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Updated: Sep 28, 2025

Psychophysiological Assessment of the Effectiveness of Emotion Regulation Strategies in Childhood
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Published on: February 11, 2017

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A randomized controlled trial of a proportionate universal parenting program delivery model (E-SEE Steps) to enhance

Tracey Bywater1, Vashti Berry2, Sarah Blower1

  • 1Department of Health Sciences, University of York, York, North Yorkshire, United Kingdom.

Plos One
|April 4, 2022
PubMed

Insights

The E-SEE Steps parenting program showed no significant improvements in child social-emotional wellbeing or maternal depression. While borderline cost-effective, its effectiveness was limited by variable fidelity and low uptake of key components.

Area of Science:

  • Child Development
  • Parenting Interventions
  • Public Health

Background:

  • Evidence on parenting programs for children under three is inconclusive.
  • The E-SEE Steps model aimed to deliver parenting programs with proportionate delivery.
  • This study investigated the fidelity, impact, and cost-effectiveness of the E-SEE Steps model.

Purpose of the Study:

  • To evaluate the fidelity, impact, and cost-effectiveness of the E-SEE Steps parenting program.
  • To assess the program's effect on child social-emotional wellbeing (ASQ:SE-2) and maternal depression (PHQ-9).
  • To determine the cost-effectiveness of the intervention compared to usual services.

Main Methods:

  • A randomized controlled trial with an embedded economic and process evaluation was conducted.
  • Parents were randomized with a 5:1 ratio to intervention or control groups.
  • Effectiveness was analyzed using intention-to-treat, and cost-effectiveness using Incremental Cost-Effectiveness Ratios (ICERs).

Main Results:

  • The target sample size was not achieved; 341 mothers were randomized.
  • No significant differences were found between intervention and control groups for ASQ:SE-2 or PHQ-9 scores.
  • The E-SEE Steps model incurred higher costs but showed borderline cost-effectiveness (ICER £20,062 per QALY).

Conclusions:

  • The E-SEE Steps parenting program was not found to be effective in improving child social-emotional wellbeing or maternal depression.
  • The program demonstrated borderline cost-effectiveness, suggesting potential value under certain conditions.
  • Variable fidelity and low uptake of the Infant/Toddler programs necessitate modifications for future evaluations.
Abstract

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