Positive Parent-child Relationships Research Articles

From Nurture to Deviance: A Study on Parenting Style and Juvenile Delinquency

ABSTRACT Drawing on data and quantitative analysis from the 2019 Recidivism Survey conducted by the Ministry of Justice in China, this study unveils a significant correlation between parenting styles, parent-child relationships, and juvenile delinquency. Negative parenting practices can lead to increased anxiety or a lack of self-control, especially in scenarios characterized by inadequate parental supervision. This shortfall in self-regulation is directly associated with a surge in criminal behavior among adolescents, thereby elevating the risk of engaging in delinquent activities. Furthermore, poor parent-child relationships exacerbate the adverse effects of insufficient parental oversight on juvenile misconduct. Youths with diminished social and emotional bonds to their parents are more susceptible to diverging from societal norms and participating in delinquent behaviors. Therefore, effective intervention strategies aimed at curbing juvenile delinquency should focus on improving parental supervision and guidance while simultaneously nurturing positive parent-child relationships.

Parenting Stress and Coping Strategies Adopted by Working Mothers; A Thematic Research

In today's society, an increasing number of mothers are balancing the demands of work and family responsibilities. As more women enter the workforce, understanding the unique stressors faced by working mothers in their parenting role becomes paramount. The challenges of juggling work and family life can contribute to heightened levels of parenting stress, impacting maternal well-being and family dynamics. Furthermore, the strategies employed by working mothers to cope with these stressors are crucial for maintaining a healthy work-family balance and promoting positive parent-child relationships. However, there is a gap in our understanding of the specific stressors experienced by working mothers and the effectiveness of various coping strategies they adopt. The study likely involves an investigation into the unique stressors experienced by older first-time mothers and how they adapt to the demands of motherhood. Reece may have conducted interviews, surveys, or observational studies to assess stress levels, coping mechanisms, and maternal adaptation among this population.

The parent–child relationship in the digital era: The mediator role of digital parental awareness

The parent–child relationship was extensively reshaped during the infusion of digital technologies into families’ daily lives. In this context, this research aims to investigate the relationship between the parent’s time spent with the child and the parent–child relationship when digital parenting awareness including negative and positive roles is taken into consideration. A cross-sectional survey research method was employed. The data was collected by demographic information form, Child-parent Relationship, and Digital Parental Awareness scales. The data was analyzed from 285 parents with 3–6 years old children. In order to test the hypotheses, the Hayes-Process model was employed to determine the mediating effects of sub-dimensions of digital parental awareness between parent’s time spent with the child and the parent–child relationship. The results revealed that being a negative digital role model, digital negligence, parents' effective use of technology, and protection from digital risks partially mediate the link between parent–child time and their relationship. An increase in negative role modeling and digital negligence are associated with a decrease in the positive parent–child relationship. Furthermore, parents’ efficient use of and protection from risks from technology affects the parent–child relationship positively.

The dynamic nature of parenting practices: a qualitative enquiry of parenting adolescents during COVID-19.

Parenting practices are known to be dynamic, evolving in response to various factors such as societal changes, cultural norms, and individual circumstances. Understanding the dynamic nature of parenting is essential for comprehending its influence on children's development. This study aimed to explore the adaptive nature of parenting practices amidst the backdrop of the COVID-19 pandemic, a global event that provided a unique context for examining these dynamics. In-depth semi-structured qualitative interviews were conducted with six heterogeneous couples who were parenting at least one adolescent during the pandemic. Attride-Sterling's thematic network analysis was employed to analyze the interview data. Five global themes emerged from the data, namely, change in parenting style due to stressors, paternal versus maternal style of parenting, intergenerational transmission of parenting practices, child-centric parenting practices, positive parenting practices and evolving parent-child relationship during COVID-19. The findings highlight the tendency of parents to adapt their parenting styles to meet the evolving needs of their children. Understanding these dynamics is crucial for supporting families during times of crisis. Future research should explore the long-term effects of these changes and effective strategies for promoting positive parent-child relationships.

