Effectiveness Evaluation of a Violence Prevention Parenting Program Implemented at Large Scale: A Randomized Controlled Trial.

Parenting programs can enhance positive parenting, reduce harsh parenting, and positively impact children's development. This two-arm randomized controlled trial examined the effectiveness of the parenting program, the ACT Action Program - Raising Safe Kids, on parenting practices (primary outcomes), parental sense of competence, stimulation activities, and children's behaviors (secondary outcomes) in low-income families. The sample consisted of 1,310 caregivers and their 0-to-6-year-old children from 17 municipalities in a Brazilian state, with the majority receiving cash transfers (governmental monetary support for families facing vulnerabilities). The caregivers were randomly allocated into the intervention (IG, = 639) or waitlist control (CG, = 671) groups. The IG participated in the ACT Program during an 8-week-in-person group session to strengthen positive parenting, and the CG in the usual care. The caregivers answered the questionnaires administered by the facilitators in the pre-intervention (after the randomization) and the post-intervention (at the end of the program), using the following tools: ACT Scale, Parenting and Family Adjustment, Parental Sense of Competence, UNICEF's Multiple Indicator Cluster Survey, home stimulation activities, and the Strengths and Difficulties Questionnaire. The analysis used the MANOVA followed by the two-way mixed ANOVA for repeated measures. Results showed that compared to GC, the IG significantly increased emotional and behavioral regulation practices, parental sense of competence, and caregivers' home stimulation and decreased parental inconsistency, coercive practices, and children's behavior problems in the post-intervention. The program was effective in improving positive parenting and decreasing child behavior problems when implemented at a large scale in a policy system.