Abstract
BackgroundChildren in many low- and middle-income countries (LMICs) are at high risk for exposure to violence and later violent behaviour. The World Health Organization has declared an urgent need for the evaluation and implementation of low-cost parenting interventions in LMICs to prevent violence. Two areas of significant early risk are harsh parenting and poor child cognitive and socio-emotional development. Parenting interventions suitable for LMIC contexts have been developed targeting these risk factors and have been shown to have promising effects. However, their impact on child aggression, a key precursor of violence, has yet to be determined. The Pelotas Trial of Parenting Interventions for Aggression (PIÁ) has been designed to address this issue.MethodsWe are conducting a randomised controlled trial to evaluate two early parenting interventions for mothers of children aged between 30 and 42 months in a Brazilian city. The first of these, dialogic book-sharing (DBS), aims to promote child cognitive and socio-emotional development; and the second, the ACT Raising Safe Kids Program (ACT), is designed to reduce harsh parenting. These interventions are being compared with a control group receiving neither intervention. Three hundred and sixty-nine families in a birth cohort are being randomly allocated to one of the three groups (DBS, ACT, Control). Facilitators deliver the interventions to groups of five to 10 mothers at weekly sessions for 8 weeks in DBS and 9 weeks in ACT. Independent assessments of parenting and child development are being made before the interventions, shortly afterwards, and at follow-up 6 months later. The primary outcome is child aggression, and the two main secondary outcomes are: (1) child cognitive and socio-emotional development and (2) harsh parenting. Longer-term outcomes will be investigated as the birth cohort is followed into late childhood, adolescence, and adulthood.DiscussionThe Pelotas Trial of Parenting Interventions for Aggression (PIÁ) aims to evaluate the impact of two early parenting interventions on child aggression and several other key risk factors for the development of violence, including aspects of parenting and child cognition and socio-emotional functioning. The study is being carried out in a LMIC context where violence constitutes a major social and health burden. Since the two interventions are brief and, with modest levels of training, readily deliverable in LMIC settings, a demonstration that they benefit parenting and reduce risk factors for violence would be of major significance.Trial registrationBrazilian Ministry of Health Register of Clinical Trials, ID: RBR-2kwfsk. Registered on 6 June 2018.
Highlights
Introduction toBook-sharingThe benefits to child development of book-sharing are explained, and the importance of establishing a book-sharing routine stressed
The biggest challenges are in high-violence Low- and middleincome country (LMIC) contexts, where data are scarce on the effectiveness of preventive interventions [14,15,16]
Data collection Data collector training Ten experienced data collectors were trained over a 1-month period by senior psychologists (SC, LA, and AA) in the child and caregiver assessments specific to The Pelotas Trial of Parenting Interventions for Aggression (PIÁ) Trial, and followed a data collection manual developed by SC, LA, AA, and RM
Summary
Study design The study is a three-arm RCT. The three arms are: 1. Dialogic book-sharing (DBS) – a parenting intervention designed to promote sensitive and supportive interactions with children over picture books with the aim of improving child cognitive development and social understanding. Following consent and baseline evaluation, mother-child pairs are being randomised to one of the three study groups This is being effected centrally (i.e. from the Federal University of Pelotas Centre for Epidemiological Research), minimising for child age, sex, level of harsh parenting at age 2 years, and child aggression at age 2 years (all binary variables). Data collection Data collector training Ten experienced data collectors were trained over a 1-month period by senior psychologists (SC, LA, and AA) in the child and caregiver assessments specific to The PIÁ Trial, and followed a data collection manual developed by SC, LA, AA, and RM This was done at the Federal University of Pelotas Centre for Epidemiological Research. The primary outcome is child aggression at the 6-month follow-up assessment, measured by parental report, and direct observation. TSC members from The PIÁ Trial study team are JM and IS
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