Cultural Influences on Parenting Styles and Child Development

Purpose: The general aim of the study was to examine the cultural influences on parenting styles and child development. Methodology: The study adopted a desktop research methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library. Findings: The findings reveal that there exists a contextual and methodological gap relating to cultural influences on parenting styles and child development. Preliminary empirical review revealed the significant role of cultural norms, values, and beliefs in shaping parenting behaviors and influencing child well-being across diverse cultural contexts. Through a comprehensive review of empirical research, it highlighted distinct patterns of parenting practices influenced by cultural factors such as collectivism, individualism, and religiosity. Findings also emphasized the dynamic nature of cultural adaptation within immigrant populations, with shifts in parenting styles observed as parents acculturated to the host society. The study underscored the importance of culturally sensitive interventions and support services in promoting positive parent-child relationships and enhancing child well-being across diverse cultural backgrounds. Unique Contribution to Theory, Practice and Policy: The Social Learning theory, Ecological Systems theory and Attachment theory may be used to anchor future studies on cultural influences on parenting styles and child development. The study provided valuable recommendations across multiple domains. It advised researchers to further explore cultural influences on parenting within diverse contexts and integrate insights from various disciplines to enhance theoretical frameworks. Practitioners were encouraged to adopt culturally sensitive approaches, receive training in cultural competence, and collaborate with community stakeholders to support families effectively. Policymakers were urged to develop culturally responsive policies addressing systemic barriers faced by diverse families and promote inclusive practices in healthcare, education, and social services. Additionally, the study emphasized the importance of continued research, culturally tailored interventions, practitioner training, and collaborative efforts to promote positive parenting and child well-being across diverse cultural backgrounds.

Parenting and Problematic Social Media Use: A Systematic Review

Abstract Purpose of Review Research on the relation between parenting and adolescents’ problematic social media use (PSMU) is relatively new and reveals rather mixed findings. This is likely due to a focus on different parenting factors as well as a diversity in outcomes of social media use. This paper is aimed at reviewing existing literature on parenting and adolescents’ PSMU and providing a reference for future research and intervention. Recent Findings There is consistent evidence that positive parent–child relationships as well as a positive family climate at home are related to less PSMU. Likewise, most studies indicate that positive parenting, parenting that is characterized by affection, responsiveness, and demandingness, is associated with less PSMU, whereas parenting characterized by inconsistency and control is associated with more PSMU. Findings concerning internet-specific parenting are far less consistent. Restrictive mediation shows a dual influence. When restrictive mediation constitutes rule setting, then a negative correlation with PSMU is found. However, when it refers to reactive restrictions, a positive association is found. Active mediation is not consistently correlated to PSMU. Finally, a clear and consistent positive correlation between parental phubbing and PSMU was found. Summary This review indicates that there is more consistent evidence that positive parent-child interactions and positive general parenting practices (e.g., affection and responsiveness) may help to prevent adolescents’ PSMU than internet-specific parenting practices that are aimed at guiding or restricting adolescents’ internet use. However, studies largely used a cross-sectional design and varied significantly in the conceptualization and operationalization of parenting practices. This review justifies further investigation which is needed to provide an integral prevention approach that includes parenting to support optimal adolescent development, including the prevention of PSMU.

Longitudinal relations among parent-child relationships, positivity, and teachers-student relationships in Chinese children.

Relationships with parents and teachers are crucial to a child's socialization. However, little is known about the transactional processes between parent-child and teachers-student relationships and their mediating mechanisms. This short-term longitudinal study examined bidirectional relations between positive parent-child and teachers-student relationships, and the potential mediating role of positivity within these relations. There were 3,450 Chinese children (44.8% girls; Mage = 10.93 years) who participated in a four-wave longitudinal study, spaced 6 months apart. The random intercept cross-lagged panel modeling found: (a) both father-child and mother-child relationships directly predicted teachers-student relationships, and vice versa; (b) positivity functioned as a mediator in bidirectional relations between parent-child and teachers-student relationships. These results support a transactional spillover effect between parent-child and teachers-student relationships, suggesting Chinese children may become caught in a virtuous cycle either directly or indirectly via their positivity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Parents’ Responses and Children’s Subjective Well-Being: The Role of Parent–Child Relationship and Friendship Quality

