Parenting for Lifelong Health (PLH) - Masayang Pamilya (MaPa) Evaluation Study
NCT ID: NCT03205449
Last Updated: 2019-02-26
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
COMPLETED
Clinical Phase
NA
Total Enrollment
120 participants
Study Classification
INTERVENTIONAL
Study Start Date
2017-06-16
Study Completion Date
2019-02-05
Brief Summary
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Parenting for Lifelong Health (PLH) Philippines Evaluation Study: Multisite randomised controlled trial to compare the efficacy of a culturally-adapted parenting programme, Masayang Pamilya, versus services as usual in the reduction of child maltreatment and improvement of child wellbeing in low-income Filipino families with children aged two to six years in Metro Manila (N = 120).
A previous study focused on adaptation and feasibility testing was conducted from January 2016 to February 2017. Community-based participatory approaches were used to culturally adapt the Sinovuyo programme to a Filipino context. A formative evaluation using qualitative in-depth interviews and focus group discussions with parents, as well as consultative workshops with service providers and other stakeholders, examined issues regarding the needs and concerns of Filipino parents, appropriateness of intervention components and delivery, and other specific cultural issues in order to balance "fidelity" to evidence-based practices with "fit" to the local context \[11\]. The Sinovuyo programme was then adapted into the MaPa programme with local materials and approaches developed to fit the Philippine cultural context based on findings from the formative evaluation.
A previous study focused on adaptation and feasibility testing was conducted from January 2016 to February 2017. Community-based participatory approaches were used to culturally adapt the Sinovuyo programme to a Filipino context. A formative evaluation using qualitative in-depth interviews and focus group discussions with parents, as well as consultative workshops with service providers and other stakeholders, examined issues regarding the needs and concerns of Filipino parents, appropriateness of intervention components and delivery, and other specific cultural issues in order to balance "fidelity" to evidence-based practices with "fit" to the local context \[11\]. The Sinovuyo programme was then adapted into the MaPa programme with local materials and approaches developed to fit the Philippine cultural context based on findings from the formative evaluation.
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Detailed Description
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Over the past decade there have been increasing calls for the scale-up of evidence-based interventions in order to reduce the risk of violence against children in low- and middle-income countries (LMICs) \[1\]. In particular, parenting programmes for families with young children have been shown to be effective in reducing the risk of child maltreatment and improving child wellbeing with promising evidence emerging from low- and middle-income countries \[2-4\]. These group-based programmes typically aim to strengthen caregiver-child relationships through positive parenting and to help parents to manage child behaviour problems through effective, age-appropriate, nonviolent discipline strategies.
Despite the emerging evidence of the effectiveness of parenting interventions in reducing violence against children, many local governments and service providers in LMICs face multiple challenges implementing evidence-based parenting programs in resource poor contexts \[5\]. Parenting programmes are often too expensive to deliver effectively at scale in low-resource settings due to their complexity, intensity, and length \[3\]. Parenting programmes developed and evaluated in other contexts also may not fit the local service delivery context and may require adaptation to be relevant to the local culture of families. Additional programme content may also be necessary to address stress related to economic deprivation, high community violence, and parental distress. The process of delivery may also need to be simplified to improve participant engagement and the quality of delivery.
As a result, it is essential that programmes implemented in LMICs are 1) effective at reducing violence against children, 2) integrated within the existing service delivery system, 3) feasible and culturally acceptable to service providers and families, and 4) scalable in terms of their affordability, replicability, and sustainability while reaching a maximum number of beneficiaries. However, there are currently very few parenting programmes that meet these criteria in LMICs, such as the Philippines, where the need is the greatest \[3\].
The PLH Philippines Evaluation Study aims to fill this gap by examining the efficacy of a locally-adapted, evidence-based parenting programme, the Masayang Pamilya Para Sa Batang Pilipino Parenting Programme (MaPa), for families with children ages two to six years living in Metro Manila who are enrolled in the Philippine Department of Social Welfare and Development (DSWD) conditional cash transfer system.
Our overall objective is to use a randomised controlled trial design to test the efficacy of the MaPa programme in reducing the risk of child maltreatment while improving child socio-emotional development, child behaviour, and parental mental health in comparison to treatment as usual controls in Metro Manila.
Our primary objective is to examine the impact of the MaPa programme on the primary outcome of child maltreatment in comparison to treatment-as-usual controls at immediate post-intervention and at 1-year follow-up.
Our secondary objective is to examine the impact of the MaPa programme on proximal outcomes associated with increased risks of child maltreatment, namely, positive parenting, intrusive parenting, and harsh parenting in comparison to treatment-as-usual controls at immediate post-intervention and at 1-year follow-up.
