Clinical trial NCT03205449: Parenting for Lifelong Health (PLH) - Masayang Pamilya (MaPa) Evaluation Study
Official title: Parenting for Lifelong Health-Philippines: Randomized Controlled Trial of a Culturally-adapted Parenting Program on Reducing the Risk of Violence Against Children in Low-income Filipino Families With Children Aged 2 to 6 Years in Manila
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Child Maltreatment
Lead sponsor: Ateneo de Manila University
Sponsor class: OTHER
Collaborators: name: University of Oxford
name: Philippine Ambulatory Pediatric Association
name: Philippine Department of Social Welfare and Development
name: Bangor University
name: University of Cape Town
name: International Child Protection Network
name: The UBS Optimus Foundation
name: UNICEF
First posted: 2017-07-02
Enrollment: 120
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: This study will use a randomised controlled trial design to test the effects of the Masayang Pamilya programme in comparison to participants allocated to a treatment as usual control group (N = 120 parents of children ages 2 to 6 years; 1:1 intervention to control group ratio).
Primary purpose: PREVENTION

Brief summary: Parenting for Lifelong Health (PLH) Philippines Evaluation Study: Multisite randomised controlled trial to compare the efficacy of a culturally-adapted parenting programme, Masayang Pamilya, versus services as usual in the reduction of child maltreatment and improvement of child wellbeing in low-income Filipino families with children aged two to six years in Metro Manila (N = 120).

A previous study focused on adaptation and feasibility testing was conducted from January 2016 to February 2017. Community-based participatory approaches were used to culturally adapt the Sinovuyo programme to a Filipino context. A formative evaluation using qualitative in-depth interviews and focus group discussions with parents, as well as consultative workshops with service providers and other stakeholders, examined issues regarding the needs and concerns of Filipino parents, appropriateness of intervention components and delivery, and other specific cultural issues in order to balance "fidelity" to evidence-based practices with "fit" to the local context \[11\]. The Sinovuyo programme was then adapted into the MaPa programme with local materials and approaches developed to fit the Philippine cultural context based on findings from the formative evaluation.

Detailed description: Over the past decade there have been increasing calls for the scale-up of evidence-based interventions in order to reduce the risk of violence against children in low- and middle-income countries (LMICs) \[1\]. In particular, parenting programmes for families with young children have been shown to be effective in reducing the risk of child maltreatment and improving child wellbeing with promising evidence emerging from low- and middle-income countries \[2-4\]. These group-based programmes typically aim to strengthen caregiver-child relationships through positive parenting and to help parents to manage child behaviour problems through effective, age-appropriate, nonviolent discipline strategies.

Despite the emerging evidence of the effectiveness of parenting interventions in reducing violence against children, many local governments and service providers in LMICs face multiple challenges implementing evidence-based parenting programs in resource poor contexts \[5\]. Parenting programmes are often too expensive to deliver effectively at scale in low-resource settings due to their complexity, intensity, and length \[3\]. Parenting programmes developed and evaluated in other contexts also may not fit the local service delivery context and may require adaptation to be relevant to the local culture of families. Additional programme content may also be necessary to address stress related to economic deprivation, high community violence, and parental distress. The process of delivery may also need to be simplified to improve participant engagement and the quality of delivery.

As a result, it is essential that programmes implemented in LMICs are 1) effective at reducing violence against children, 2) integrated within the existing service delivery system, 3) feasible and culturally acceptable to service providers and families, and 4) scalable in terms of their affordability, replicability, and sustainability while reaching a maximum number of beneficiaries. However, there are currently very few parenting programmes that meet these criteria in LMICs, such as the Philippines, where the need is the greatest \[3\].

The PLH Philippines Evaluation Study aims to fill this gap by examining the efficacy of a locally-adapted, evidence-based parenting programme, the Masayang Pamilya Para Sa Batang Pilipino Parenting Programme (MaPa), for families with children ages two to six years living in Metro Manila who are enrolled in the Philippine Department of Social Welfare and Development (DSWD) conditional cash transfer system.

