Embedding a Parenting Intervention within the Local Public Health System for Low-Income Families with Children Aged 2-9 Years: Preliminary Findings from a Feasibility Pilot in Udon Thani, Thailand

Background: According to the latest 2015-2016 Multiple Indicator Cluster Survey, based on a national sample of 28,652 households, household members subjected over 75% of children in Thailand to at least one form of psychological or physical punishment during the past month. Given the growing evidence from systematic reviews that social learning theory-based parenting interventions can improve positive parenting, reduce harsh parenting, and diminish actual rates of violence against children, the Thai Ministry of Public Health and international development agencies have demonstrated a keen interest in investing in evidence-based parenting interventions that are adapted to the Thai context and which demonstrate effectiveness.

Objective: The Parenting for Lifelong Health for Young Children in Thailand (PLH-Thailand) study is a partnership between the Thai Ministry of Public Health, UNICEF Thailand, University of Oxford, University of Cape Town, and members of the Thai Parenting Experts Working Group. The second phase of this study aims to conduct a feasibility pilot of a culturally and contextually adapted version of the Parenting for Lifelong Health for Young Children programme, initially developed in South Africa and subsequently tested in several other LMICs. The objective of the pilot is to test the feasibility of this version for low-income families with children aged 2-9 years living in Udon Thani, by assessing: 1) implementation, including fidelity, quality, recruitment, retention, and engagement; 2) cultural and contextual relevance, including acceptability and satisfaction; and 3) study feasibility, including internal validity of procedures and outcome measures.

Methods: This feasibility study involves a mixed methods process evaluation, which will include the administration of facilitator self-report checklists, a facilitator assessment tool, self-report home practice checklists, and attendance registration; the conduct of individual interviews with 12 parents/primary caregivers and a focus group discussion with facilitators; as well as the administration of a self-report satisfaction questionnaire for parents/primary caregivers. The feasibility study is a single-subject pre-post design, with no control group. The study has been registered with ClinicalTrials.gov: NCT03539341.

Results: Preliminary data from the feasibility pilot (which will be ending in early 2019) will be presented, as well as implications for the further adaptation of the PLH program in Thailand and the conduct of the randomized controlled trial (N = 120) in mid-2019.