The current study examined the psychological mechanism that underlies the relationship between parents’ response style and children’s subjective well-being and its boundary conditions, the mediating role of the parent–child relationship, and the moderating role of friendship quality. Using the Parents’ Responses to Children’s Performance Scale, the Buchanan Scale of Closeness to Parents, the Friendship Quality Questionnaire, and the Campbell Index of Well-being, our study investigated 686 pupils who were randomly selected from three public schools in central China. Employing Mplus 8.3 for pathway analysis, we found the following results: Failure-oriented responses negatively predict children’s subjective well-being (β = −0.16, p < 0.001), while success-oriented responses positively predict children’s subjective well-being (β = 0.13, p < 0.01). Both failure-oriented (ab = 0.18, SE = 0.03, 95% CI = [0.13, 0.25]) and success-oriented responses (ab = −0.10, SE = 0.02, 95% CI = [−0.14, −0.06]) predict children’s subjective well-being through the mediating effect of the parent–child relationship. Friendship quality has a moderating effect on the mediating path (β = −0.09, p < 0.05), such that when friendship quality is lower, the parent–child relationship has a higher mediating effect between the parents’ responses and children’s subjective well-being. This study offers empirical evidence that parents’ responses to children’s performance significantly contribute to children’s subjective well-being. Moreover, it offers actionable insights for enhancing children’s subjective well-being. The enhancement could be achieved by fostering positive parent–child relationships and enhancing the quality of children’s friendships, thereby positively impacting their well-being.

Overparenting in Parents of Elementary School Children: The Direct Association with Positive Parent-Child Relationship and the Indirect Associations with Parental Self-Efficacy and Psychological Well-Being

Overparenting in Parents of Elementary School Children: The Direct Association with Positive Parent-Child Relationship and the Indirect Associations with Parental Self-Efficacy and Psychological Well-Being

Interplay between Parental Knowledge and Adolescent Inebriation, and Their Links to Parent–Child Relationships over Time

While parental knowledge of adolescents’ whereabouts is generally considered to be a key protective factor for adolescent alcohol use, the developmental links during adolescence are unclear. Focusing on within-family processes on a sample of Swedish early to late adolescents (n = 782; 49% female) over four waves of data, we (1) tested the interplay between parental knowledge and adolescent alcohol inebriation, (2) investigated whether changes over time in parental knowledge and adolescent inebriation were linked to the parent–child relationship, and (3) tested the moderating role of adolescent gender and SES on these potential links. The results from random intercept cross-lagged panel models showed that increases in parental knowledge predicted decreases in frequencies of adolescent inebriation the following year as well a more positive parent–child relationship over time. Increases in adolescent inebriation were predicted by less parental knowledge only in late adolescence. These links were not moderated by adolescent gender or SES. The results emphasize the importance of increasing parental knowledge of adolescent activities in order to reduce adolescent involvement in heavy alcohol use as well as the importance of parent–child closeness.

Parents' Knowledge, Attitudes, and Practices Regarding Baby Walkers, Baby Car Seats, Oral Health, and Child Screen Time in Saudi Arabia: A Cross-Sectional Study.

Background Awareness of age-appropriate milestones and developmental stages is crucial for parents to identify any potential delays or concerns early on and seek appropriate interventions. This study aimed to assess the knowledge, attitudes, and practices of caregivers in Saudi Arabia regarding baby walkers, baby car seats, early dental visits, and screen time for young children. Methods A cross-sectional survey was conducted among parents in Saudi Arabia using a structured questionnaire. A convenience and snowball sampling method was employed to recruit participants from various regions of the country. The questionnaire aimed to assess parents' knowledge regarding the recommended use of baby walkers and baby car seats, their awareness of the importance of early dental visits, and their understanding of appropriate screen time guidelines. Additionally, the survey explored parents' practices toward these recommendations. Descriptive statistics were used to analyze the data, and associations between variables were examined using the chi-squared test. Results A total of 1318 participants were included. The analysis revealed that the majority of the participants (n=1066,81.3%) use a baby walker, while only (n=292,22.3%) consider that they should never be used. Overall, (n=388,29.6%) of the participants never used a car seat for their infants or children. In terms of early childhood dental visits, approximately (n=518,39.5%) of the participants reported actually taking their child to the dentist within the recommended timeframe. Regarding screen time for children, (n=148,11.3%) of the participants reported that their children spend >5 hours daily in front of the screen. Conclusions Raising parents' awareness about recent childcare recommendations and safe practices is crucial for promoting optimal child development, preventing health problems, facilitating evidence-based decision-making, reducing risks, enhancing parental confidence and empowerment, and nurturing positive parent-child relationships.