Another secondary objective is to examine the impact of the MaPa programme at immediate post-intervention and at 1-year follow-up on child behaviour problems, child development outcomes (i.e., communication skills and socio-emotional development), parenting efficacy, parental wellbeing, parenting stress, parental depression, marital satisfaction, and intimate partner violence, in comparison to treatment as usual controls.
Our tertiary objective is to examine the implementation of the MaPa programme when delivered within the DSWD conditional cash transfer system in terms of programme adherence by parents (i.e., recruitment, enrolment, attendance, engagement, dropout, and completion) and delivery by service providers (i.e., competency and fidelity).
Our final objective is to examine predictors of programme adherence and associations between programme adherence and primary and secondary outcomes at immediate post-test and at 1-year follow-up.
Despite the emerging evidence of the effectiveness of parenting interventions in reducing violence against children, many local governments and service providers in LMICs face multiple challenges implementing evidence-based parenting programs in resource poor contexts \[5\]. Parenting programmes are often too expensive to deliver effectively at scale in low-resource settings due to their complexity, intensity, and length \[3\]. Parenting programmes developed and evaluated in other contexts also may not fit the local service delivery context and may require adaptation to be relevant to the local culture of families. Additional programme content may also be necessary to address stress related to economic deprivation, high community violence, and parental distress. The process of delivery may also need to be simplified to improve participant engagement and the quality of delivery.
As a result, it is essential that programmes implemented in LMICs are 1) effective at reducing violence against children, 2) integrated within the existing service delivery system, 3) feasible and culturally acceptable to service providers and families, and 4) scalable in terms of their affordability, replicability, and sustainability while reaching a maximum number of beneficiaries. However, there are currently very few parenting programmes that meet these criteria in LMICs, such as the Philippines, where the need is the greatest \[3\].
The PLH Philippines Evaluation Study aims to fill this gap by examining the efficacy of a locally-adapted, evidence-based parenting programme, the Masayang Pamilya Para Sa Batang Pilipino Parenting Programme (MaPa), for families with children ages two to six years living in Metro Manila who are enrolled in the Philippine Department of Social Welfare and Development (DSWD) conditional cash transfer system.
Our overall objective is to use a randomised controlled trial design to test the efficacy of the MaPa programme in reducing the risk of child maltreatment while improving child socio-emotional development, child behaviour, and parental mental health in comparison to treatment as usual controls in Metro Manila.
Our primary objective is to examine the impact of the MaPa programme on the primary outcome of child maltreatment in comparison to treatment-as-usual controls at immediate post-intervention and at 1-year follow-up.
Our secondary objective is to examine the impact of the MaPa programme on proximal outcomes associated with increased risks of child maltreatment, namely, positive parenting, intrusive parenting, and harsh parenting in comparison to treatment-as-usual controls at immediate post-intervention and at 1-year follow-up.
Another secondary objective is to examine the impact of the MaPa programme at immediate post-intervention and at 1-year follow-up on child behaviour problems, child development outcomes (i.e., communication skills and socio-emotional development), parenting efficacy, parental wellbeing, parenting stress, parental depression, marital satisfaction, and intimate partner violence, in comparison to treatment as usual controls.
Our tertiary objective is to examine the implementation of the MaPa programme when delivered within the DSWD conditional cash transfer system in terms of programme adherence by parents (i.e., recruitment, enrolment, attendance, engagement, dropout, and completion) and delivery by service providers (i.e., competency and fidelity).
Our final objective is to examine predictors of programme adherence and associations between programme adherence and primary and secondary outcomes at immediate post-test and at 1-year follow-up.
Conditions
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Child Maltreatment
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
This study will use a randomised controlled trial design to test the effects of the Masayang Pamilya programme in comparison to participants allocated to a treatment as usual control group (N = 120 parents of children ages 2 to 6 years; 1:1 intervention to control group ratio).
Primary Study Purpose
PREVENTION
Blinding Strategy
DOUBLE
Investigators
Outcome Assessors
Study Groups
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MaPa Programme
Masayang Pamilya Parenting Program: A 12-session, a group-based parenting programme focused on reducing violence against children and improving child wellbeing in low-income families with young children
Group Type
EXPERIMENTAL
Masayang Pamilya Para Sa Batang Pilipino Parenting Programme (MaPa)
Intervention Type
BEHAVIORAL
The MaPa programme includes the following content: 1) spending one-on-one time with children; 2) describing actions and feelings for cognitive development and socio-emotional awareness; 3) using praise and rewards to encourage positive behaviour; 4) establishing limits through effective instruction giving and consistent household rules; 5) nonviolent discipline such as ignoring negative attention seeking behaviour, and consequences for noncompliance, rule-breaking, and aggressive behaviour; 6) problem solving with children; and 7) mindfulness based stress reduction for caregivers.
