Objective: A community-based randomized controlled trial (RCT) was conducted in urban areas characterized by high levels of disadvantage to test the effectiveness of the Incredible Years BASIC parent training program (IYBP) for children with behavioral problems. Potential moderators of intervention effects on child behavioral outcomes were also explored. Method: Families were included if the child (aged 32-88 months) scored above a clinical cutoff on the Eyberg Child Behavior Inventory (ECBI). Participants (n ϭ 149) were randomly allocated on a 2:1 ratio to an intervention group (n ϭ 103) or a waiting-list control group (n ϭ 46). Child behavior, parenting skills, and parent well-being were assessed at baseline and 6 months later using parent-report and independent observations. An intentionto-treat analysis of covariance was used to examine postintervention differences between groups. Results: Statistically significant differences in child disordered behavior favored the intervention group on the ECBI Intensity (effect size ϭ 0.7, p Ͻ .001) and Problem subscales (effect size ϭ 0.75, p Ͻ .001). Intervention effects on child hyperactive-inattentive behaviors and social competence, as well as parent competencies and well-being, were also found. Moderator analyses showed that the effects of the IYBP intervention on the primary child outcomes were not moderated by child or family demographic characteristics or risk factors. Conclusion: The results demonstrate the effectiveness of the IYBP in alleviating problem behavior among children and in improving well-being among families living in disadvantaged areas. The findings also highlight the importance of parental intervention in early childhood for parents and children most in need of support.

Teachers frequently struggle to cope with conduct problems in the classroom. The aim of this study was to assess the effectiveness of the Incredible Years Teacher Classroom Management Training Programme for improving teacher competencies and child adjustment. The study involved a group randomised controlled trial which included 22 teachers and 217 children (102 boys and 115 girls). The average age of children included in the study was 5.3 years (standard deviation = 0.89). Teachers were randomly allocated to an intervention group (n = 11 teachers; 110 children) or a waiting-list control group (n = 11; 107 children). The sample also included 63 'high-risk' children (33 intervention; 30 control), who scored above the cut-off (>12) on the Strengths and Difficulties Questionnaire for abnormal socioemotional and behavioural difficulties. Teacher and child behaviours were assessed at baseline and 6 months later using psychometric and observational measures. Programme delivery costs were also analysed. Results showed positive changes in teachers' selfreported use of positive classroom management strategies (effect size = 0.56), as well as negative classroom management strategies (effect size = −0.43). Teacher reports also highlight improvements in the classroom behaviour of the high-risk group of children, while the estimated cost of delivering the Incredible Years Teacher Classroom Management Training Programme was modest. However, analyses of teacher and child observations were largely non-significant. A need for further research exploring the effectiveness and costeffectiveness of the Incredible Years Teacher Classroom Management Training Programme is indicated.

BackgroundGroup-based early parenting interventions delivered through community-based services may be a potentially effective means of promoting infant and family health and wellbeing. Process evaluations of these complex interventions provide vital information on how they work, as well as the conditions which shape and influence outcomes. This information is critical to decision makers and service providers who wish to embed prevention and early interventions in usual care settings. In this paper, a process evaluation protocol for an early years parenting intervention, the Parent and Infant (PIN) program, is described. This program combines a range of developmentally-appropriate supports, delivered in a single intervention process, for parents and infants (0–2 years) and aimed at enhancing parental competence, strengthening parent-infant relationships and improving infant wellbeing and adjustment.MethodsThe process evaluation is embedded within a controlled trial and accompanying cost-effectiveness evaluation. Building from extant frameworks and evaluation methods, this paper presents a systematic approach to the process evaluation of the PIN program and its underlying change principles, the implementation of the program, the context of implementation and the change mechanisms which influence and shape parent and infant outcomes. We will use a multi-method strategy, including semi-structured interviews and group discussions with key stakeholders, documentary analysis and survey methodology.DiscussionThe integration of innovations into existing early years systems and services is a challenging multifaceted undertaking. This process evaluation will make an important contribution to knowledge about the implementation of such programs, while also providing an example of how theory-based research can be embedded within the evaluation of community-based interventions. We discuss the strengths of the research, such as the adoption of a collaborative approach to data collection, while we also identify potential challenges, including capturing and assessing complex aspects of the intervention.Trial registrationISRCTN17488830 (Date of registration: 27/11/15). This trial was retrospectively registered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1737-3) contains supplementary material, which is available to authorized users.