Cultivation Approaches of Personality Development in Preschool Children through Family Education

The personality development of preschool children constitutes a crucial task in the realm of family education. Simultaneously, family education plays an indispensable role in shaping the personality of preschool children. This paper delves into an in-depth exploration of methodologies to effectively facilitate the personality development of preschool children. It focuses on providing a stable family environment, establishing positive parent-child relationships, nurturing proactive emotional expression abilities, fostering the development of social skills, cultivating self-control capabilities, and encouraging autonomy and creativity in preschool children. Through these approaches, family education can effectively stimulate the personality development of preschool children, thereby laying a solid foundation for their future growth.

Promoting Free Play in Families Using the Kindergarten PLAYBAG Intervention in Hong Kong: An Exploratory Study

This exploratory study examined whether the kindergarten PLAYBAG intervention protocol administered for parents and children during the pandemic in Hong Kong could generate positive outcomes in embracing play freedom, fostering positive parent–child relationships, and promoting parents’ mental health. Self-administrated questionnaires were used to generate quantitative data before and after the distribution of the PLAYBAG intervention protocol. A total of 32 parents who completed both the pre-test and post-test were investigated regarding the outcomes of PLAYBAG. Recommendations from the study suggest enhancing the PLAYBAG protocol to address the specific needs of parents from different socio-economic backgrounds and help resolve the difficulties experienced by parents in engaging in free play with their children. Consideration should also be given to empowering children’s voices in the co-creation of a free play environment.

Clinical and cost-effectiveness of an adapted intervention for preschoolers with moderate to severe intellectual disabilities displaying behaviours that challenge: the EPICC-ID RCT.

Stepping Stones Triple P is an adapted intervention for parents of young children with developmental disabilities who display behaviours that challenge, aiming at teaching positive parenting techniques and promoting a positive parent-child relationship. To evaluate the clinical and cost-effectiveness of level 4 Stepping Stones Triple P in reducing behaviours that challenge in children with moderate to severe intellectual disabilities. A parallel two-arm pragmatic multisite single-blind randomised controlled trial recruited a total of 261 dyads (parent and child). The children were aged 30-59 months and had moderate to severe intellectual disabilities. Participants were randomised, using a 3 : 2 allocation ratio, into the intervention arm (Stepping Stones Triple P; n = 155) or treatment as usual arm (n = 106). Participants were recruited from four study sites in Blackpool, North and South London and Newcastle. Level 4 Stepping Stones Triple P consists of six group sessions and three individual phone or face-to-face contacts over 9 weeks. These were changed to remote sessions after 16 March 2020 due to the coronavirus disease 2019 pandemic. The primary outcome measure was the parent-reported Child Behaviour Checklist, which assesses the severity of behaviours that challenge. We found a small non-significant difference in the mean Child Behaviour Checklist scores (-4.23, 95% CI -9.98 to 1.52, p = 0.146) in the intervention arm compared to treatment as usual at 12 months. Per protocol and complier average causal effect sensitivity analyses, which took into consideration the number of sessions attended, showed the Child Behaviour Checklist mean score difference at 12 months was lower in the intervention arm by -10.77 (95% CI -19.12 to -2.42, p = 0.014) and -11.53 (95% CI -26.97 to 3.91, p = 0.143), respectively. The Child Behaviour Checklist mean score difference between participants who were recruited before and after the coronavirus disease 2019 pandemic was estimated as -7.12 (95% CI -13.44 to -0.81) and 7.61 (95% CI -5.43 to 20.64), respectively (p = 0.046), suggesting that any effect pre-pandemic may have reversed during the pandemic. There were no differences in all secondary measures. Stepping Stones Triple P is probably value for money to deliver (-£1057.88; 95% CI -£3218.6 to -£46.67), but decisions to roll this out as an alternative to existing parenting interventions or treatment as usual may be dependent on policymaker willingness to invest in early interventions to reduce behaviours that challenge. Parents reported the intervention boosted their confidence and skills, and the group format enabled them to learn from others and benefit from peer support. There were 20 serious adverse events reported during the study, but none were associated with the intervention. There were low attendance rates in the Stepping Stones Triple P arm, as well as the coronavirus disease 2019-related challenges with recruitment and delivery of the intervention. Level 4 Stepping Stones Triple P did not reduce early onset behaviours that challenge in very young children with moderate to severe intellectual disabilities. However, there was an effect on child behaviours for those who received a sufficient dose of the intervention. There is a high probability of Stepping Stones Triple P being at least cost neutral and therefore worth considering as an early therapeutic option given the long-term consequences of behaviours that challenge on people and their social networks. Further research should investigate the implementation of parenting groups for behaviours that challenge in this population, as well as the optimal mode of delivery to maximise engagement and subsequent outcomes. This study is registered as NCT03086876 (https://www.clinicaltrials.gov/ct2/show/NCT03086876?term=Hassiotis±Angela&draw=1&rank=1). This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: HTA 15/162/02) and is published in full in Health Technology Assessment; Vol. 28, No. 6. See the NIHR Funding and Awards website for further award information.

