Preventing child mental health problems in southeastern Europe: Feasibility study (phase 1 of MOST framework)
Elena Jansen1, Inga Frantz2, Judy Hutchings3
1Institute of Psychology, University of Klagenfurt, Klagenfurt, Austria.
Insights
This pilot study shows that a low-cost parenting program effectively reduced child behavior problems and improved parenting in low-resource countries. The findings support scalable interventions for child mental health prevention.
Area of Science:
- Child and Adolescent Psychiatry
- Global Mental Health
- Implementation Science
Background:
- Child emotional and behavioral problems are a global concern, particularly in low- and middle-income countries (LMICs) with limited mental health resources.
- Parenting programs offer a scalable, cost-effective prevention strategy but require adaptation to local contexts.
- The RISE project addresses this need by adapting and evaluating a parenting program in Southeastern Europe.
Purpose of the Study:
- To systematically adapt, implement, and evaluate a low-cost parenting program for preventing/reducing child mental health problems.
- To test the feasibility of intervention delivery, implementation, and evaluation procedures using the RE-AIM framework.
- To inform future large-scale trials through Phase 1 of the Multiphase Optimization Strategy (MOST).
Main Methods:
- A pilot pre-post study involving 140 families with children aged 2-9 in North Macedonia, Moldova, and Romania.
- Local facilitators delivered the Parenting for Lifelong Health (PLH) for Young Children program.
- Data collected via pre- and post-program assessments of child behavior and parenting.
Main Results:
- Significant positive pre-post changes observed in child externalizing and internalizing symptoms across all participating countries.
- Improvements in parenting behaviors were noted in participating families.
- Program participation was positively associated with improved child and family outcomes.
Conclusions:
- The adapted low-cost parenting program is feasible and shows promise for reducing child mental health problems in LMICs.
- Findings provide practical insights for implementing parenting interventions in Southeastern Europe.
- Results inform the design of subsequent study phases, including factorial experiments and randomized controlled trials (RCTs).
Abstract:
The prevalence of child emotional and behavioral problems is an international problem but is higher in low- and middle-income countries (LMIC) where there are often less mental health supports for families. Parenting programs can be an effective means of prevention, but must be low-cost, scalable, and suitable for the local context. The RISE project aims to systematically adapt, implement, and evaluate a low-cost parenting program for preventing/reducing child mental health problems in three middle-income countries in Southeastern Europe. This small pre-post pilot study is informed by the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework and tested the feasibility of the intervention, the implementation, and evaluation procedures: Phase 1 of the three-phase Multiphase Optimization Strategy (MOST) for program adaptation. Local facilitators delivered the Parenting for Lifelong Health (PLH) for Young Children program to parents of children aged 2-9 in North Macedonia, the Republic of Moldova and Romania in 2018. Parents completed assessments pre- and post-program. Results demonstrated positive pre-post change for participating families (N = 140) on various outcomes including child externalizing and internalizing symptoms and parenting behavior, in all three countries, all in the expected direction. Program participation was associated with positive outcomes in participating families. Based on the experiences of this pilot study, we outline the practical implications for the successful implementation of parenting programs in the three countries that will inform our next study phases, factorial experiment, and RCT.
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