Abstract
OBJECTIVES: Group-format, peer-led parenting interventions may be valuable for parents with significant emotional and interpersonal difficulties in improving child behaviour, parenting and parent mental health. This article presents the results of a feasibility pilot randomised controlled trial (RCT) of a novel peer-led group intervention, Being a Parent (BaP)-Enjoying Family Life. DESIGN: Two-arm, parallel group superiority feasibility RCT, with pre-post intervention (postintervention) and 6-month follow-up (6-month follow-up). SETTING: Community recruitment across four South London boroughs. PARTICIPANTS: Main inclusion criteria were (1) primary parental caregivers, (2) aged 18-65 years and (3) significant emotional and interpersonal difficulties (score ≥3 on Standardised Assessment of Personality-Abbreviated Scale screening tool) and had a child (a) aged 2-11 years, (b) living with parent participant and (c) with caregiver-reported behavioural difficulties. INTERVENTIONS: Intervention arm: BaP-Enjoying Family Life, a 10-session, peer-led, group intervention for parents with significant emotional and interpersonal difficulties. CONTROL ARM: BaP-Standard, a nine-session, peer-led group parenting intervention. OUTCOMES: Primary feasibility criteria were rates of recruitment, retention, intervention acceptability and fidelity. Initial estimates of intervention effect were measured using the Eyberg Child Behaviour Inventory (primary outcome), and the Concerns about my Child scale, Arnold O'Leary Parenting Scale, Parental Reflective Function Questionnaire, Kansas Parent Satisfaction Scale, Brief Parent Self Efficacy Scale, Brief Adjustment Scale-6 and Home Observation Measurement of the Environment (secondary outcomes). Data collection was conducted with the researcher masked to intervention allocation. RESULTS: Predefined thresholds were met for three of five feasibility indices and partially met for the remaining two. Eligibility criteria were met by 70% (n=77) of 110 interested parents, and 85% (n=66) of those eligible completed baseline data collection and were randomised. Data were collected at postintervention for 91% (n=60) of parents. 75% (n=49) of participants attended at least one session and 50% (n=33) completed 5 or more sessions (intervention completers). The intervention was found to be acceptable by 60.71% of participants in BaP-Enjoying Family Life and 62.50% of participants in BaP-Standard arm, increasing to 93.33% and 88.24%, respectively, among intervention completers. Fidelity was reached for three of five groups in each arm, with missing data and group cancellation contributing to lack of observed fidelity in the remaining two groups. We aimed to obtain estimates of intervention effect and, while underpowered, estimates of effect on the primary outcome (child behaviour) were moderate within each arm (BaP-Enjoying Family Life d=0.73 (95% CI 0.30 to 1.15), BaP-Standard d=0.73 (95% CI 0.34 to 1.12)) from baseline to postintervention. Improvements were maintained at 6-month follow-up. Moderate and large pre-post effects were observed on most secondary outcomes. Effect sizes also indicated no between-arm effect of intervention BaP-Enjoying Family Life and BaP-Standard on most primary and secondary outcomes. CONCLUSIONS: Findings indicate that both interventions show promise in supporting parents with significant emotional and interpersonal difficulties with limited differential effects. Further refinements which increase intervention completion, acceptability and fidelity should be conducted prior to progression to a full-scale RCT. TRIAL REGISTRATION NUMBER: ISRCTN10950727.