The effectiveness of the Incredible Years Basic parent programme (IYBP) in reducing child conduct problems and improving parent competencies and mental health was examined in a 12-month follow-up. Pre- to post-intervention service use and related costs were also analysed. A total of 103 families and their children (aged 32-88 months), who previously participated in a randomised controlled trial of the IYBP, took part in a 12-month follow-up assessment. Child and parent behaviour and well-being were measured using psychometric and observational measures. An intention-to-treat analysis was carried out using a one-way repeated measures ANOVA. Pairwise comparisons were subsequently conducted to determine whether treatment outcomes were sustained 1 year post-baseline assessment. Results indicate that post-intervention improvements in child conduct problems, parenting behaviour and parental mental health were maintained. Service use and associated costs continued to decline. The results indicate that parent-focused interventions, implemented in the early years, can result in improvements in child and parent behaviour and well-being 12 months later. A reduced reliance on formal services is also indicated.

Strengthening stakeholder buy-in and engagement for successful exploration and installation: a case study of the development of an area-wide, evidence-based prevention and early intervention strategy. Children and Youth Services Review, 91, 185-195.

Objective: A randomised control trial was conducted to assess whether the combined Incredible Years parent training and child training programmes (PT + CT) led to improvements in ADHD-type behaviours in children, when compared to a PT-only group and a Wait List Control (WLC) group. Method: Forty-five families with a child aged 3-7 years who displayed ADHD-type behaviours were referred for treatment and randomised to a combined treatment group (PT + CT; n = 12), a PT group (n = 19) or a WLC group (n = 14). Programmes were delivered by community-based organisations. Short-term follow-up (six months) assessments were undertaken with parents and children based on parent reports of child behaviour and parent well-being and behaviour. A qualitative sub-study was also conducted with parent participants (n = 8) and programme facilitators (n = 5) to explore experiences and views of the combined programme. Results: Statistically significant differences were found between the PT group and the WLC group with regard to child hyperactivity (p < 0.001) and pro-social skills (p < 0.05). No significant differences were found between the combined group (PT + CT) and the PT group except for child hyperactivity (p < 0.05), which was significantly lower in the PTonly group. Significant effects were found for PT + CT versus WLC on the Strengths and Difficulties Questionnaire Impact subscale only. Conclusion: These findings suggest that the combined treatment (PT + CT) produced little added benefit for child hyperactive/ inattentive behaviour post-intervention despite the very positive views expressed by parents in the qualitative interviews. The PT training alone was more effective in tackling some core ADHD behaviours when compared to the WLC group, but a need for further more large-scale research is indicated. Trial Registration: ISRCTN82596506.

Background: This study explores mothers' wellbeing, experiences, and attitudes and the impact of cumulative demographic and antenatal risks and parity on parenting outcomes. A secondary aim was to assess mother and infant service utilisation.Method: This study involved an assessment of the baseline characteristics of a sample of mothers (N = 190; Mean age = 31.6 years, SD = 5.4) with young infants (average age = 10.13 weeks, SD = 0.8) living in disadvantaged communities in Ireland.Results: Mothers with more risk factors (e.g., lone and/or teenage parenthood, socioeconomic disadvantage, and low social support) reported significantly higher levels of depression and lower parental self-efficacy. Observations of the home environment indicated that at-risk parents engaged in less cognitive stimulation and lower levels of emotional support for their child. The impact of these risk factors differed for primiparous and multiparous mothers.Conclusions: At-risk mothers are more susceptible to mental health difficulties and poorer parenting outcomes during the transition to parenthood. This study also provides important comparative insights into experiences of primiparous and multiparous parents. These findings have important implications for practitioners and policy makers, particularly the provision of universal and proportionate supports to prevent and/or interrupt poor parent-child relationships and negative developmental outcomes.

No abstract