Our overall objective is to use a randomised controlled trial design to test the efficacy of the MaPa programme in reducing the risk of child maltreatment while improving child socio-emotional development, child behaviour, and parental mental health in comparison to treatment as usual controls in Metro Manila.

Our primary objective is to examine the impact of the MaPa programme on the primary outcome of child maltreatment in comparison to treatment-as-usual controls at immediate post-intervention and at 1-year follow-up.

Our secondary objective is to examine the impact of the MaPa programme on proximal outcomes associated with increased risks of child maltreatment, namely, positive parenting, intrusive parenting, and harsh parenting in comparison to treatment-as-usual controls at immediate post-intervention and at 1-year follow-up.

Another secondary objective is to examine the impact of the MaPa programme at immediate post-intervention and at 1-year follow-up on child behaviour problems, child development outcomes (i.e., communication skills and socio-emotional development), parenting efficacy, parental wellbeing, parenting stress, parental depression, marital satisfaction, and intimate partner violence, in comparison to treatment as usual controls.

Our tertiary objective is to examine the implementation of the MaPa programme when delivered within the DSWD conditional cash transfer system in terms of programme adherence by parents (i.e., recruitment, enrolment, attendance, engagement, dropout, and completion) and delivery by service providers (i.e., competency and fidelity).

Our final objective is to examine predictors of programme adherence and associations between programme adherence and primary and secondary outcomes at immediate post-test and at 1-year follow-up.

Eligibility criteria: Inclusion Criteria:

* Age 18 or older;
* Primary caregiver responsible for the care of a child between the ages of two and six who is staying in the same household at least four nights a week in the previous month;
* Spend at least four nights a week in the same household as the child;
* Unemployed parent;
* Recipient of the 4Ps conditional cash transfer programme;
* Agreement to participate in the MaPa programme if allocated to the treatment condition;
* Provision of consent to participate in the full study.

Exclusion Criteria:

