A critical appraisal of the paper titled Effectiveness of a parent-training program in Spain: reducing the Southern European evaluation gap. Gaceta sanitaria. 

In recent years parenting training programs have been introduced to encourage positive parenting. Each parent has a different way in which they raise their children and instil various skills as they grow up. They are responsible for early learning which involves language and abilities to understand and solve issues, they also shape the emotional skills on how to address issues such as stress, self-esteem, and emotions regulation. In addition, parents are an influencing factor in the development of positive and negative behaviour. Whatever a child learn from the early years, they bring this to their adult lives. Hence, the importance of parenting skills, as it is a continuous process from one generation to the other. These programs are beneficial to a parent as they equip them with knowledge and skills that enhances child learning, development and improve on their parenting.

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A study in Spain examining the effectiveness of the parent-training program aims to examine the difference in parenting skills, social support, children’s behaviours, and parental stress and to identify various mechanisms that the intervention has in relation to the outcomes examined (Vazquez et al 2017). Parenting programs act as an early intervention to help families cope with the parent-child relationship, promoting early childhood behaviours, relationship with peers, and success in school. This has also decreased the negative outcomes associated with early childhood behaviour that can lead to juvenile delinquency (Proctor & Brestan 2016 and Trivette & Dunst 2018). Therefore, parenting programs been of great help to parents in learning various ways to deal with children behaviours, encouraging learning and development and also gain knowledge on child rearing.

The study was conducted in two phases, a pilot study done in 2011- 2013 and the main study done in 2013-2015. The data was collected before, immediately after and after six months. The first study included professional and parents; professional were trained to deliver the study. The second one included parents only and the professional trained during the pilot programme to administer the study. Training the professional was an advantage as it ensures continuity of the project after the intervention. The data was collected from different ethnicity, thus can be seen as a representative of the larger population. Out of the 257 parent recruited only 216 completed baseline and immediately after and 130 completed after six months. Although the authors conclude that the study was a success, the higher drop rate of participants after six months could not have given concrete results as compared to immediately after.  Introducing a tracking system of participant could be used in the study to reduce the number of drop out. Zweben, Fucito and O’Malley (2009), suggest establishing an efficient tracking system, where the participants give consent to use their diving licences and social security numbers could to locate them. They also suggest asking participant to provide their email addresses and to show the best time in which they can be contacted, and lastly provide reference contacts, who can be used in tracking if they are unreachable.

A quasi experimental study was used to measure data, it combine both qualitative and quantitative method were used to measure data. Quantitative was used to measure the changes from before, immediately after and after six months and the qualitative was used to measure the changes in the four outcome involved. Quasi experiment has been used in other studies and has shown constant results as this study. Özyurt, Dinsever, Caliskan, & Evgin (2018) found that different mean score of children’s behaviour before and after the study and the mean score of before and after the training to have a significant improvement. The study design before, immediately after and after six months have been effective way to measure results which has evidence from the studies. Schrott, Kasperzack, Weber, Becker, Burghardt, & Kamp-Becker (2018), using the both qualitative and quantitative data is used to eliminate the weakness of both methods thus strengthening the impact on the results.

Data was collected using questionnaire that focused on 1)baby stressors and rewards, 2)confidence, emotional and social support, 3)children understanding, emotional self-regulation, parenting self-esteem, empathy and assertive communication,4)strength and difficulty questionnaire and 5)sociodemographic. Although this questionnaire has explored many aspects of parenting it has not shown how parent reaction to anger is assessed and also doesn’t address the behaviour of children checklist which would be used to categorize participant with similar characteristics (Del, Jerusalmi, & Terjesen, 2017). Linkert scale of measure is a recommended tool of measurement in psychology experiment and has been widely used by other studies in psychology, (Brown, West, Loverich, & Biegel 2011, Watkins, Woodward, Stone, & Kolts, 2003). Questionnaires were used to collected quantitative data, for qualitative data it was collected using structured interviews and groups discussions and were conducted by external researcher, within a duration of one and a half hours for each group, the data was then analysed and categorised when the data collected was reached its estimates. The data collected in both quantitative and qualitative was later triangulated at the discussion phase. Although the study does not use a control group, the qualitative and quantitate data collected helped to minimize the effects of the parenting skills program. Comparing the two data’s enhanced the credibility and validity of the findings (Bamberger 2012).

