Abstract
Despite ample evidence of the efficacy and effectiveness of evidence-based parenting programs (EBPPs) within research-led environments, there is very little evidence of maintenance of effectiveness when programs are delivered as part of regular service provision. The present study examined the effectiveness of EBPPs provided during a period of sustained service-led implementation in comparison to research-led effectiveness evaluation. Data from 3706 parents who received EBPPs during sustained implementation by services were compared to data from 1390 parents who had participated in an earlier researcher-led effectiveness trial of a national roll-out of EBPPs in England. In both phases, parents completed measures of child behavior problems, parenting style and parental mental well-being prior to starting parenting programs (pre-test), at the end of the programs (post) and at 12-months follow up. Results from Generalized Estimating Equations controlling for potential covariates indicated significant improvements in child behavior problems during sustained implementation, similar to the effectiveness phase; significant improvements in parenting style which were larger than the effectiveness phase at 12-month follow up; and significant improvements in parental mental well- being. Our findings demonstrate effective maintenance of gains when EBPPs are provided as part of regular provision across a large sample of English parents. Successful long-term implementation should consider effectiveness of EBPPs across the population, given the large contextual changes that take place between researcher-led evaluations and service take-up. Our findings support the integration of EBPPs in public health approaches to addressing child behavior problems and parent well-being.
Highlights
Evidence-informed policy making in public health or specialist service provision relies, in part, on research evidence about the efficacy and effectiveness of available interventions (Davies et al, 2000)
Generalized Estimating Equations were fitted for each outcome to examine whether the effect of study phase, time or their interaction was significant, accounting for the effect of Local Authorities (LAs), parent program type, child age, child gender, child’s Special Educational Need (SEN) status, parent gender, parent support need, ethnicity, and socioeconomic deprivation
The current study examined whether evidence-based parenting programs (EBPPs) remain effective when delivered entirely by service providers as part of regular service delivery during the sustained implementation phase
Summary
Evidence-informed policy making in public health or specialist service provision relies, in part, on research evidence about the efficacy and effectiveness of available interventions (Davies et al, 2000). According to recent standards of evidence (Gottfredson et al, 2015), interventions are gradually developed by building up the evidence in relation to the core mechanism of change, Sustained Effectiveness of Parenting Programs testing the efficacy of the full intervention package in controlled conditions, and examining the effectiveness of the intervention under conditions that resemble real-life conditions more closely (Flay et al, 2005; Gottfredson et al, 2015). Within implementation science it has become recognized that this evidence pathway should not end after demonstration of efficacy and effectiveness when the intervention is scaled up and implemented as part of regular service provision. Models of evidence pathways have extended to a further stage of sustainment or sustainability (Aarons et al, 2011). A recent review demonstrates consistency has not improved (Moore et al, 2017)
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