Abstract
BackgroundThe quality of the home learning environment has a significant influence on children’s language and communication skills during the early years with children from disadvantaged families disproportionately affected. This paper describes the protocol and participant baseline characteristics of a community-based effectiveness study. It evaluates the effects of ‘smalltalk’, a brief group parenting intervention (with or without home coaching) on the quality of the early childhood home learning environment.Methods/designThe study comprises two cluster randomised controlled superiority trials (one for infants and one for toddlers) designed and conducted in parallel. In 20 local government areas (LGAs) in Victoria, Australia, six locations (clusters) were randomised to one of three conditions: standard care (control); smalltalk group-only program; or smalltalk plus (group program plus home coaching). Programs were delivered to parents experiencing socioeconomic disadvantage through two existing age-based services, the maternal and child health service (infant program, ages 6–12 months), and facilitated playgroups (toddler program, ages 12–36 months). Outcomes were assessed by parent report and direct observation at baseline (0 weeks), post-intervention (12 weeks) and follow-up (32 weeks). Primary outcomes were parent verbal responsivity and home activities with child at 32 weeks. Secondary outcomes included parenting confidence, parent wellbeing and children’s communication, socio-emotional and general development skills. Analyses will use intention-to-treat random effects (“multilevel”) models to account for clustering.Recruitment and baseline dataAcross the 20 LGAs, 986 parents of infants and 1200 parents of toddlers enrolled and completed baseline measures. Eighty four percent of families demonstrated one or more of the targeted risk factors for poor child development (low income; receives government benefits; single, socially isolated or young parent; culturally or linguistically diverse background).DiscussionThis study will provide unique data on the effectiveness of a brief group parenting intervention for enhancing the early home learning environment of young children from disadvantaged families. It will also provide evidence of the extent to which additional one-on-one support is required to achieve change and whether there are greater benefits when delivered in the 1st year of life or later. The program has been designed for scale-up across existing early childhood services if proven effective.Trial registration8 September 2011; ACTRN12611000965909.
Highlights
The quality of the home learning environment has a significant influence on children’s language and communication skills during the early years with children from disadvantaged families disproportionately affected
The goal was to conduct a large-scale effectiveness study to determine whether a brief group parenting intervention delivered within existing community services could improve the capacity of parents experiencing social and economic disadvantage to provide a rich home learning environment to their young children
Over half the families reported two or more risk factors and approximately 20 % reported four or more risk factors. This cluster randomised controlled trial is the largest experimental study undertaken in Australia to improve the quality of the home learning environment during a child’s formative years
Summary
This cluster randomised controlled trial is the largest experimental study undertaken in Australia to improve the quality of the home learning environment during a child’s formative years. Locally-based services received program funding based on enrolments and were responsible for parent recruitment, staff employment and program scheduling. This ensures that the resulting trial data are relevant to the state government funders and community service providers. Group-based programs are more efficient to deliver and building social connections was an important policy goal The results of this trial will provide valuable data of international relevance on a novel approach to enhancing the home learning environment for young children from disadvantaged circumstances, whilst providing practical information to service providers in Australia. Abbreviations AUD, Australian dollars ($1AUD roughly equivalent to $0.70US); ECI, Early Communication Indicator; IPCI, Indicator of Parent–Child Interaction; LGA, Local Government Area; RCT, randomised controlled trial
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