Childhood behavioural disorders affect up to 9% of UK children under the age of ten (Meltzer et al.,2000). The consequences of these difficulties are widespread, placing the dchild at greater risk for later psychopathology, unemployment, relatioship problems and criminal activity. The trajectory towards the development of behavioural difficulties presents a complex milieu of potential risk and protective factors. Individual risk factors includes cognitive deficits, premature birth and childhood physical illness, although these are tempered by interactions with environmental risk factors such as low socioeconomic status and parental factors such as parental self-efficacy and mental health. Parenting skills are consistently highlighted as a key factor for the mediation of behavioral difficulties, and consequently lend themselves to the most influential intervention approach - the group parenting programme. Despite a wealth of programmes available, strenth of content and supporting evidence base vary widely. Current approaches are outlined and critiqued. 'Getting throught the day' is a manualised group parenting programme developed to impact upon child behaviour, parental self-efficacy and parental wellbeing. The aim of the current study was to evaluate this resource in the community setting within which it is delivered. Following longitudinal design, group participants and parents of 'healthy controls' from local schools and nurseries completed the standarised assessment questionnaires Strenght and Difficulties Questionnaire (corroborated by teacher version), Parenting Stress Index-Short Form, Hospital Anxiety and Depression Scale and the non-standardised Tool to Measure Parenting Self-Efficacy. statistical analyses of Analysis of Variance and Analysis of Covariance were conducted as appropriate, Results indicate positive change for intervention group participants as compared to healthy controls across domains of parent self-efficacy and parent mental health. Results and clinical implications are discussed in the context of this valuable resource and the existing evidence base for group parenting interventions.

The movement towards the provision of evidence-based services has become increasingly important to psychological practice (CPA Task Force on Evidence-Based Practice of Psychological Treatments, 2012; Levant, 2005). One of the key components of this movement is the summarizing and dissemination of important findings to key stakeholders for interventions using techniques such as meta-analysis. Meta-analyses are typically based on reviews of the published literature on a particular topic, but increasingly researchers are acknowledging the importance of examining and including unpublished, grey literature in their reviews in presenting an accurate picture of a body of literature (Hopewell, McDonald, Clarke, & Egger, 2008; McAuley, Pham, Tugwell, & Moher, 2000). However, the inclusion of grey literature in meta-analyses and reviews remains controversial (Coad, Hardicre, & Devitt, 2006; Martin, Perez, Sacristan, & Alvarez, 2005; Seymour, 2010). A number of reviews of behavioural parenting interventions have been conducted. The body of literature in this area continues to grow quickly, and recent meta-analyses in this area have examined only subsets of the literature, thus necessitating an overall examination of all available literature in this area: published and unpublished. The present meta-analysis synthesized the results of 42 published and 6 unpublished behavioural parenting intervention studies conducted between 1966 and 2011. In the first manuscript, treatment efficacy was examined with respect to three different outcomes (parent behaviour, child behaviour, and parent adjustment). I also examined the differential effects of six moderator variables in two categories: child characteristics (child formal diagnostic status and child age) and methodological characteristics (overall quality, comparison group, experimenter allegiance, and publication status). In the second manuscript, I examined both the advantages and challenges of including grey literature in meta-analyses, and explored the use of an innovative search program. I also explored the influence of the inclusion of grey literature on outcomes, including whether effect sizes, sample homogeneity, and publication bias indices are affected by the inclusion of grey literature. Results of the present study confirm the efficacy of behavioural parenting interventions on parent behaviour, child behaviour, and parent adjustment outcomes. Further, I extend the knowledge base through the inclusion of recent reports, grey literature, searches of basic search engines such as Google and Yahoo, and the examination of previously unexplored moderator variables. My results underline the importance of consistent reporting practices in the field and their impact on the availability of evidence for policy-makers, administrators, researchers, clinicians and consumers. I also discuss the implications of these findings for the provision of evidence-based services for parents, knowledge translation, and grey literature.

