macedonia

[10 ] departmentDepartment of Psychology , University of Cape Town , Rondebosch, South Africa

Author notes

[Correspondence to ] Dr Inga Frantz; i.frantz@ 123456tu-braunschweig.de

Article

Publisher ID: bmjopen-2018-026684

DOI: 10.1136/bmjopen-2018-026684

PMC ID: 6352775

PubMed ID: 30782760

SO-VID: d29c411f-9de1-415d-9310-35bf932552f2

License:

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

History

Date received : 14 September 2018

Date revision received : 16 October 2018

Date accepted : 17 October 2018

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100004431, Directorate-General for Research and Innovation;

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ScienceOpen disciplines: Medicine

Keywords: community child health,mental health,child protection,clinical trials

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ScienceOpen disciplines: Medicine

Keywords: community child health, mental health, child protection, clinical trials

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Prevention of child mental health problems in Southeastern Europe: a multicentre sequential study to adapt, optimise and test the parenting programme ‘Parenting for Lifelong Health for Young Children’, protocol for stage 1, the feasibility study

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Abstract

Introduction

Methods and analysis

Ethics and dissemination

Trial registration number

Related collections

Emerald: Healthier Lives

Most cited references 12

Design and analysis of pilot studies: recommendations for good practice.

Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries

A systematic review and meta-analysis of quantitative interviewing tools to investigate self-reported HIV and STI associated behaviours in low- and middle-income countries.

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Article

History

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Cited by 10

Most referenced authors 795