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TITLE: A model for the cross-cultural dissemination of a preventive parenting program into a developing country
ABSTRACT BODY:
Introduction: Studies suggest that parenting programs are effective for preventing drug abuse. Existing interventions developed in high income countries are disseminated into developing countries. However, are these programs effective in a different setting? The socio-economic reality of developing countries is different, and there is a need for systematic research to adapt existing evidence-based programs into a new context. The present project tested a four-step model to determine the cultural acceptability and effectiveness of a preventive parenting program, the Triple P Positive Parenting Program, in a developing country of Central America, Panama. UNODC statistics suggest that countries in Central America, including Panama, are amongst the top ten in terms of annual prevalence of cocaine use. The aim of implementing this program is reducing the risk of drug abuse by promoting healthy relationships between parents and children from an early age.
Methods: In steps 1 to 3, the cultural acceptability of Triple P was examined using a survey design. The aim was to capture the views of consumers and practitioners before moving to implementation. In step 1, sample material from the program was shown to 136 parents. In step 2, 80 practitioners were surveyed using a similar methodology. In step 3, two new brief instruments for measuring child behavior, the CAPES and the PAFAS, were validated with a sample of 174 parents. After gathering data on cultural acceptability, in step 4 the effectiveness of the program was examined. A RCT with two groups, intervention and waiting list, was carried out with 108 parents. The intervention was a one-session Triple P Discussion Group. The main outcome measure was the Eyberg Child Behavior Inventory (ECBI).
Results: Data from steps 1 and 2 suggested that parents and practitioners found program materials acceptable and expressed that they would be willing to participate in a program if one was offered. Results from step 3 suggested that the instruments are good in terms of internal consistency (α = 0.87 to 0.89) and are reliable over time (r = 0.74 to 0.75). Finally, in step 4 the program was shown to be effective in reducing child behaviour difficulties in the short-term. Effect size from T1 to T2 was d=1.08 for the ECBI Intensity Scale and d=0.81 for the ECBI Problem scale. Three and six-month follow ups are still taking place, and these results will be available at the conference.
Conclusion: It is important to follow a systematic process to determine the “fit” of existing preventive interventions in new settings before implementation efforts take place. The four-step model demonstrated in this work can be applied to other evidence-based interventions and cultural contexts.