Lachman Jamie M, Alampay Liane Peña, Jocson Rosanne M, Alinea Cecilia, Madrid Bernadette, Ward Catherine, Hutchings Judy, Mamauag Bernice Landoy, Garilao Maria Ana Victoria Felize V, Gardner Frances
University of Oxford, Centre for Evidence-Based Interventions, Department of Social Policy and Intervention, Wellington Square, Oxford, OX1 2ER, United Kingdom.
University of Glasgow, MRC/CSO Social and Public Health Sciences Unit, 200 Renfield Street, Glasgow, G2 3AX, United Kingdom, +44 (0) 141 353 6508.
Lancet Reg Health West Pac. 2021 Oct 5;17:100279. doi: 10.1016/j.lanwpc.2021.100279. eCollection 2021 Dec.
Parenting interventions and conditional cash transfer (CCT) programmes are promising strategies to reduce the risk of violence against children, but evidence of the effectiveness of combining such programmes is lacking for families in low- and middle-income countries with children over two years of age. This study examined the effectiveness of a locally adapted parenting programme delivered as part of a government CCT system to low-income families with children aged two to six years in Metro Manila, Philippines.
Participants were randomly assigned (1:1) to either a 12-session group-based parenting programme or treatment-as-usual services ( = 120). Participation in either service was required among the conditions for receiving cash grants. Baseline assessments were conducted in July 2017 with one-month post-intervention assessments in January-February 2018 and 12-month follow-up in January-February 2019. All assessments were parent-report (ClinicalTrials.gov: NCT03205449).
One-month post-intervention assessments indicated moderate intervention effects for primary outcomes of reduced overall child maltreatment ( = -0.50 [-0.86, -0.13]), emotional abuse ( = -0.59 [-0.95; -0.22]), physical abuse (IRR = 0.51 [0.27; 0.74]), and neglect (IRR = 0.52 [0.18; 0.85]). There were also significant effects for reduced dysfunctional parenting, child behaviour problems, and intimate partner violence, and increased parental efficacy and positive parenting. Reduced overall maltreatment, emotional abuse, and neglect effects were sustained at one-year follow-up.
Findings suggest that a culturally adapted parenting intervention delivered as part of a CCT programme may be effective in sustaining reductions in violence against children in low- and middle-income countries.
This research was supported by UBS Optimus Foundation and UNICEF Philippines, and by the Complexity and Relationships in Health Improvement Programmes of the Medical Research Council MRC UK and Chief Scientist Office (Grant: MC_UU_00022/1 and CSO SPHSU16, MC_UU_00022/3 and CSO SPHSU18).
育儿干预措施和有条件现金转移（CCT）计划是降低暴力侵害儿童风险的有效策略，但对于低收入和中等收入国家中孩子超过两岁的家庭而言，缺乏关于此类计划相结合有效性的证据。本研究调查了作为政府CCT系统一部分，向菲律宾马尼拉大都会区有2至6岁孩子的低收入家庭提供的本地化育儿计划的有效性。
参与者被随机分配（1:1）到一个为期12节的小组育儿计划或常规治疗服务组（n = 120）。获得现金补助的条件之一是必须参与其中一项服务。2017年7月进行了基线评估，2018年1月至2月进行了干预后1个月的评估，2019年1月至2月进行了12个月的随访。所有评估均由家长报告（ClinicalTrials.gov：NCT03205449）。
干预后1个月的评估表明，在减少总体儿童虐待（IRR = -0.50 [-0.86，-0.13]）、情感虐待（IRR = -0.59 [-0.95；-0.22]）、身体虐待（IRR = 0.51 [0.27；0.74]）和忽视（IRR = 0.52 [0.18；0.85]）等主要结果方面有中等程度的干预效果。在减少功能失调的育儿方式、儿童行为问题和亲密伴侣暴力，以及提高父母效能和积极育儿方面也有显著效果。在1年随访时，总体虐待、情感虐待和忽视的减少效果得以持续。
研究结果表明，作为CCT计划一部分提供的经过文化适应的育儿干预措施，可能在低收入和中等收入国家持续减少暴力侵害儿童行为方面有效。
本研究得到瑞银集团优擎基金会和联合国儿童基金会菲律宾办事处的支持，以及英国医学研究理事会MRC和首席科学家办公室的健康改善计划中的复杂性与关系项目的支持（资助号：MC_UU_00022/1和CSO SPHSU16，MC_UU_00022/3和CSO SPHSU18）。
