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Parenting Education for Parents of Young Children

Parenting Education for Parents of Young Children. Dr Shirley Leung SL MB,BS(HK); MPH(Auckland); FHKAM(Paed); FRCP(Glasg) Principal Medical & Health Officer Family Health Service Department of Health. Parenting Programme in Maternal & Child Health Centres. Aim:

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Parenting Education for Parents of Young Children

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  1. Parenting Education for Parents of Young Children Dr Shirley Leung SL MB,BS(HK); MPH(Auckland); FHKAM(Paed); FRCP(Glasg) Principal Medical & Health Officer Family Health Service Department of Health

  2. Parenting Programme in Maternal & Child Health Centres Aim: To equip parents with the necessary knowledge and skills to bring up healthy and well-adjusted children

  3. The Universal Programme: To provide Anticipatory Guidance to all parents on the physical & psychosocial care of the child, through various modes & channels

  4. Anticipatory Guidance to Parents

  5. Universal Programme: Delivered through various Modes and Channels Leaflets Individual Interview AV resources Telephone hotline Website Happy Parenting Workshops

  6. Community-based Promotion Activities Baby Expo Roving exhibition Advertising in mass transit system TV series API and poster campaign

  7. Targetted Programmes: • Breastfeeding • Coaching • Management of complications • Support group • Child behaviour management • Positive Parenting Programme (Triple P)

  8. Triple P: Principles & Strategies Principle: To foster self efficacy & self-regulation of parents in child behaviour management • Understanding the causes of child behaviour problems • Setting goals for change in parent’s own & child’s behaviours • Keeping track of parent’s own & child’s behaviour (Behaviour diary/graph) • Acquiring the knowledge & skills of • 10 positive parenting strategies (enhance parent-child relationship; encourage desirable behaviours, etc) • 7 strategies to manage behaviour problems • Application of the above to solve current problems and prevent future ones

  9. Group Triple P Role Play Group discussion Mini-lecture Phone follow up

  10. Does not address relationship or values • Emphasizes building of a positive parent-child relationship • Respects parent’s own values Fiction Fact • Directed & controlled by professionals • Empowerment of parents • Facilitate self-regulation • Build self-efficacy • A western product suited for western culture • A programme for middle-class parents • Programme effectiveness has been proven in local Chinese families (RCT) • Larger magnitude of improvement in low income level & new immigrants • Universality of human psychology & Globalization • Need to respect diversity & be culturally sensitive during service provision

  11. The Evidence Leung C, Sanders MR, Leung S, Mak R & Lau J. An outcome evaluation ofthe implementation of the Triple P - Positive Parenting Program in Hong Kong. Fam Process 2003; 42:531-44. • A randomised controlled trial 69 parents with children 3 to 7 years • Intervention group 33 • Control group 36 • Results • Increase in parenting sense of competence • Decrease in dysfunctional parenting practices • Decrease in child behaviour problems • Decrease in marital conflicts

  12. Directions & Approaches to Family Education

  13. Tertiary Care Secondary Care Intervention Primary Care Intervention Universal Programme The Scope of Family Education • Family members at different life stages: • Different needs (difficulties & problems) • Programmes of different levels: • Universal programme • Anticipatory guidance • Preventive • Targetted programme • Address special needs / problems • Early intervention(primary care level) • Treatment & remedial • Provided by professionals of various disciplines in different sectors

  14. Common Ground for all Professionals: Evidence-based Practices • The Cochrane Collaboration • Established in 1993 • A global research network • Aims toimprove healthcare decision-making through systematic reviews of the effects of healthcare interventions • Published in the Cochrane Library • [A systematic review aims to sum up the best available research on a specific question. It uses transparent procedures to find, evaluate and synthesize the results of all relevant research]

  15. Common Ground for all Professionals: Evidence-based Practices • The Campbell Collaboration • established in 2000 • an international research network that produces systematic reviews of the effects of social interventions in the areas of • education • crime and justice • social welfare • Published in the Campbell Library • to better inform policy and practice, and ultimately improve people's well being

  16. Systematic Reviews on Parenting Programmes Cochrane Library • Parenting interventions for the prevention of unintentional injuries in childhoodDenise Kendrick, Jane Barlow, Amanda Hampshire, Leon Polnay, Sarah Stewart-Brown; 2007 • Group-based parent-training programmes for improving emotional and behavioural adjustment in 0-3 year old childrenJane Barlow, Jacqueline Parsons; 2003 • Individual and group-based parenting programmes for the treatment of physical child abuse and neglectJane Barlow, Isabelle Johnston, Denise Kendrick, Leon Polnay, Sarah Stewart-Brown; 2006 • Individual and group-based parenting programmes for improving psychosocial outcomes for teenage parents and their childrenEsther Coren, Jane Barlow; 2001 Campbell Library • Group-based parent-training programmes for improving emotional and behavioural adjustment in 0-3 year old children (Social welfare) Jane Barlow and Jacqueline Parsons; 2005 • Parent-training programmes for improving maternal psychosocial health (Social welfare) Jane Barlow, Sarah Stewart-Brown and Esther Coren; 2005. • Parental involvement and the academic performance of elementary school children (Education) Chad Nye, Herb Turner and Jamie Schwartz; 2006.

  17. The Evidence-based Intervention Programme Development Model Needs Assessment Programme Design Efficacy Testing Effectiveness Testing Programme Diffusion • The condition • Distribution • Determinants Biological / Socio-behavioural Research RCT Training Quality management Ongoing Evaluation Field trials

  18. Thank You!

  19. Effectiveness and Efficiency: Random Reflections on Health Services (1972) Resources are always limited – should be used to provide forms of health care which has been shown in properly designed evaluations to be effective – the importance of using evidence from randomised controlled trials (RCT's) "It is surely a great criticism of our profession that we have not organised a critical summary, by specialty or subspecialty, adapted periodically, of all relevant randomised controlled trials." (1979) Professor Archibald Leman Cochrane CBE FRCP FFCM (1909 - 1988) Source: Cochrane Collaboration Source: The Cochrane Collaboration.

  20. The Hierarchy of Evidence(of causality) Level 1: Randomised controlled trials Results from a systematic review (& meta-analysis) of trials One or more individual trials Level 2: Cohort & case-control studies Results from a meta-analysis of such studies One of more individual studies Level 3: Other comparative studies Level 4: Case series, descriptive studies. Professional experiences

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