Learning, Enjoying, Growing, Support model: an innovative collaborative approach to the prevention of conduct disorder in preschoolers in hard to reach rural families.

OBJECTIVE: To develop, implement and evaluate a pilot program targeting rural families with preschool aged children at risk of conduct disorder.
DESIGN: A prospective single group repeated measures design.
SETTING: Communities in four local government areas in the Mid Western Area Health Service, New South Wales.
SUBJECTS: A total of 33 families were referred to the program through community services where they were established clients.
INTERVENTIONS: The Learning, Enjoying, Growing, Support model comprised a parenting program (Incredible Years; Kids Challenge and Change); a children's social skills program (Playing and learning to Socialise) and a transition to school component. Group programs were run simultaneously over 5-10 weeks. MAIN OUTCOME MEASURES: Measures of positive parenting and child problem behaviour and social skills were conducted on referral, and at completion of the program.
RESULTS: There was a self-reported increase in utilisation of all positive parenting skills with significant increases in rewarding (median score on referral: 4 (range: 4-6); at completion of program 6 (4-6); (P = 0.02)) and ignoring (2 (0-6) to 3 (1-8); (P = 0.02)). Children increased their levels of social skills. Significant improvement was reported in cooperation: (median score: 24 (18-33) to 27 (19-33); (P = 0.02)); interaction (24 (6-9) to 26 (11-32); (P = 0.03)) and independence(25 (16-33) to 28 (20-33); (P = 0.008)). There was a downward trend in problem behaviour exhibited with a significant reduction in internalising behaviour (median score 19 (3-30) to 12 (0-32); (P = 0.04)).
CONCLUSIONS: The positive impact of the model on parenting skills and child behaviour is promising and communities are continuing to run the programs. We recommend a broader adoption through rural communities.