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

Primary outcomes:
measure: Change in frequency of child maltreatment
timeFrame: Change from baseline at 7 months and at 19 months
Secondary outcomes:
measure: Change in frequency of positive parenting
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in frequency of dysfunctional parenting
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in levels of endorsement of physical punishment
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in number of daily child behavior problems and parenting behaviors
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in number of child behavior problems
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in levels of child development - communication skills
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in levels of child socio-emotional development
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in levels of parent efficacy
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in levels of parenting stress
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in levels of parental depression
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in levels of parental wellbeing
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in levels of parent dependency on alcohol
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in frequency of intimate partner violence
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in levels of marital satisfaction
timeFrame: Change from baseline at 7 months and at 19 months
measure: Change in levels of parent/child sleep
timeFrame: Change from baseline at 7 months and at 19 months
Other outcomes:
measure: Implementation fidelity
timeFrame: 7 months after baseline and at 19 months
measure: Quality of delivery
timeFrame: 7 months after baseline and at 19 months
measure: Program adherence
timeFrame: 7 months after baseline and at 19 months
measure: Engagement in home activities
timeFrame: 7 months after baseline and at 19 months
measure: Participant satisfaction
timeFrame: 7 months after baseline and at 19 months
measure: Program acceptability and participation
timeFrame: 7 months after baseline and at 19 months
Locations:
city: Taguig
country: Philippines
facility: Barangay Western Bicutan
state: Metro Manila
Study officials:
affiliation: Ateneo de Manila University
name: Liane P Alampay, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Oxford
name: Jamie M Lachman, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Philippine Ambulatory Pediatric Association
name: Cecilia Alinea, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Oxford
name: Frances Gardner, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Bangor University
name: Judy Hutchings, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Cape Town
name: Catherine Ward, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: International Child Protection Network
name: Bernadette Madrid, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Ateneo de Manila University
name: Rosanne Jocson, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Altman DG, Schulz KF, Moher D, Egger M, Davidoff F, Elbourne D, Gotzsche PC, Lang T; CONSORT GROUP (Consolidated Standards of Reporting Trials). The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med. 2001 Apr 17;134(8):663-94. doi: 10.7326/0003-4819-134-8-200104170-00012.
citation: Anderson LS. Predictors of parenting stress in a diverse sample of parents of early adolescents in high-risk communities. Nurs Res. 2008 Sep-Oct;57(5):340-50. doi: 10.1097/01.NNR.0000313502.92227.87.
citation: Armstrong R, Waters E, Moore L, Riggs E, Cuervo LG, Lumbiganon P, Hawe P. Improving the reporting of public health intervention research: advancing TREND and CONSORT. J Public Health (Oxf). 2008 Mar;30(1):103-9. doi: 10.1093/pubmed/fdm082. Epub 2008 Jan 19.
citation: Baldwin SA, Murray DM, Shadish WR. Empirically supported treatments or type I errors? Problems with the analysis of data from group-administered treatments. J Consult Clin Psychol. 2005 Oct;73(5):924-35. doi: 10.1037/0022-006X.73.5.924.