Adolescents and Retaliation Coping with Cyberbullying: Do Individual and Social Factors Matter?

Cyberbullying has been linked with a host of negative outcomes for adolescents. This study explored the role of child-parent-teacher-peer relationships (external social factors) and self-esteem and assertiveness (individual factors) in predicting the use of a retaliation coping strategy among adolescents. The study employed a cross-sectional research design, and a total of 778 secondary school adolescents aged 14 to 18 completed a self-report questionnaire. Results showed that adolescents with higher levels of self-esteem reported less likelihood of using the retaliation coping strategy in dealing with cyberbullying, while adolescents with greater levels of assertiveness reported a high likelihood of using retaliation. It was also found that older male adolescents are less likely to report the use of retaliation compared to female adolescents. Also, older adolescents who reported more positive parent-child relationships are more likely to use retaliation. Results further showed that highly assertive adolescents with more positive teacher relationships are less likely to use retaliation. Findings suggest gendered and age-specific education and intervention programmes that promote positive adolescent relationships with parents and teachers and responsible online assertiveness skills to cope with cyberbullying.

Sociocultural Risk and Resilience in the Context of Adverse Childhood Experiences

Knowledge about childhood resilience factors relevant in circumstances of marginalization and high numbers of adverse childhood experiences (ACEs) can improve interventions. To identify sociocultural resilience factors in childhood that are associated with better young adult mental health in the context of ACEs. This cohort study examined 4 waves of data from the Boricua Youth Study, which included Puerto Rican children from the South Bronx, New York, and San Juan, Puerto Rico. Participants were aged 5 to 17 years at waves 1 through 3 (2000-2003) and aged 15 to 29 years at wave 4 (2013-2017). Linear and logistic regression models tested the associations of 7 childhood resilience factors and their interaction with ACEs on young adult mental health outcomes. Data were analyzed from June 2021 to October 2023. Perceived stress, major depressive disorder and/or generalized anxiety disorder (MDD/GAD), and substance use disorder (SUD) in young adulthood. Among a total 2004 participants, the mean (SD) age at wave 4 was 22.4 (2.9) years; 1024 participants (51.1%) were female, and 980 (48.9%) were male. Positive parent-child relationships and nonparental adult support during childhood were associated with both lower perceived stress (β = -0.14; SE = 0.02; P < .001; β = -0.08; SE = 0.03; P = .003, respectively) and lower odds of MDD/GAD (adjusted odds ratio [aOR], 0.84; 95% CI, 0.73 to 0.97; aOR = 0.81; 95% CI, 0.69 to 0.95, respectively) in young adulthood. Maternal warmth reported during childhood was also associated with lower young adult perceived stress (β = -0.11; SE = 0.02; P < .001). None of the resilience factors were associated with SUD. The resilience factors familism, friendships, and family religiosity were not associated with any of the mental health outcomes. ACEs were associated with poorer mental health outcomes; however, none of the resilience factors exhibited interactions consistent with being protective for ACEs. Unexpectedly, higher family religiosity was associated with more perceived stress in the presence of higher ACEs. The results of this study suggest that promoting positive relationships with adults during childhood may reduce later young adulthood stress and MDD/GAD. However, there is still a need to identify sociocultural childhood protective factors for ACEs. Caution should be taken in assuming what resilience factors are relevant for a given group, as higher family religiosity (one postulated resilience factor) was unexpectedly associated with a stronger, rather than a weaker, association between ACEs and perceived stress in young adulthood.