Data collected during the baseline, immediately after and after six months showed a significant improvement in parenting skills, reduction in children’s negative behaviour, decrease in parent stress and increased social support. This result were consistent with other studies done in other countries. Kane, Wood and Barlow (2007) suggested that acceptance and understanding from other parent’s support, knowledge, skills gained help parents gain control and they were able to cope, which in turn led to increased confidence and empathy and reduced social isolation and guilt in dealing with children behaviour. Therefore parental support is seen to have significant changes in parenting resulting to both parents and children relationship improvement.

The main weakness of the study is that it include parent with children between the ages of 2-12 years where the most of the children were between the ages of 3-5 years, it does not describe whether the groups of parents were grouped according to their children’s age. Incredible years parenting programmes suggest categorising parent in their children’s age as it will give an insight on what to address based on children’s age. Developmental stages vary depending on the age of child and how one handles toddle is different from a middle schooler. A large number of the population involved in the study were female (95%) which shows bias on male parenting. Including both father and mother in parenting skills has shown maintain treatment gains as compared to those that fathers were not involved ( Bagner & Eyberg 2003). Since this study the first of its kind in Spain, future studies could investigate parenting programmes that involve a gender balance population.

The finding from these studies conclude that that parenting programmes improved all aspects of the parenting skills and also directly influenced positive parenting and family wellbeing, the effect of the study were shown to improve after six month without returning to baseline values, hence parenting programme is an effective way to improving positive parenting and family wellbeing. Although there was a significant improvement in parenting skills, positive parenting and wellbeing, the result after six months should be viewed with caution due the dropout rate. Also the results of the study cannot be used to generalize on the relationship between children and their fathers as just 5% of the study population included the fathers and the results can only be used to generalize on children between the age of 3-5 years but not for other ages 6-12 and 2 years as their population participation numbers were minimal.

References

Trivette, C., & Dunst, C. (2005). Community-based parent support programs. Encyclopedia on Early Childhood Development (online). Montreal, Quebec: Centre of Excellence for Early Childhood Development.

Proctor, K. B., & Brestan-Knight, E. (2016). Evaluating the use of assessment paradigms for preventive interventions: A review of the Triple P—Positive Parenting Program. Children and Youth Services Review, 62, 72-82.

Zweben, A., Fucito, L. M., & O’Malley, S. S. (2009). Effective strategies for maintaining research participation in clinical trials. Drug information journal, 43(4), 459-467.

Özyurt, G., Dinsever, C., Caliskan, Z., & Evgin, D. (2018). Can positive parenting program (Triple P) be useful to prevent child maltreatment?. Indian journal of psychiatry, 60(3), 286.

Schrott, B., Kasperzack, D., Weber, L., Becker, K., Burghardt, R., & Kamp-Becker, I. (2018). Effectiveness of the Stepping Stones Triple P Group Parenting Program as an Additional Intervention in the Treatment of Autism Spectrum Disorders: Effects on Parenting Variables. Journal of autism and developmental disorders, 1-11.

Del Vecchio, T., Jerusalmi, D., & Terjesen, M. D. (2017). Psychometric characteristics of the Parenting Scale in a Vietnamese sample. International Journal of Psychology, 52(6), 482-490.

Brown, K. W., West, A. M., Loverich, T. M., & Biegel, G. M. (2011). Assessing adolescent mindfulness: Validation of an Adapted Mindful Attention Awareness Scale in adolescent normative and psychiatric populations. Psychological assessment, 23(4), 1023.

Watkins, P. C., Woodward, K., Stone, T., & Kolts, R. L. (2003). Gratitude and happiness: Development of a measure of gratitude, and relationships with subjective well-being. Social Behaviour and Personality: an international journal, 31(5), 431-451.

Bamberger, M. (2012). Introduction to mixed methods in impact evaluation. Impact Evaluation Notes, 3(3), 1-38.

Kane, G. A., Wood, V. A., & Barlow, J. (2007). Parenting programmes: a systematic review and synthesis of qualitative research. Child: care, health and development, 33(6), 784-793.

Bagner, D. M., & Eyberg, S. M. (2003). Father involvement in parent training: When does it matter? Journal of Clinical Child and Adolescent Psychology, 32(4), 599-605.

The Incredible Years (2013) http://www.incredibleyears.com/programs/