Session: Experiences in Conducting Feasibility Studies for Parenting Programs in Low- and Middle-Income Countries (Society for Prevention Research 27th Annual Meeting)

Feasibility studies are an essential part of prevention research. Although rather unattended, not designed for hypothesis testing, and not powered to detect intervention effects, they may inform the development and adaptation of preventive interventions that are safe, scalable and can be integrated into existing services. Feasibility testing has the capacity to save resources, reduce risks, and increase the probability of success of subsequent main larger-scale studies and/or scale-up. It is especially crucial to explore the feasibility of parenting programs and their implementation and evaluation procedures in low-and middle-income countries (LMIC), where service infrastructure, human resource capacity, success of recruitment strategies, participant retention and applicability of evaluation questionnaires might vary. Also, clinical experience with the program in the new setting can be helpful to optimally adapt the competencies and skills required for delivery, as well as its delivery format and content, according to contextual needs. Based on the experience gained in delivering feasibility trials, the budget, time, sample size and measures needed to assess intervention effects in a larger study and/or wide scale implementation can be estimated and the implementation and evaluation procedures can be optimized.

The three papers outline the research design, methods and results of three feasibility studies implementing the Parenting for Lifelong Health for Young Children program (PLH for families with children ages 2 to 9 years. The PLH program was originally developed and tested in South Africa and is now being implemented in 15 countries in Africa, East Asia, and Eastern Europe. Feasibility studies were conducted in six LMIC: Thailand, Montenegro, FYR of Macedonia, Republic of Moldova and Romania. The study in Thailand tested the feasibility of PLH when delivered by community nurses and village health volunteers within the public health system. The study in Montenegro highlights the utility of engaging multiple cross-sectoral ministries in the early stage testing of a parenting program prior to scaling up on a national level. The last study explores the complexities of testing the feasibility of the program in three Southeastern European countries at the same time. Quantitative outcomes focused process measures (i.e., implementation and participation), preliminary effectiveness (i.e., reduced violence against children and/or reduced child behavior difficulties), and study feasibility (i.e., recruitment, retention, measure reliability). Qualitative data explored cultural acceptability and implementation feasibility of the adapted program. All three studies have implications regarding the methodological aspects involved in testing program feasibility during the early stages of intervention development and evaluation. Findings also inform further testing during randomized controlled trials and other empirical studies. Furthermore, the experiences gained may help other researchers to carefully plan and conduct prevention trials in LMIC and to enhance feasibility, cost-effectiveness, and sustainability of interventions.