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The Children and Parents in Focus project: a population-based cluster-randomised controlled trial to prevent
Raziye Salari1, Helena Fabian, Ron Prinz
1Department of Women's and Children's Health, Samariterhemmets Hospital, Uppsala University, Box 609, 751 25 Uppsala, Sweden. raziye.salari@kbh.uu.se.
Insights
This study evaluates the cost-effectiveness of a universal parenting program for children aged 3-5 years in Sweden. It compares different intervention intensities to improve child behavior and parental well-being.
Area of Science:
- Child development research
- Public health interventions
- Health economics
Background:
- Early interventions are crucial for child health and development.
- Identifying cost-effective, feasible parenting programs is essential.
- The Children and Parents in Focus trial investigates a Swedish universal parenting program.
Purpose of the Study:
- To compare the impact and cost-effectiveness of two parenting program intensity levels against a control group.
- To evaluate an evidence-based parenting program within the Swedish healthcare system.
- To generate population-based data on preschool children's mental health in Sweden.
Main Methods:
- Cluster randomised controlled trial with three arms: Universal, Universal Plus, and Services as Usual.
- Recruitment of parents with children aged 3-5 years in Uppsala municipality, Sweden (2013-2017).
- Annual outcome measurement of children's behavioral/emotional problems, parental behavior, and general health; health economic evaluations.
Main Results:
- Primary outcome: Children's behavioral and emotional problems (rated by fathers, mothers, preschool teachers).
- Secondary outcomes: Parental behavior and general health.
- Health economic analysis of cost-effectiveness based on mental health and quality of life impacts.
Conclusions:
- Addresses the need for evaluating long-term effects, costs, and benefits of early parenting interventions.
- Provides population-based data on the mental health and well-being of Swedish preschool-aged children.
- Informs the integration of effective parenting programs into existing health systems.
Background:
There is large body of knowledge to support the importance of early interventions to improve child health and development. Nonetheless, it is important to identify cost-effective blends of preventive interventions with adequate coverage and feasible delivery modes. The aim of the Children and Parents in Focus trial is to compare two levels of parenting programme intensity and rate of exposure, with a control condition to address impact and cost-effectiveness of a universally offered evidence-based parenting programme in the Swedish context.
Methods/Design:
The trial has a cluster randomised controlled design comprising three arms: Universal arm (with access to participation in Triple P - Positive Parenting Program, level 2); Universal Plus arm (with access to participation in Triple P - Positive Parenting Program, level 2 as well as level 3, and level 4 group); and Services as Usual arm. The sampling frame is Uppsala municipality in Sweden. Child health centres consecutively recruit parents of children aged 3 to 5 years before their yearly check-ups (during the years 2013-2017). Outcomes will be measured annually. The primary outcome will be children's behavioural and emotional problems as rated by three informants: fathers, mothers and preschool teachers. The other outcomes will be parents' behaviour and parents' general health. Health economic evaluations will analyse cost-effectiveness of the interventions versus care as usual by comparing the costs and consequences in terms of impact on children's mental health, parent's mental health and health-related quality of life.
Discussion:
This study addresses the need for comprehensive evaluation of the long-term effects, costs and benefits of early parenting interventions embedded within existing systems. In addition, the study will generate population-based data on the mental health and well-being of preschool aged children in Sweden.
Trial Registration Isrctn:
ISRCTN16513449.
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