Treatment-as-usual
Parenting Effectiveness Service programme: A family strengthening programme delivered by trained service providers on a monthly basis.
Group Type
ACTIVE_COMPARATOR
Parenting Effectiveness Service
Intervention Type
OTHER
Content uses a thematic manual that includes sessions on Filipino family dynamics, early childhood development, child behaviour management, marital relationships, prevention of child maltreatment, health care, nutrition, and government anti-poverty initiatives, as well as disaster preparedness. \[12\].
Interventions
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Masayang Pamilya Para Sa Batang Pilipino Parenting Programme (MaPa)
The MaPa programme includes the following content: 1) spending one-on-one time with children; 2) describing actions and feelings for cognitive development and socio-emotional awareness; 3) using praise and rewards to encourage positive behaviour; 4) establishing limits through effective instruction giving and consistent household rules; 5) nonviolent discipline such as ignoring negative attention seeking behaviour, and consequences for noncompliance, rule-breaking, and aggressive behaviour; 6) problem solving with children; and 7) mindfulness based stress reduction for caregivers.
Intervention Type
BEHAVIORAL
Parenting Effectiveness Service
Content uses a thematic manual that includes sessions on Filipino family dynamics, early childhood development, child behaviour management, marital relationships, prevention of child maltreatment, health care, nutrition, and government anti-poverty initiatives, as well as disaster preparedness. \[12\].
Intervention Type
OTHER
Other Intervention Names
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MaPa Programme
PES
Eligibility Criteria
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Inclusion Criteria
* Age 18 or older;
* Primary caregiver responsible for the care of a child between the ages of two and six who is staying in the same household at least four nights a week in the previous month;
* Spend at least four nights a week in the same household as the child;
* Unemployed parent;
* Recipient of the 4Ps conditional cash transfer programme;
* Agreement to participate in the MaPa programme if allocated to the treatment condition;
* Provision of consent to participate in the full study.
* Primary caregiver responsible for the care of a child between the ages of two and six who is staying in the same household at least four nights a week in the previous month;
* Spend at least four nights a week in the same household as the child;
* Unemployed parent;
* Recipient of the 4Ps conditional cash transfer programme;
* Agreement to participate in the MaPa programme if allocated to the treatment condition;
* Provision of consent to participate in the full study.
Exclusion Criteria
* Any adult who has already participated in the Parent Effectiveness Service;
* Any adult exhibiting severe mental health problems or acute mental disabilities;
* Any adult that has been referred to child protection services due to child abuse.
* Any adult exhibiting severe mental health problems or acute mental disabilities;
* Any adult that has been referred to child protection services due to child abuse.
Minimum Eligible Age
18 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
Yes
Sponsors
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University of Oxford
OTHER
Sponsor Role
collaborator
Philippine Ambulatory Pediatric Association
UNKNOWN
Sponsor Role
collaborator
Philippine Department of Social Welfare and Development
UNKNOWN
Sponsor Role
collaborator
Bangor University
OTHER
Sponsor Role
collaborator
University of Cape Town
OTHER
Sponsor Role
collaborator
International Child Protection Network
OTHER
Sponsor Role
collaborator
The UBS Optimus Foundation
UNKNOWN
Sponsor Role
collaborator
UNICEF
OTHER
Sponsor Role
collaborator
Ateneo de Manila University
OTHER
Sponsor Role
lead
Responsible Party
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Responsibility Role
SPONSOR
Principal Investigators
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Liane P Alampay, PhD
Role: PRINCIPAL_INVESTIGATOR
Ateneo de Manila University
Jamie M Lachman, PhD
Role: PRINCIPAL_INVESTIGATOR
University of Oxford
Cecilia Alinea, MD
Role: PRINCIPAL_INVESTIGATOR
Philippine Ambulatory Pediatric Association
Frances Gardner, PhD
Role: PRINCIPAL_INVESTIGATOR
University of Oxford
Judy Hutchings, PhD
Role: PRINCIPAL_INVESTIGATOR
Bangor University
Catherine Ward, PhD
Role: PRINCIPAL_INVESTIGATOR
University of Cape Town
Bernadette Madrid, MD
Role: PRINCIPAL_INVESTIGATOR
International Child Protection Network
Rosanne Jocson, PhD
Role: PRINCIPAL_INVESTIGATOR
Ateneo de Manila University
Locations
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Barangay Western Bicutan
City of Taguig, National Capital Region, Philippines
Site Status
Countries
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Philippines
References
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Reference Type
DERIVED
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
AdMUREC_16_090
Identifier Type: -
Identifier Source: org_study_id
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