Transcript Document

Evaluation of the Webster-Stratton BASIC
Parenting Programme with Parents of ‘at risk’ Preschool Children in Sure Start Areas Across North &
Mid Wales
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This research has been funded by The Health Foundation
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Qu i c k T i m e ™ a n d a
Ph o t o - J P EG d e c o m p re s s o r
a re n e e d e d t o s e e t h i s p i c t u re .
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Dr. Frances Gardner & Dr. Dave Daley
Dr. Tracey Bywater
Dr. Judy Hutchings
The Incredible Years (IY) Programmes:
Programmes for children, teachers & parents were developed by Professor Webster-Stratton, University of Washington.
The Programmes have been identified as achieving exceptional, long-term, evidence for violence reduction & prevention.
The parent programme was originally developed & researched as a treatment programme for diagnosed conduct disordered children & its effectiveness
has been demonstrated in the USA, Canada, Norway & the UK.
Webster-Stratton has since established the parenting programme as an early intervention strategy with high-risk Head Start communities in Seattle.
IY Programme training has been available in Wales for the last six years & many services have IY trained staff & have delivered the programmes.
The IY BASIC Parenting Programme:
Focuses on strengthening parenting skills with the intention of preventing, reducing, & treating conduct problems, & increasing social competence among
children aged 2-8 years.
Consists of 12 weekly sessions that emphasise the importance of play, relationship building, ways to help children learn, effective praise, use of incentives,
limit setting, & ways to deal effectively with misbehaviour. A collaborative approach is emphasised, with skills developed through group discussion,
videotape modeling, rehearsal & home assignments.
Has been researched over the last 20 years using randomised controlled group studies with long-term positive results replicated by independent
researchers in both academic & service settings.
The Need to Evaluate the IY BASIC Parenting Programme in Wales:
As yet no UK evaluation of the programme in an early intervention/preventive setting.
As yet no examination of the special challenges of programme implementation to a largely bi-lingual & rural based population such as that found in Wales.
The majority of Sure Start services in North & Mid Wales were implementing the programme & required evidence of effectiveness.
Overview of the Project funded by The Health Foundation, October 2002 to 2007:
Randomised controlled trial replication of Webster-Stratton’s (1998)1 successful implementation of the programme in Head Start Centres in Seattle.
Families with a child (36-59 months) ‘at risk’ of developing conduct problems were approached by a local Health Visitor who administered the Eyberg Child
Behaviour Inventory. families were eligible if the child resided with the primary carer, scored above the clinical cut-off on the Eyberg and the primary carer
was able to attend group times.
Recruitment: 153 families (104 intervention, 49 control). Drop-out rate was 13% at 6 months & 24% by the last, 18-month, follow-up .
Data collection: At baseline & 6 months for both the intervention & waiting list control, & again at 12 & 18 months for intervention families only.
Parenting programme was delivered by accredited group leaders - the staff of collaborating Sure Start Services.
12 intervention groups were run in total from 11 Sure Start areas across North & Mid Wales.
Programme delivery was standardised across centres: centres provided transport, free crèche & meal, the project provided course materials, all parenting
sessions were videotaped, randomly selected tapes were monitored by an independent IY trainer for fidelity.
Outcome Measures - Interview/Self report:
Demographic & family risk factors
Parental competencies
Parental satisfaction with parenting programme
Child social & verbal competence, & conduct problems
Outcome Measures: Observation of parent-child interaction:
Dyadic Parent-Child Interactive Coding System
30 minute observations take place in family home, 4-7pm
positive parenting, parent commands, affect,critical statements
child deviance, child affect, prosocial behaviour
Short-term Results: baseline to follow-up 1
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Long-term Results
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Figure 1. T otal Positive Parenting (sum of positive affect, praise, physical positive) in a
30-minute Observation Session
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Figure 3. Eyberg Child Behaviour Int ensity Scores
Figure 2. Eyberg Child Behaviour Problem Scores
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Figure 4. Intervention Eyberg Child Problem Scores
Summary of Findings
There are differences between the intervention & control groups at follow-up 1, showing statistically & clinically significant outcomes for the intervention group.
Observation data shows that:
Intervention parents practice more positive parenting at follow-up 1 (Figure 1).
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Intervention children show less anti-social behaviour
Parent report data shows that:
Intervention parents perceive their child as having fewer & less intense problem behaviours at follow-up (Figures 2 & 3)
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These improvements have been maintained up to the 18-month follow-up (Figure 4)
A cost-effectiveness analysis of the IY groups (Edwards et al., in press, BMJ) found that the programme improved children’s behaviour at a modest cost - even when
taking into account set-up, leader training, group & supervision costs, travel, telephone calls, clerical support etcetera.
Conclusions
The intervention improved parenting skills, this had a positive effect on child behaviour in both the short and long term
Positive changes for high-risk Sure Start families were demonstrated when using an effective evidenced-based parent programme delivered with fidelity
Webster-Stratton, C. (1998). Preventing Conduct Problems in Head Start Children: Strengthening Parenting Competencies. Journal of Consulting and Clinical Psychology, 66(5), 715-730
The short-term findings are currently in press in the British Medical Journal 2007
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