citation: Barlow J, Johnston I, Kendrick D, Polnay L, Stewart-Brown S. Individual and group-based parenting programmes for the treatment of physical child abuse and neglect. Cochrane Database Syst Rev. 2006 Jul 19;(3):CD005463. doi: 10.1002/14651858.CD005463.pub2.
citation: Bauer DJ, Sterba SK, Hallfors DD. Evaluating Group-Based Interventions When Control Participants Are Ungrouped. Multivariate Behav Res. 2008 Apr 2;43(2):210-236. doi: 10.1080/00273170802034810.
citation: Bellg AJ, Borrelli B, Resnick B, Hecht J, Minicucci DS, Ory M, Ogedegbe G, Orwig D, Ernst D, Czajkowski S; Treatment Fidelity Workgroup of the NIH Behavior Change Consortium. Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH Behavior Change Consortium. Health Psychol. 2004 Sep;23(5):443-51. doi: 10.1037/0278-6133.23.5.443.
citation: Borrelli B, Sepinwall D, Ernst D, Bellg AJ, Czajkowski S, Breger R, DeFrancesco C, Levesque C, Sharp DL, Ogedegbe G, Resnick B, Orwig D. A new tool to assess treatment fidelity and evaluation of treatment fidelity across 10 years of health behavior research. J Consult Clin Psychol. 2005 Oct;73(5):852-60. doi: 10.1037/0022-006X.73.5.852.
citation: Castro FG, Barrera M Jr, Martinez CR Jr. The cultural adaptation of prevention interventions: resolving tensions between fidelity and fit. Prev Sci. 2004 Mar;5(1):41-5. doi: 10.1023/b:prev.0000013980.12412.cd.
citation: Chen M, Chan KL. Effects of Parenting Programs on Child Maltreatment Prevention: A Meta-Analysis. Trauma Violence Abuse. 2016 Jan;17(1):88-104. doi: 10.1177/1524838014566718. Epub 2015 Jan 8.
citation: Delgado-Rodriguez M, Llorca J. Bias. J Epidemiol Community Health. 2004 Aug;58(8):635-41. doi: 10.1136/jech.2003.008466.
citation: Dunne MP, Zolotor AJ, Runyan DK, Andreva-Miller I, Choo WY, Dunne SK, Gerbaka B, Isaeva O, Jain D, Kasim MS, Macfarlane B, Mamyrova N, Ramirez C, Volkova E, Youssef R. ISPCAN Child Abuse Screening Tools Retrospective version (ICAST-R): Delphi study and field testing in seven countries. Child Abuse Negl. 2009 Nov;33(11):815-25. doi: 10.1016/j.chiabu.2009.09.005. Epub 2009 Oct 22.
citation: Eames C, Daley D, Hutchings J, Whitaker CJ, Jones K, Hughes JC, Bywater T. Treatment fidelity as a predictor of behaviour change in parents attending group-based parent training. Child Care Health Dev. 2009 Sep;35(5):603-12. doi: 10.1111/j.1365-2214.2009.00975.x. Epub 2009 Jun 8.
citation: Filgueiras A, Pires P, Maissonette S, Landeira-Fernandez J. Psychometric properties of the Brazilian-adapted version of the Ages and Stages Questionnaire in public child daycare centers. Early Hum Dev. 2013 Aug;89(8):561-76. doi: 10.1016/j.earlhumdev.2013.02.005. Epub 2013 Mar 16.
citation: Garcia-Moreno C, Jansen HA, Ellsberg M, Heise L, Watts CH; WHO Multi-country Study on Women's Health and Domestic Violence against Women Study Team. Prevalence of intimate partner violence: findings from the WHO multi-country study on women's health and domestic violence. Lancet. 2006 Oct 7;368(9543):1260-9. doi: 10.1016/S0140-6736(06)69523-8.
citation: Gardner F, Shaw DS, Dishion TJ, Burton J, Supplee L. Randomized prevention trial for early conduct problems: effects on proactive parenting and links to toddler disruptive behavior. J Fam Psychol. 2007 Sep;21(3):398-406. doi: 10.1037/0893-3200.21.3.398.
citation: Gardner F, Hutchings J, Bywater T, Whitaker C. Who benefits and how does it work? Moderators and mediators of outcome in an effectiveness trial of a parenting intervention. J Clin Child Adolesc Psychol. 2010;39(4):568-80. doi: 10.1080/15374416.2010.486315.
citation: Gardner MJ, Altman DG. Confidence intervals rather than P values: estimation rather than hypothesis testing. Br Med J (Clin Res Ed). 1986 Mar 15;292(6522):746-50. doi: 10.1136/bmj.292.6522.746.
citation: Gershoff ET, Aber JL, Raver CC, Lennon MC. Income is not enough: incorporating material hardship into models of income associations with parenting and child development. Child Dev. 2007 Jan-Feb;78(1):70-95. doi: 10.1111/j.1467-8624.2007.00986.x.
citation: Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001 Nov;40(11):1337-45. doi: 10.1097/00004583-200111000-00015.
citation: Graham JW, Olchowski AE, Gilreath TD. How many imputations are really needed? Some practical clarifications of multiple imputation theory. Prev Sci. 2007 Sep;8(3):206-13. doi: 10.1007/s11121-007-0070-9. Epub 2007 Jun 5.
