Evaluating the Impact of a Positive Parenting Intervention on Child Maltreatment and Parent-child Interactions

The lasting and detrimental consequences of physical, verbal, and sexual abuse endured by young children are clear, and children in post-conflict settings are often at elevated risk. As parents are often perpetrators of child  maltreatment, interventions at the parent and family levels allow the important opportunity to decrease negative or abusive behavior. The IRC and researchers at Duke University developed a positive parenting intervention in Liberia called “Parents Make the Difference” (PMD). This 10-session  intervention is designed to help parents and guardians of young children learn and practice alternatives to harsh punishment; develop more nurturing, warm relationships with their children; and to actively participate in promoting their child’s positive emotional and pre-academic skills development.

This  study used  a parallel randomized  superiority trial design  with equal allocation to three  study arms to estimate the impact  of the PMD program on parent/guardian  and child outcomes. Parents were randomly assigned to either the group parenting program (PMD) alone or the group parenting program plus home visits (PMD+). The waitlist control  arm was offered the group parenting program (without home visits) after the 12-month post-intervention survey round was completed. 

Follow-up surveys were conducted with participants in all study arms at 3-months and 12 months post-intervention. This  study found that PMD reduced child maltreatment, as measured by caregivers’ discipline preferences, and   improved parent-child interactions 3-months after the intervention concluded. However, one year after the intervention, we no longer see differences between the intervention  and control groups on our primary outcomes of harsh discipline or parent-child interactions. This suggests that we are not seeing continual growth in parenting skills over time post-intervention. We observed clinically meaningful reductions in parent depression, and found some support for improved attitudes about discipline practices at 3-months post-intervention. Couples’ relationships also appear to have improved  as a result of the intervention, but the estimates carry more uncertainly because only a subset of the sample was married or in a union (i.e., we have fewer data points to estimate the effect). At the child level, we have some evidence for small improvements in perceived child 

behavior  problems as  assessed by parents’  levels of anger related  to specific problem behaviors.

Results  suggest that  home visits did  not uniquely impact  any of the study’s primary outcomes. Although, it is notable that children of families receiving  home visits experienced benefits in academic readiness. However, as conducting home visits  is incredibly time and resource-intensive, the inclusion of home visits does not appear critical and is very unlikely to be cost effective.

Importantly,  we do have limited  evidence of longer lasting  program impacts on parents of  children in the sample with the  highest levels of behavior problems  at baseline. These results suggest that  children and families who need the intervention  the most receive the most benefit. If this is the case, targeting children and caregivers with existing problems may increase the positive impact of PMD and, ultimately, cost effectiveness.

The Airbel Impact Lab at IRC is a team of researchers, strategists and innovators committed to the accelerated design, rigorous evaluation and cost-effective scaling of the most impactful solutions supporting people affected by crisis.