Masayang Pamilya Feasibility Study

The aim of this study is to test the feasibility of (1) an 8-session version of the Masayang Pamilya (MaPa) parenting program for families with children aged 2-9 (MaPa Kids) and (2) a culturally and contextually adapted 9-session MaPa parenting program for families with children aged 10-17 (MaPa Teens).

The feasibility of MaPa Kids and MaPa Teens will be assessed through self-report questionnaires, in-depth interviews and focus group discussions, and implementation data. Together, the focus groups, questionnaires, interviews, and implementation data will assess the overall feasibility of the MaPa Kids and MaPa Teen programs in the Philippines by examining program delivery, participation, acceptability, scalability, and preliminary effectiveness on reducing child maltreatment and associated risks.

Child maltreatment occurs at much higher rates in low- and middle-income countries (LMIC) than in high-income countries. Parenting programs have shown particular promise in preventing child maltreatment, as well as improving child health and educational outcomes. However, there are currently very few parenting programs that are both evidence-based and affordable for LMIC, such as the Philippines, where the need is the greatest. For instance, the 2015 national baseline survey on violence against children (VAC) revealed that 80% of Filipino youth respondents had experienced violence in childhood, with 60% of these cases occurring at home. Mothers, fathers, and siblings were the most commonly reported perpetrators of harsh physical and psychological punishment (UNICEF, 2016). A logical recourse to decrease child maltreatment in the country is to implement interventions/programs that improve parents' relationships with their children and their knowledge and skills in child behavior management.

There is extensive scientific evidence that parenting support programs are effective in reducing child maltreatment and associated risk factors such as corporal punishment and parent negative psychological health (e.g., Desai, Reece \& Shakespeare-Pellington, 2017; Mikton \& Butchart, 2009). Parenting for Lifelong Health (PLH) is one such initiative led by UNICEF and WHO to support evidence-based parenting programs to reduce VAC in low and middle-income contexts.

In 2016-2017, PLH-Philippines embarked on the cultural adaptation, feasibility study (N=30), and pilot randomized control trial (RCT) (N=120) of the MaPa Kids program in the National Capital Region, which was implemented with families with children ages 2-6 and who were beneficiaries of the Department of Social Welfare and Development (DSWD) Pantawid Pamilyang Pilipino Program (4Ps). The results of this initial RCT were promising with reduced child maltreatment, dysfunctional parenting, less support of corporal punishment, lower levels of child problem behavior intensity, and higher sense of parenting efficacy at post-intervention reported by parents who participated in MaPa Kids compared to control group families who underwent the 4Ps Family Development Sessions (FDS). Reduced child maltreatment persisted at one-year follow-up assessment.

Building on the aforementioned trial, this study aims to expand the development, implementation, and evaluation of the parenting programs in the Philippines as part of a systematic effort to further assess the feasibility of (1) an 8-session version of the MaPa Kids program for families with children aged 2-9 and (2) a culturally adapted 9-session parenting program for families with children aged 10-17 (MaPa Teens).

The 8-session MaPa Kids and 9-session MaPa Teens modules will be piloted through a pre-post feasibility study. Both MaPa Kids and MaPa Teens parenting intervention modules will be implemented by eight local facilitators and two coaches in a low-income community - in Quezon City, Philippines - identified in collaboration with DSWD. Following participant recruitment and informed consent and assent procedures, baseline sociodemographic information and primary, proximal, and secondary information will be collected from parents/caregivers and their children (aged 10-17 in MaPa Teens).

Standardized baseline and one-month post-program questionnaires assessing primary and secondary outcomes, as well as demographic data, will be administered to 60 parents/primary caregivers and 30 children who participate in the program. Implementation data will be collected from parents/caregivers and program facilitators through report forms/checklists and video-recordings of each program session. Focus group discussions will be held with 60 parents/primary caregivers, 30 children aged 10-17, and eight program facilitators.

Eligibility Criteria:
Eligibility criteria Participants must have provided written, informed consent prior to the occurrence of any study procedures.

Inclusion criteria for participating parents or caregivers (N=60):

1. Age 18 or older;
2. Primary caregiver responsible for the care of a child between the ages 2-9 (Kids) or 10-17 (Teens);
3. Spend at least four nights a week in the same household as the child in the previous month;
4. Recipient of the 4Ps conditional cash transfer program;
5. Provision of consent to participate in the full study;
6. Provision of consent for their child to participate in the full study (for MaPa Teens only).

Exclusion criteria for adult parents:

1. Any adult who has already participated in the Parent Effectiveness Service;
2. Any adult exhibiting severe mental health problems or acute mental disabilities;
3. Any adult that has been referred to child protection services due to child abuse.

Inclusion criteria for child respondents (N=30):

1. Age 10 to 17 years at initial assessment;
2. Lives in the house at least 4 nights per week;
3. Must have an adult primary caregiver who lives in the household, who provides consent, and who participates in the study;
4. Provides assent to participate in the full study.

Exclusion criteria for child respondents:

1. Any child who is either experiencing severe mental health problems, has acute developmental disabilities and
2. If the child participant has been referred to social services during baseline data collection due to reported or observed indications of significant harm.

The study will also assess program fidelity and quality of delivery by program facilitators (N=8). These facilitators and coaches will have the following inclusion criteria:

1. Age 18 or older;
2. Prior participation in a 5-day facilitator training workshop;
3. Agreement to implement the entire program;
4. Provision of consent to participate in the full study.