citation: Henkel V, Mergl R, Kohnen R, Maier W, Moller HJ, Hegerl U. Identifying depression in primary care: a comparison of different methods in a prospective cohort study. BMJ. 2003 Jan 25;326(7382):200-1. doi: 10.1136/bmj.326.7382.200. No abstract available.
citation: Henry JD, Crawford JR. The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample. Br J Clin Psychol. 2005 Jun;44(Pt 2):227-39. doi: 10.1348/014466505X29657.
citation: Heo KH, Squires J. Cultural adaptation of a parent completed social emotional screening instrument for young children: Ages And Stages Questionnaire-Social Emotional. Early Hum Dev. 2012 Mar;88(3):151-8. doi: 10.1016/j.earlhumdev.2011.07.019. Epub 2011 Sep 8.
citation: Herth K. Hope as seen through the eyes of homeless children. J Adv Nurs. 1998 Nov;28(5):1053-62. doi: 10.1046/j.1365-2648.1998.00813.x.
citation: Hinshaw SP. Intervention research, theoretical mechanisms, and causal processes related to externalizing behavior patterns. Dev Psychopathol. 2002 Fall;14(4):789-818. doi: 10.1017/s0954579402004078.
citation: Hutchings J, Gardner F, Bywater T, Daley D, Whitaker C, Jones K, Eames C, Edwards RT. Parenting intervention in Sure Start services for children at risk of developing conduct disorder: pragmatic randomised controlled trial. BMJ. 2007 Mar 31;334(7595):678. doi: 10.1136/bmj.39126.620799.55. Epub 2007 Mar 9.
citation: Kazdin AE, Holland L, Crowley M, Breton S. Barriers to Treatment Participation Scale: evaluation and validation in the context of child outpatient treatment. J Child Psychol Psychiatry. 1997 Nov;38(8):1051-62. doi: 10.1111/j.1469-7610.1997.tb01621.x.
citation: Kerstjens JM, Bos AF, ten Vergert EM, de Meer G, Butcher PR, Reijneveld SA. Support for the global feasibility of the Ages and Stages Questionnaire as developmental screener. Early Hum Dev. 2009 Jul;85(7):443-7. doi: 10.1016/j.earlhumdev.2009.03.001. Epub 2009 Apr 7.
citation: Kianifard F, Islam MZ. A guide to the design and analysis of small clinical studies. Pharm Stat. 2011 Jul-Aug;10(4):363-8. doi: 10.1002/pst.477. Epub 2010 Dec 8.
citation: Knerr W, Gardner F, Cluver L. Improving positive parenting skills and reducing harsh and abusive parenting in low- and middle-income countries: a systematic review. Prev Sci. 2013 Aug;14(4):352-63. doi: 10.1007/s11121-012-0314-1.
citation: Kraemer HC, Robinson TN. Are certain multicenter randomized clinical trial structures misleading clinical and policy decisions? Contemp Clin Trials. 2005 Oct;26(5):518-29. doi: 10.1016/j.cct.2005.05.002.
citation: Kraemer HC, Wilson GT, Fairburn CG, Agras WS. Mediators and moderators of treatment effects in randomized clinical trials. Arch Gen Psychiatry. 2002 Oct;59(10):877-83. doi: 10.1001/archpsyc.59.10.877.
citation: Labadarios D, Maunder E, Steyn N, MacIntyre U, Swart R, Gericke G, Nesamvuni E, Huskisson J, Vorster HH, Dannhauser A. National food consumption survey in children aged 1-9 years: South Africa 1999. Forum Nutr. 2003;56:106-9. No abstract available.
citation: Lachman P, Poblete X, Ebigbo PO, Nyandiya-Bundy S, Bundy RP, Killian B, Doek J. Challenges facing child protection. Child Abuse Negl. 2002 Jun;26(6-7):587-617. doi: 10.1016/s0145-2134(02)00336-8.
citation: Leung C, Sanders MR, Leung S, Mak R, Lau J. An outcome evaluation of the implementation of the Triple P-Positive Parenting Program in Hong Kong. Fam Process. 2003 Winter;42(4):531-44. doi: 10.1111/j.1545-5300.2003.00531.x.
citation: Leung C, Leung S, Chan R, Tso K, Ip F. Child behaviour and parenting stress in Hong Kong families. Hong Kong Med J. 2005 Oct;11(5):373-80.
citation: Lorenc T, Oliver K. Adverse effects of public health interventions: a conceptual framework. J Epidemiol Community Health. 2014 Mar;68(3):288-90. doi: 10.1136/jech-2013-203118. Epub 2013 Dec 13.
citation: Martinez CR Jr, Eddy JM. Effects of culturally adapted parent management training on Latino youth behavioral health outcomes. J Consult Clin Psychol. 2005 Oct;73(5):841-51. doi: 10.1037/0022-006X.73.5.841.
citation: McEachern AD, Dishion TJ, Weaver CM, Shaw DS, Wilson MN, Gardner F. Parenting Young Children (PARYC): Validation of a Self-Report Parenting Measure. J Child Fam Stud. 2012 Jun;21(3):498-511. doi: 10.1007/s10826-011-9503-y.
