Liliana A Ponguta1, Ghassan Issa2, Lara Aoudeh2, Cosette Maalouf2, Sascha D Hein3, Anna L Zonderman4, Liliya Katsovich5, Kaveh Khoshnood5, Johanna Bick6, Abir Awar2, Sawsan Nourallah2, Sarah Householder7, Christina C Moore8, Rima Salah7, Pia R Britto9, James F Leckman7. 1. Child Study Center, School of Medicine, Yale University, New Haven, Connecticut. Electronic address: angelica.ponguta@yale.edu. 2. Arab Resource Collective, Beirut, Lebanon. 3. Dr. Hein is with Freie Universität Berlin, Germany. 4. Ms. Zonderman is with the Section of Hospital Medicine, Biological Sciences Division, The University of Chicago, Illinois. 5. Dr. Khoshnood and Ms. Katsovich are with the School of Public Health, Yale University, New Haven, Connecticut. 6. Dr. Bick is with The University of Houston, Texas. 7. Child Study Center, School of Medicine, Yale University, New Haven, Connecticut. 8. Ms. Moore is with the University of Delaware, Newark. 9. Dr. Britto is with UNICEF, New York.
Abstract
OBJECTIVE: Few randomized controlled trials (RCTs) have explored the implementation and impact of early childhood parenting education programs in very fragile contexts and humanitarian settings. We tested the effects of a group-based intervention, the Mother-Child Education Program (MOCEP), on parenting stress and practices among two refugee communities and one other marginalized community in Beirut, Lebanon. METHOD: A pilot wait-list RCT was conducted to assess the program's impact on maternal, child (average age: 4 years), and dyadic outcomes. A total of 106 mother-child dyads were randomly assigned to either the intervention group (n = 53) or the wait-list control group (n = 53). Analysis was conducted by modified intention-to-treat and supplemental analyses through multiple imputation of missing post-intervention data. RESULTS:Forty families (38%) withdrew early from the study. After completing the program, mothers in the intervention group showed a reduction in their harsh parenting practices, as indexed by the Disciplinary Style Questionnaire (Cohen's d = -0.76, 95% CI = -1.24, -0.27) and in their level of parenting stress, as indexed by the Parenting Stress Index-Short Form (PSI-SF; Cohen's d = -0.90, 95% CI = -1.39, -0.40). Exploratory but underpowered analyses of dyadic interactions revealed reductions in the PSI were associated with a reduction in harsh parenting after the intervention. However, we did not detect any positive impact on behavioral or emotional outcomes among the children. CONCLUSION: Our analyses suggest that MOCEP had a positive impact on disciplinary practices and parenting stress in a context of high fragility, but that broader effects on maternal and child outcomes may be dependent on program attendance and the availability of other services. We discuss implications of this pilot study for practice and research of a largely unexplored area of program evaluation. CLINICAL TRIAL REGISTRATION INFORMATION: Mother and Child Education Program in Palestinian Refugee Camps; https://clinicaltrials.gov; NCT02402556.
RCT Entities:
OBJECTIVE: Few randomized controlled trials (RCTs) have explored the implementation and impact of early childhood parenting education programs in very fragile contexts and humanitarian settings. We tested the effects of a group-based intervention, the Mother-Child Education Program (MOCEP), on parenting stress and practices among two refugee communities and one other marginalized community in Beirut, Lebanon. METHOD: A pilot wait-list RCT was conducted to assess the program's impact on maternal, child (average age: 4 years), and dyadic outcomes. A total of 106 mother-child dyads were randomly assigned to either the intervention group (n = 53) or the wait-list control group (n = 53). Analysis was conducted by modified intention-to-treat and supplemental analyses through multiple imputation of missing post-intervention data. RESULTS: Forty families (38%) withdrew early from the study. After completing the program, mothers in the intervention group showed a reduction in their harsh parenting practices, as indexed by the Disciplinary Style Questionnaire (Cohen's d = -0.76, 95% CI = -1.24, -0.27) and in their level of parenting stress, as indexed by the Parenting Stress Index-Short Form (PSI-SF; Cohen's d = -0.90, 95% CI = -1.39, -0.40). Exploratory but underpowered analyses of dyadic interactions revealed reductions in the PSI were associated with a reduction in harsh parenting after the intervention. However, we did not detect any positive impact on behavioral or emotional outcomes among the children. CONCLUSION: Our analyses suggest that MOCEP had a positive impact on disciplinary practices and parenting stress in a context of high fragility, but that broader effects on maternal and child outcomes may be dependent on program attendance and the availability of other services. We discuss implications of this pilot study for practice and research of a largely unexplored area of program evaluation. CLINICAL TRIAL REGISTRATION INFORMATION: Mother and Child Education Program in Palestinian Refugee Camps; https://clinicaltrials.gov; NCT02402556.
Authors: Sascha Hein; Johanna Bick; Ghassan Issa; Lara Aoude; Cosette Maalouf; Abir Awar; Sawsan Nourallah; Anna L Zonderman; Sarah Householder; Liliya Katsovich; Kaveh Khoshnood; Christina Moore; Rima Salah; Pia R Britto; James F Leckman; Liliana Angelica Ponguta Journal: PLoS One Date: 2020-03-05 Impact factor: 3.240
Authors: James F Leckman; Liliana Angelica Ponguta; Gabriela Pavarini; Sascha D Hein; Michael F McCarthy; Haifa Staiti; Suna Hanöz-Penney; Joanna Rubinstein; Kyle D Pruett; M Yanki Yazgan; N Shemrah Fallon; Franz J Hartl; Margalit Ziv; Rima Salah; Pia Rebello Britto; Siobhán Fitzpatrick; Catherine Panter-Brick Journal: Compr Psychoneuroendocrinol Date: 2021-10-09
Authors: Sarah Gillespie; Jasmine Banegas; Joseph Maxwell; Athena C Y Chan; Neveen Ali-Saleh Darawshy; Akash R Wasil; Scott Marsalis; Abigail Gewirtz Journal: Clin Child Fam Psychol Rev Date: 2022-01-10