The movement towards the provision of evidence-based services has become increasingly important to psychological practice (CPA Task Force on Evidence-Based Practice of Psychological Treatments, 2012; Levant, 2005). One of the key components of this movement is the summarizing and dissemination of important findings to key stakeholders for interventions using techniques such as meta-analysis. Meta-analyses are typically based on reviews of the published literature on a particular topic, but increasingly researchers are acknowledging the importance of examining and including unpublished, grey literature in their reviews in presenting an accurate picture of a body of literature (Hopewell, McDonald, Clarke, & Egger, 2008; McAuley, Pham, Tugwell, & Moher, 2000). However, the inclusion of grey literature in meta-analyses and reviews remains controversial (Coad, Hardicre, & Devitt, 2006; Martin, Perez, Sacristan, & Alvarez, 2005; Seymour, 2010). A number of reviews of behavioural parenting interventions have been conducted. The body of literature in this area continues to grow quickly, and recent meta-analyses in this area have examined only subsets of the literature, thus necessitating an overall examination of all available literature in this area: published and unpublished. The present meta-analysis synthesized the results of 42 published and 6 unpublished behavioural parenting intervention studies conducted between 1966 and 2011. In the first manuscript, treatment efficacy was examined with respect to three different outcomes (parent behaviour, child behaviour, and parent adjustment). I also examined the differential effects of six moderator variables in two categories: child characteristics (child formal diagnostic status and child age) and methodological characteristics (overall quality, comparison group, experimenter allegiance, and publication status). In the second manuscript, I examined both the advantages and challenges of including grey literature in meta-analyses, and explored the use of an innovative search program. I also explored the influence of the inclusion of grey literature on outcomes, including whether effect sizes, sample homogeneity, and publication bias indices are affected by the inclusion of grey literature. Results of the present study confirm the efficacy of behavioural parenting interventions on parent behaviour, child behaviour, and parent adjustment outcomes. Further, I extend the knowledge base through the inclusion of recent reports, grey literature, searches of basic search engines such as Google and Yahoo, and the examination of previously unexplored moderator variables. My results underline the importance of consistent reporting practices in the field and their impact on the availability of evidence for policy-makers, administrators, researchers, clinicians and consumers. I also discuss the implications of these findings for the provision of evidence-based services for parents, knowledge translation, and grey literature.

The early onset of externalizing behaviour problems (EBP) is associated with negative outcomes later in life, such as poor mental health, substance use, crime, and unemployment. Some children also develop conduct disorder (CD), entailing a high disease and economic burden for both individuals and society. Most studies on the effectiveness and cost-effectiveness of parenting interventions targeting EBP among children have evaluated selective or indicated preventive interventions, or treatment strategies. Evidence on the effectiveness of universally delivered parenting programmes is controversial, partly due to methodological difficulties. The overall aim of this thesis was to 1) address the methodological challenges of evaluating universal parenting programmes, and to 2) employ different health economic methods to evaluate parenting interventions for EBP and CD in children. Study I indicated that offering low intensity levels of Triple P universally, with limited intervention attendance, does not result in improved outcomes, and may not be a worthwhile use of public resources. Study II showed that using the distribution of an outcome variable makes it possible to estimate the impact of public health interventions at the population level. Study III supports offering bibliotherapy to initially target CP in children, whereas Comet could be offered to achieve greater effects based on decision-makers’ willingness to make larger investments. Cope could be offered when targeting symptom improvement, rather than clinical caseness. The economic decision model in Study IV demonstrated that Triple P for the treatment of CD appears to represent good value for money, when delivered in a Group format, but less likely, when delivered in an Individual format. To reduce the burden of mental health problems in childhood, cost-effective and evidence-based interventions should be provided on a continuum from prevention through early intervention to treatment. We believe our results can assist decision-makers in resource allocation to this field.

No description available.

No / Several international organizations have suggested the need for disseminating existing evidence-based parenting interventions into low-resource settings of the world in order to prevent societal difficulties such as violence. Before dissemination efforts take place, it is important to examine the fit of existing interventions in these contexts. In the present study, 80 practitioners from low-resource communities in Panama, Central America, were surveyed in order to explore their views on materials, principles and strategies of an evidence-based parenting program, the Triple P Positive Parenting Program. This study is part of a larger project in which cultural relevance was also explored from parents’ perspective, instruments were translated and validated, and a RCT was carried out to determine efficacy. Practitioners in the present study were psychologists, teachers, social workers and learning disability specialists based in school settings. Descriptive statistics were used to analyze the data and regression analyses were carried out in order to determine whether socio-demographic variables predicted acceptability scores. Scores for cultural relevance and usefulness of the program were high. A sample of material was found to be interesting, familiar, and acceptable. All practitioners (100 %) expressed a need to implement a parenting program in their community. Only being female and greater hours of consultation per week were associated with greater acceptability. These results have the potential to inform implementation efforts in Panama and the study offers a methodology which can be used to explore the relevance of other programs in other low-resource settings.

Yes / Evidence for early intervention and prevention-based approaches for im-proving social and emotional health in young children is robust. However, rates of participation in programmes are low. We explored the dynamics which affect levels of community readiness to address the issues of social and emotional health for preg-nant women, young children (0-4 years) and their mothers.Setting:A deprived inner‐city housing estate in the north of England. The estate falls within the catchment area of a project that has been awarded long-term funding to address social and emotional health during pregnancy and early childhood.Methods:We interviewed key respondents using the Community Readiness Model. This approach applies a mixed methodology, incorporating readiness scores and qualitative data. A mean community readiness score was calculated enabling the placement of the community in one of nine possible stages of readiness. Interview transcripts were analysed using a qualitative framework approach to generate con-textual information to augment the numerical scores.Results:An overall score consistent with vague awareness was achieved, indicating a low level of community readiness for social and emotional health interventions. This score suggests that there will be a low likelihood of participation in programmes that address these issues.Conclusion:Gauging community readiness offers a way of predicting how willing and prepared a community is to address an issue. Modifying implementation plans so that they first address community readiness may improve participation rates. / Better Start Bradford