citation: Mejia A, Calam R, Sanders MR. A pilot randomized controlled trial of a brief parenting intervention in low-resource settings in Panama. Prev Sci. 2015 Jul;16(5):707-17. doi: 10.1007/s11121-015-0551-1.
citation: Mertens JR, Ward CL, Bresick GF, Broder T, Weisner CM. Effectiveness of nurse-practitioner-delivered brief motivational intervention for young adult alcohol and drug use in primary care in South Africa: a randomized clinical trial. Alcohol Alcohol. 2014 Jul-Aug;49(4):430-8. doi: 10.1093/alcalc/agu030. Epub 2014 Jun 4.
citation: Mikton C, MacMillan H, Dua T, Betancourt TS. Integration of prevention of violence against children and early child development. Lancet Glob Health. 2014 Aug;2(8):e442-3. doi: 10.1016/S2214-109X(14)70233-5. Epub 2014 Jul 23. No abstract available.
citation: Montgomery MR, Gragnolati M, Burke KA, Paredes E. Measuring living standards with proxy variables. Demography. 2000 May;37(2):155-74.
citation: Morsbach SK, Prinz RJ. Understanding and improving the validity of self-report of parenting. Clin Child Fam Psychol Rev. 2006 Mar;9(1):1-21. doi: 10.1007/s10567-006-0001-5.
citation: Pals SL, Murray DM, Alfano CM, Shadish WR, Hannan PJ, Baker WL. Individually randomized group treatment trials: a critical appraisal of frequently used design and analytic approaches. Am J Public Health. 2008 Aug;98(8):1418-24. doi: 10.2105/AJPH.2007.127027. Epub 2008 Jun 12.
citation: Phillips AE, Gomez GB, Boily MC, Garnett GP. A systematic review and meta-analysis of quantitative interviewing tools to investigate self-reported HIV and STI associated behaviours in low- and middle-income countries. Int J Epidemiol. 2010 Dec;39(6):1541-55. doi: 10.1093/ije/dyq114. Epub 2010 Jul 14.
citation: Potterton J, Stewart A, Cooper P. Parenting stress of caregivers of young children who are HIV Positive. Afr J Psychiatry (Johannesbg). 2007 Nov;10(4):210-4. doi: 10.4314/ajpsy.v10i4.30257.
citation: Reid MJ, Webster-Stratton C, Beauchaine TP. Parent training in head start: a comparison of program response among African American, Asian American, Caucasian, and Hispanic mothers. Prev Sci. 2001 Dec;2(4):209-27. doi: 10.1023/a:1013618309070.
citation: Runyan DK, Dunne MP, Zolotor AJ, Madrid B, Jain D, Gerbaka B, Menick DM, Andreva-Miller I, Kasim MS, Choo WY, Isaeva O, Macfarlane B, Ramirez C, Volkova E, Youssef RM. The development and piloting of the ISPCAN Child Abuse Screening Tool-Parent version (ICAST-P). Child Abuse Negl. 2009 Nov;33(11):826-32. doi: 10.1016/j.chiabu.2009.09.006. Epub 2009 Oct 24.
citation: Bodenmann G, Cina A, Ledermann T, Sanders MR. The efficacy of the Triple P-Positive Parenting Program in improving parenting and child behavior: a comparison with two other treatment conditions. Behav Res Ther. 2008 Apr;46(4):411-27. doi: 10.1016/j.brat.2008.01.001. Epub 2008 Jan 5.
citation: Straus MA, Douglas EM. A short form of the Revised Conflict Tactics Scales, and typologies for severity and mutuality. Violence Vict. 2004 Oct;19(5):507-20. doi: 10.1891/vivi.19.5.507.63686.
citation: Streiner D, Geddes J. Intention to treat analysis in clinical trials when there are missing data. Evid Based Ment Health. 2001 Aug;4(3):70-1. doi: 10.1136/ebmh.4.3.70. No abstract available.
citation: Topp CW, Ostergaard SD, Sondergaard S, Bech P. The WHO-5 Well-Being Index: a systematic review of the literature. Psychother Psychosom. 2015;84(3):167-76. doi: 10.1159/000376585. Epub 2015 Mar 28.
citation: Vameghi R, Sajedi F, Kraskian Mojembari A, Habiollahi A, Lornezhad HR, Delavar B. Cross-Cultural Adaptation, Validation and Standardization of Ages and Stages Questionnaire (ASQ) in Iranian Children. Iran J Public Health. 2013 May 1;42(5):522-8. Print 2013.
citation: Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996 Mar;34(3):220-33. doi: 10.1097/00005650-199603000-00003.
citation: Lachman JM, Alampay LP, Jocson RM, Alinea C, Madrid B, Ward C, Hutchings J, Mamauag BL, Garilao MAVFV, Gardner F. Effectiveness of a parenting programme to reduce violence in a cash transfer system in the Philippines: RCT with follow-up. Lancet Reg Health West Pac. 2021 Oct 5;17:100279. doi: 10.1016/j.lanwpc.2021.100279. eCollection 2021 Dec.