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      Evaluating the effectiveness and cost effectiveness of the ‘strengthening families, strengthening communities’ group-based parenting programme: study protocol and initial insights


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          Up to 20% of UK children experience socio-emotional difficulties which can have serious implications for themselves, their families and society. Stark socioeconomic and ethnic inequalities in children’s well-being exist. Supporting parents to develop effective parenting skills is an important preventive strategy in reducing inequalities. Parenting interventions have been developed, which aim to reduce the severity and impact of these difficulties. However, most parenting interventions in the UK focus on early childhood (0–10 years) and often fail to engage families from ethnic minority groups and those living in poverty. Strengthening Families, Strengthening Communities (SFSC) is a parenting programme designed by the Race Equality Foundation, which aims to address this gap. Evidence from preliminary studies is encouraging, but no randomised controlled trials have been undertaken so far.


          The TOGETHER study is a multi-centre, waiting list controlled, randomised trial, which aims to test the effectiveness of SFSC in families with children aged 3–18 across seven urban areas in England with ethnically and socially diverse populations. The primary outcome is parental mental well-being (assessed by the Warwick-Edinburgh Mental Well-Being Scale). Secondary outcomes include child socio-emotional well-being, parenting practices, family relationships, self-efficacy, quality of life, and community engagement. Outcomes are assessed at baseline, post intervention, three- and six-months post intervention. Cost effectiveness will be estimated using a cost-utility analysis and cost-consequences analysis. The study is conducted in two stages. Stage 1 comprised a 6-month internal pilot to determine the feasibility of the trial. A set of progression criteria were developed to determine whether the stage 2 main trial should proceed. An embedded process evaluation will assess the fidelity and acceptability of the intervention.


          In this paper we provide details of the study protocol for this trial. We also describe challenges to implementing the protocol and how these were addressed. Once completed, if beneficial effects on both parental and child outcomes are found, the impact, both immediate and longer term, are potentially significant. As the intervention focuses on supporting families living in poverty and those from minority ethnic communities, the intervention should also ultimately have a beneficial impact on reducing health inequalities.

          Trial registration

          Prospectively registered Randomised Controlled Trial ISRCTN15194500.

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          Developing and evaluating complex interventions: the new Medical Research Council guidance

          Evaluating complex interventions is complicated. The Medical Research Council's evaluation framework (2000) brought welcome clarity to the task. Now the council has updated its guidance
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            Process evaluation of complex interventions: Medical Research Council guidance

            Process evaluation is an essential part of designing and testing complex interventions. New MRC guidance provides a framework for conducting and reporting process evaluation studies
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              EuroQol - a new facility for the measurement of health-related quality of life


                Author and article information

                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                19 October 2021
                19 October 2021
                : 21
                : 1887
                [1 ]GRID grid.83440.3b, ISNI 0000000121901201, Department of Epidemiology and Public Health, , University College London, ; London, UK
                [2 ]GRID grid.7362.0, ISNI 0000000118820937, NWORTH Clinical Trials Unit, , Bangor University, ; Bangor, UK
                [3 ]GRID grid.499474.3, Race Equality Foundation, ; London, UK
                [4 ]GRID grid.15822.3c, ISNI 0000 0001 0710 330X, School of Health and Education, Middlesex University, ; London, UK
                [5 ]GRID grid.7445.2, ISNI 0000 0001 2113 8111, Division of Psychiatry, , Imperial College London, ; London, UK
                [6 ]PPI lead, Manchester, UK
                [7 ]GRID grid.5337.2, ISNI 0000 0004 1936 7603, Centre for the Study of Ethnicity and Citizenship, , University of Bristol, ; Bristol, UK
                [8 ]GRID grid.5335.0, ISNI 0000000121885934, Department of Public Health & Primary Care, , Cambridge University, ; Cambridge, UK
                [9 ]GRID grid.5335.0, ISNI 0000000121885934, PEDAL Research Centre, Faculty of Education, , Cambridge University, ; Cambridge, UK
                Author information
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                : 30 September 2021
                : 4 October 2021
                Funded by: FundRef http://dx.doi.org/10.13039/501100001921, Public Health Research Programme;
                Award ID: NIHR-PHR: 16/122/35
                Award Recipient :
                Study Protocol
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                © The Author(s) 2021

                Public health
                ‘parenting’,‘child outcomes’,‘parental well-being’,‘health inequalities’,‘randomised controlled trial’,‘parenting programme’,‘child well-being’,‘intervention’


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