Best Practices for Parenting Programs: Developing an Assessment Framework

INTRODUCTION: Parenting programs have been shown to have wide-ranging benefits, including the prevention of behavioral and emotional problems in children, as well as child maltreatment. They may also lead to long-term benefits such as reductions in mental health issues in adulthood as well as later violence. As a result, the development and implementation of high quality, evidence-based and scaleable programs, which are easily accessible to parents, are an imperative. This is particularly necessary in low- and middle-income countries, such as South Africa, which typically have higher rates of poverty and violence than high-income countries, and fewer resources to meet the need. Of concern, is the lack of evidence on programs within these countries.

METHODS: First, a framework for assessing best practice in parenting programs was developed.  This was done via a comprehensive analysis of the international evidence base on parenting programs, and prevention programs more broadly, which enabled the extraction of key best practices in the field. The framework focused on needs assessment; program design and content; facilitator training, supervision, and delivery; monitoring and evaluation; as well as replicability and scalability. Significant consideration was given to the transferability of best practices from high-income countries to low- and middle-income countries. Second, through the use of snowball and convenience sampling, 21 programs located across South Africa were recruited into the study. Information on programs was collected via telephonic and face-to-face interviews with program staff. Programs were then assessed against the developed framework. Third, a metric was developed which enabled the ranking of participating programs according to their fit with best practices. This metric assisted in the identification of programs which were likely to be suitable for successful scaling up. Scalability is a particularly important characteristic within low-resourced settings, due to the extreme levels of need.

FINDINGS: The framework enabled a rich understanding of the use of best practices within the sample. The use of these practices was low, especially in the areas of program design, and monitoring and evaluation. This reflects a clear need to strengthen the use of evidence-based practices among parenting programs in South Africa, and other low- and middle-income countries. The scalability metric revealed that none of the participating programs were at a point where they could be scaled-up successfully, due largely to a lack of evidence of efficacy and effectiveness. This study concludes with recommendations for practice and research, including uses of the assessment framework for strengthening programs in low- and middle-income countries.