Parenting intervention in Sure Start services for children at risk of developing conduct disorder: Pragmatic randomised control trial. British Medical Journal, 334, 678-681

School of Psychology, University of Wales Bangor, Bangor, Gwynedd, LL57 2DG.
BMJ (online) (Impact Factor: 17.45). 03/2007; 334(7595):678. DOI: 10.1136/bmj.39126.620799.55
Source: PubMed


To evaluate the effectiveness of a parenting programme as a preventive intervention with parents of preschool children considered to be at risk of developing conduct disorder.
Pragmatic randomised controlled trial using a block design with allocation by area.
Eleven Sure Start areas in north and mid-Wales.
153 parents from socially disadvantaged areas, with children aged 36-59 months at risk of conduct disorder defined by scoring over the clinical cut off on the Eyberg child behaviour inventory. Participants were randomised on a 2:1 basis, 104 to intervention and 49 to remaining on the wait listing (control). Twenty (13%) were lost to follow-up six months later, 18 from the intervention group.
The Webster-Stratton Incredible Years basic parenting programme, a 12 week group based intervention.
Problem behaviour in children and parenting skills assessed by self reports from parents and by direct observation in the home. Parents' self reported parenting competence, stress, and depression. Standardised and well validated instruments were used throughout.
At follow-up, most of the measures of parenting and problem behaviour in children showed significant improvement in the intervention group. The intention to treat analysis for the primary outcome measure, the Eyberg child behaviour inventory, showed a mean difference between groups of 4.4 points (95% confidence interval 2.0 to 6.9, P<0.001) on the problem scale with an effect size of 0.63, and a mean difference of 25.1 (14.9 to 35.2, P<0.001) on the intensity scale with an effect size of 0.89.
This community based study showed the effectiveness of an evidence based parenting intervention delivered with fidelity by regular Sure Start staff. It has influenced policy within Wales and provides lessons for England where, to date, Sure Start programmes have not been effective.

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    • "This standard is seldom met in Prevention Science, even though such studies are clearly feasible. Several independent evaluations have yielded results similar to those reported by the developer (see, for example, Gardner et al. (2006) and Hutchings et al. (2007) as well as the Menting et al. (2013) systematic review of Incredible Years trials that reported no effect of developer involvement on the effect size). On the other hand, the past decade has also witnessed a disturbingly high rate of failures to replicate when independent evaluation teams conduct studies of prevention interventions and practices that had met all criteria for effectiveness. "
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    ABSTRACT: A decade ago, the Society of Prevention Research (SPR) endorsed a set of standards for evidence related to research on prevention interventions. These standards (Flay et al., Prevention Science 6:151-175, 2005) were intended in part to increase consistency in reviews of prevention research that often generated disparate lists of effective interventions due to the application of different standards for what was considered to be necessary to demonstrate effectiveness. In 2013, SPR's Board of Directors decided that the field has progressed sufficiently to warrant a review and, if necessary, publication of "the next generation" of standards of evidence. The Board convened a committee to review and update the standards. This article reports on the results of this committee's deliberations, summarizing changes made to the earlier standards and explaining the rationale for each change. The SPR Board of Directors endorses "The Standards of Evidence for Efficacy, Effectiveness, and Scale-up Research in Prevention Science: Next Generation."
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    • "Attention - Deficit / Hyperactivity Disorder ( ADHD ) symp - toms , common in preschoolers ( Egger & Angold , 2006) , affect daily functioning , are a risk for development and a burden to services ( Pelham , Foster , & Robb , 2007 ). Par - enting programmes for preschool ADHD are evidence based ( Hutchings et al . , 2007 ; Sonuga - Barke , Daley , Thompson , Laver - Bradbury , & Weeks , 2001 ) . However , practical constraints ( e . g . adverse family life circum - stances ) may undermine access and engagement and reduce effectiveness ( Koerting et al . , 2013 ) . The New For - est Parenting Programme ( NFPP ) , originally an eight week home - based pac"
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    ABSTRACT: Background Effective implementation of parent training programmes for preschool Attention-Deficit/Hyperactivity Disorder type is constrained by barriers limiting take-up and effective engagement by ‘hard to reach’ and ‘difficult to treat’ families.Method We describe an evidence-driven adaptation and piloting of an existing empirically supported preschool ADHD parenting programme to address these problems.ResultsThe New Forest Parenting programme was changed substantially in terms of length; content and delivery on the basis of information gathered from the literature, from parents and practitioners, further modifications were made after the pilot study.Conclusions The adapted-NFPP is currently being assessed for efficacy in a large multicentre randomized controlled trial.
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