Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .
Measuring the impact and costs of a universal group based parenting programme: protocol and implementation of a trial
Background Sub-optimal parenting is a common risk factor for a wide range of negative health , social and educational outcomes . Most parenting programmes have been developed in the USA in the context of delinquency prevention for targeted or indicated groups and the main theoretical underpinning for these programmes is behaviour management . The Family Links Nurturing Programme ( FLNP ) focuses on family relationships as well as behaviour management and is offered on a universal basis . As a result it may be better placed to improve health and educational outcomes . Developed in the UK voluntary sector , FLNP is popular with practitioners , has impressed policy makers throughout the UK , has been found to be effective in before/after and qualitative studies , but lacks a r and omised controlled trial ( RCT ) evidence base . Methods / Design A multi-centre , investigator blind , r and omised controlled trial of the FLNP with a target sample of 288 south Wales families who have a child aged 2 - 4 yrs living in or near to Flying Start/Sure Start areas . Changes in parenting , parent child relations and parent and child wellbeing are assessed with vali date d measures immediately and at 6 months post intervention . Economic components include cost consequences and cost utility analyses based on parental ranking of states of quality of life . Attendance and completion rates and fidelity to the FLNP course delivery are assessed . A nested qualitative study will assess reasons for participation and non-participation and the perceived value of the programme to families . By the end of May 2010 , 287 families have been recruited into the trial across four areas of south Wales . Recruitment has not met the planned timescales with barriers including professional anxiety about families entering the control arm of the trial , family concern about video and audio recording , programme facilitator concern about the recording of FLNP sessions for fidelity purpose s and delays due to the new UK research governance procedures . Discussion Whilst there are strong theoretical arguments to support universal provision of parenting programmes , few universal programmes have been subjected to r and omised controlled trials . In this paper we describe a RCT protocol with quantitative and qualitative outcome measures and an economic evaluation design ed to provide clear evidence with regard to effectiveness and costs . We describe challenges implementing the protocol and how we are addressing these . Trial Registration Current Controlled Trials IS RCT
Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .