What Affects Attendance and Engagement in a Parenting Program in South Africa?

Yulia Shenderovich,Manuel Eisner,Jenny Doubt,Lucie Cluver,Sybil Majokweni,Aja Louise Murray,Mckenzie Berezin

doi:10.1007/s11121-018-0941-2

Abstract

Parenting programs are a promising approach to improving family well-being. For families to benefit, programs need to be able to engage families actively in the interventions. Studies in high-income countries show varying results regarding whether more disadvantaged families are equally engaged in parenting interventions. In low- and middle-income countries (LMICs), almost nothing is known about the patterns of participation in parent training. This paper examines group session attendance and engagement data from 270 high-risk families enrolled in the intervention arm of a cluster-randomized controlled trial in South Africa. The trial evaluated a 14-week parenting intervention aiming to improve parenting and reduce maltreatment by caregivers. The intervention was delivered in 20 groups, one per study cluster, with 8 to 16 families each. Overall, caregivers attended 50% of group sessions and children, 64%. Using linear multilevel models with Kenward-Roger correction, we examined child and caregiver baseline characteristics as predictors of their attendance and engagement in the group sessions. Variables examined as predictors included measures of economic, educational, and social and health barriers and resources, as well as family problems and sociodemographic characteristics. Overall, the study yielded no evidence that the level of stressors, such as poverty, was related to attendance and engagement. Notably, children from overcrowded households attended on average 1.2 more sessions than their peers. Our findings suggest it is possible to engage highly disadvantaged families that face multiple challenges in parenting interventions in LMICs. However, some barriers such as scheduling, and alcohol and substance use, remain relevant.

Highlights

Parenting programs are a promising approach to improving family well-being
Group parenting interventions rely on participants attending sessions and engaging with the content
Several studies demonstrated that the extent of participation is important in determining benefits gained from a parenting intervention

Summary

Introduction

Parenting programs are a promising approach to improving family well-being. For families to benefit, programs need to be able to engage families actively in the interventions. There is a need to build knowledge on promoting effective parenting in LMICs. Parenting interventions are a promising approach to improve parenting, and to reduce and prevent child maltreatment (e.g., Mikton and Butchart 2009; Barlow et al 2013). Parenting interventions are a promising approach to improve parenting, and to reduce and prevent child maltreatment (e.g., Mikton and Butchart 2009; Barlow et al 2013) They can target other outcomes, such as parent mental health, child externalizing behavior, and substance use (e.g., Chen and Chan 2016). These interventions include a range of designs, and are usually delivered individually or in groups over several weeks, based on a treatment manual. Drawing on categories in previous research, we look at four groups of predictors: economic and educational barriers and resources, social and health barriers and resources, parenting and child behavior, and sociodemographic factors

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