Lucie Cluver|Franziska Meinck|Alexa R. Yakubovich|Jenny Doubt|Alice Redfern|Catherine L. Ward|Nasteha Salah|Sachin De Stone|Tshiamo Petersen|Phelisa Mpimpilashe|Rocio Herrero Romero|Lulu Ncobo|Jamie M. Lachman|Sibongile Tsoanyane|Yulia Shenderovich|Heidi Loening|Jasmina Byrne|Lorraine Sherr|Lauren M. Kaplan|Frances Gardner
Reducing child abuse amongst adolescents in low- and middle-income countries: A pre-post trial in South Africa
Oxford Policy Management|University of Oxford|Oxford Policy Management|University of Oxford|Oxford Policy Management|University of Oxford|Oxford Policy Management|University of Oxford|Oxford Policy Management|University of Oxford|University of Cape Town|Oxford Policy Management|University of Oxford|Oxford Policy Management|University of Oxford|Oxford Policy Management|University of Oxford|Oxford Policy Management|University of Oxford|Oxford Policy Management|University of Oxford|Médecins Sans Frontières|Médecins Sans Frontières|Médecins Sans Frontières|Oxford Policy Management|University of Oxford|University College London|The Royal Free Hospital|Alcohol Research Group|Public Health Institute|Oxford Policy Management|University of Oxford
known studies tested effectiveness child abuse prevention programmes adolescents low middleincome countries parenting lifelong health httptinyccwhoplh collaborative project develop rigorously test abuseprevention parenting programmes free use lowresource contexts research aims first prepost trial south africa identify indicative effects programme child abuse related outcomes ii investigate programme safety testing future randomised trial iii identify potential adaptations two hundred thirty participants adolescents primary caregivers recruited schools welfare services communitysampling rural highpoverty south africa exclusion criteria participated 12week parenting programme implemented local ngo childcare workers ensure realworld external validity standardised prepost measures adolescents caregivers used paired ttests conducted primary outcomes abuse physical emotional abuse neglect adolescent behaviour problems parenting positive involved parenting poor monitoring inconsistent discipline secondary outcomes mental health social support substance use participants reported high levels socioeconomic deprivation eg 60 adolescents either hivpositive caregiver orphaned aids 50 caregivers experienced intimate partner violence indicative effects primary outcomes comparing pretest posttest assessments showed reductions reported adolescents caregivers child abuse adolescent report 630 pretest 295 posttest caregiver report 755 pretest 365 posttest p 0001 poor monitoringinconsistent discipline p 001 adolescent delinquencyaggressive behaviour p 001 improvements positiveinvolved parenting p 01 adolescent report p 001 caregiver report secondary outcomes showed improved social support p 001 adolescent caregiver reports reduced parental adolescent depression p 001 parenting stress p 001 caregiver report caregiver substance use p 002 caregiver report changes adolescent substance use negative effects detected ii programme acceptability attendance high unanticipated programme diffusion within study villages families initiating parenting groups churches diffusion school assemblies religious sermons iii potential adaptations identified included need strengthen components adolescent substance use consider support spontaneous programme diffusion fidelity programme showed signs harm initial evidence reductions child abuse improved caregiver adolescent outcomes showed high acceptability unexpected communitylevel diffusion findings indicate needs adaptations suitability next research step rigorous testing randomised trials using cluster randomization allow diffusion effects