Parenting Practices and Parenting Program Preferences of Chinese Immigrant Parents in New Zealand

Participation in evidence-based parenting programs benefits parents and children, but these programs have limited reach. This study utilized a mixed-method design to investigate the parenting concerns and parenting program needs of Chinese immigrant parents in New Zealand. Parents (n = 159) were surveyed about their perceived levels of child adjustment problems, parenting confidence, and parenting risk and protective factors. Parents’ knowledge and experience with parenting programs, and their program preferences were also examined. Eight Chinese parenting practitioners were interviewed about parenting challenges, parental concerns, and barriers to program participation of Chinese immigrant parents. Survey results showed that parents who gave their child higher ratings on behavior problems reported less parental self-efficacy, and more parental adjustment, family relationship, teamwork, and parenting difficulties. Parents’ knowledge and experience of available parenting programs was low. Barriers to program participation included time constraints, lack of program awareness, cultural and language barriers, and no childcare provision. Parents indicated a preference for a range of delivery options including group-based, seminar, and individually tailored programs. Program features most likely to influence attendance were content that addresses personally relevant issues and children’s self-development (such as coping with failure, managing negative emotions, and increasing confidence), and convenient location of program. Practitioners indicated that managing difficult child behavior and maintaining positive parent-child relationships were key parenting challenges. These concerns were linked to cultural expectations about child obedience, academic performance, and parent/grandparent relationships. Findings highlight program preferences that could be offered to meet Chinese immigrant parenting support needs and increase program participation.

The Association between Parent-Child Relationship and Emotional Regulation

Emotional regulation is the way people control their emotions, adjust emotions, and maintain emotional stability. The parenting style are influencing children’s mental health development a lot, and a positive parent-child relationship will help children’s emotional regulation ability develop. This research is focused on the attachment relationship of children to their parents in their childhood, and what kind of influence people's growth environment will have on their personality and social adaptability in adulthood. The ability to control depression before they grow up, and what behaviors of parents will lead negative impact on children's psychological development, and how mothers and fathers have different influences on children's growth, etc. to conduct research. In the end, the result shows a warm family environment and emotionally stable parents will raise strong emotional regulation ability children. The studies also have some limitations, such as there was no investigation into the experiences of the participants as adults. Future studies should do more surveys about experiences in the adulthood of the participant.

Addressing Early Education and Child Care Expulsion.

An important goal of early childhood education is teaching emotional self-regulation within the context of a safe, stable, nurturing environment. Expulsion of young children ignores underlying emotional and behavioral concerns, disproportionately affects children of color (Black or Hispanic), males, children with disabilities, and socioeconomically disadvantaged populations, and has long-term consequences on educational and life success. Addressing implicit bias and providing child mental health consultation (psychologists, social workers, developmental behavioral pediatricians, child psychiatrists, and child neurologists) to child care providers can prevent expulsion. Pediatricians and other providers within the medical home play an important part in preventing expulsion. However, pediatricians need more training in early childhood mental health and in understanding how systemic racism and implicit bias lead to preschool expulsion in children of color. By identifying children at risk for expulsion because of poverty, racial discrimination, toxic stress, insecure attachment, or history of trauma, the pediatrician can connect families with community resources that may ameliorate these effects. Pediatricians can provide information on social-emotional development in early childhood, promote positive parent-child relationships, and model and discuss age-appropriate and developmentally appropriate behavior management. Pediatricians can also guide parents toward high-quality child care programs that use mental health consultation and developmentally appropriate activities, both of which lessen the chance of child expulsion. Furthermore, behavioral health providers integrated into the medical home can provide consultation to child care providers on managing patients. These recommendations are consistent with our knowledge of early child brain development and support the current tenets of the American Academy of Pediatrics regarding the pediatrician's role in building resilience and buffering toxic stress to promote optimal child development.

Measuring the cost-effectiveness of a home-visiting intervention to promote early child development among rural families linked to the Rwandan social protection system.

Early childhood development (ECD) programmes are heralded as a way to improve children's health and educational outcomes. However, few studies in developing countries calculate the effectiveness of quality early childhood interventions. This study estimates the cost and cost-effectiveness of the Sugira Muryango (SM) trial, a home-visiting intervention to improve ECD outcomes through positive parent-child relationships. Cost-effectiveness analysis of ECD interventions is challenging given their potential to have multiple benefits. We propose a cost-effectiveness method using a single outcome, in this case the improvement in cognitive development per home-visit session, as an indication of efficiency comparable across similar interventions. The trial intervention cost US$456 per family. This cost will likely fall below US$200 if the intervention is scaled through government systems. The cost-effectiveness analysis suggests that while SM generated a relatively small impact on markers of early development, it did so efficiently. The observed improvements in cognitive development per home-visit are similar to other home-visiting interventions of longer duration. SM by focusing on the family had benefits beyond ECD, including reductions in violence against children and intermate partner violence, further analysis is needed to include these returns in the economic evaluation.