This study was conducted in San Bernardino County, California. Participants completed a questionnaire regarding conflicts that arise between co-parents, levels of stress from conflicts, how parts negotiate, cooperate, collaborate and communicate and the types of coping skills that participants use when stressed. The purpose of this study was to examine conflicts between parents and caregivers who share the custody of their children with another parent or caregiver. This study also assessed coping skills and co-parenting resources that are available in San Bernardino County. Twenty-two participants completed the study, 19 were female and 3 were male. Most of the participants were Latino. Over 77% of participants reported having conflicts with the other parent or caregiver. Nearly 73% of participants reported high levels of stress when having conflicts with the other parent or caregiver. However, participants reported being able to negotiate, cooperate, collaborate and communicate appropriately with the other parent or caregiver. Participants reported that they used a variety of primitive, less primitive and mature coping mechanism when dealing with conflicts with the other parent or giver. The results also showed that few participants had engaged in co-parenting interventions that were provided in San Bernardino County.

John Bowlby made a profound contribution to the field of early parenting with his theory of attachment. He suggested that attachment theory has universal applicability. However, it has been argued that attachment theory is based upon a Western worldview, and as such, lacks applicability in cross-cultural contexts. In light of this objection, this study aimed to examine the relevancy of attachment theory within the South African context. In order to do this, a qualitative research design, employing focus groups, was set up to explore isiZulu-speaking mothers’ constructions of infant-caregiver relationships. Participants were recruited from two Non-Governmental Organizations (NGOs) in KwaZulu-Natal. Each participant partook in three focus groups. The focus group data was analyzed using a form of thematic analysis. The group discussion provided support for attachment theory in the South African context. However, there appeared to be some cultural variations in the ways in which the attachment relationship is carried out within this context. In particular, it appeared that isiZulu-speaking mothers employ physical touch and a rapid response style with their infants. Furthermore, evidence emerged to suggest that there are certain barriers to the attachment relationship in South Africa. Finally, this research study showed that urbanization has had an important impact on parenting. As such, from this research, it can be concluded that attachment interventions are useful in South Africa, yet these may need to occur alongside other interventions. There is also room for further research to explore understandings of attachment within broader population groups, including fathers and grandmothers. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2013.

Intensifying interventions to improve the quality of care that children receive from parents/ primary caregivers is mandated by several strategic objectives, such as the National Plan of Action for Children 2012-2017 (South Africa 2012), the White Paper on Families in South Africa (2013), and the Children’s Amendment Act 41 of 2007 (South Africa 2007). Parenting programmes remain popular parenting interventions (Daly, Bray, Bruckauf, Byrne, Margaria, Pecnik & Samms-Vaughan 2015:18; Richter & Naicker 2013:9) reporting outcomes of enhanced parent-child relationships, improved behaviour of children, and reduced parental stress. There is a concern that parenting programmes offered in South Africa lack evidence of their efficacy (Wessels 2012:9) and cultural and contextual relevance for the recipients (Begle, Lopez, Cappa, Dumas & de Arellano 2012:56; Richter & Naicker 2013:1). The study developed a locally specific parenting support intervention for parents/ primary caregivers living in the low-cost housing development of Welbedacht East using the Intervention Development Design model. Parents/ primary caregivers were involved throughout the study, contributing to the intervention’s applicability, as well as its contextual and cultural relevance. Bioecological and social inclusion theories framed the study. A qualitative research approach supported by an exploratory, descriptive and contextual design was used. Two purposive samples (parents/ primary caregivers and community champions) were recruited. Semi-structured interviews were conducted to collect the data. Thematic analysis (Braun & Clarke 2006) produced the findings that were presented at a consultation workshop attended by research participants and relevant stakeholders where the parameters of the intervention were determined. These were subsequently developed into the elements and intervention protocols by four indigenous community experts following the Delphi process. Lincoln and Guba’s (1985) approach to trustworthiness as presented by Porter (2007:85) and Thomas and Magilvy (2011:152) was used. Cultural competence was maintained throughout and ethical considerations were observed to circumvent harm to participants and uphold the integrity of the research process. The perceptions of the parents/ primary caregivers were consistent with scholarly indicators of ‘good enough’ parenting, but the contextual stressors they experienced challenges their ability to fulfil some of these indicators. An intervention was needed to increase parental capacity to improve parent-child relationships, cultivate life skills for improved psychological health, and advance the financial independence of parents. It was concluded that a parenting programme on its own would fail to address the most pressing needs of parents/ primary caregivers living in disadvantaged circumstances and custom-made parenting support interventions were needed to increase parental capacity to manage the structural challenges that compromised parenting, such as socioeconomic interventions of a social developmental nature. / Social Work / D. Phil. (Social Work)