Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A pre-post and one-year follow-up study of a hybrid-digital parenting programme for caregivers of adolescents on preventing maltreatment and sexual violence, and improving positive parenting practices, mental health distress, and problematic externalising behaviours in Tanzania.
ABSTRACT
Background:
Violence against adolescents remains a critical global public health challenge, with over one billion children and young people affected annually.
Objective:
ParentApp is an app-based adaptation of an evidence-based parenting programme aimed at preventing adolescent violence and sexual violence by promoting positive parenting practices. This study evaluated the intervention’s pre-post and one-year observed change in Tanzania
Methods:
A pre-post study with one-year follow-up conducted with 206 adolescents and caregivers (103 dyads) in rural, urban, and peri-urban Tanzania. Data were collected at baseline, 3-month post-test, and 12-month follow-up. Outcomes included adolescent maltreatment, sexual violence, parenting practices, psychosocial well-being, family functioning, and economic hardship. Analyses employed generalized and linear mixed-effects models.
Results:
Sustained impacts at one-year showed significant decreases in emotional abuse (adolescent-report MR=0.33[0.26,0.41]P<.001, caregiver-report MR=0.32[0.27,0.38] P<.001), physical abuse (adolescent report MR=0.29[0.22, 0.37] P<.001; caregiver report MR=0.25[0.19,0.33] P<.001), sexual violence vulnerability (adolescent report MR=0.32[0.25,0.40] P<.001; caregiver report MR=0.14[0.11,0.20] P<.001), sexual violence victimisation (only asked of adolescents) (MR=0.20[0.09,0.47] P<.045). Improved parenting outcomes for involvement (adolescents: d=0.34[0.27,0.40] P<.001; caregivers: d=0.52[0.42,0.62] P<.001), and positive parenting (adolescents: d=0.51[0.41,0.61] P<.001; caregivers: d=0.67[0.54,0.80] P<.001). Significant improvements for adolescents in attitudes towards gender roles, and both adolescents and caregivers in parenting stress, mental health depressive symptoms, problematic adolescent externalising and antisocial behaviour, economic hardship, poor monitoring and supervision, witnessing family violence, and inconsistent discipline. Non-significant changes were observed for caregivers in IPV experience, attitudes towards gender or gender equitable behaviours. Both adolescents and caregivers had null results for impacting social support.
Conclusions:
ParentApp demonstrated significant improvements across the majority of outcomes but requires refinement in areas such as parent-child communication. Results highlight the opportunity for programmatic refinement towards optimal effectiveness. Robust randomised controlled trials are recommended to confirm effectiveness. Clinical Trial: Adolescent; child maltreatment; digital intervention; low- and middle-income countries; parenting intervention; violence against children
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.