A feasibility study of an evidence-based parenting intervention to prevent violence and improve positive parenting in Thailand
PLH-Thailand aims to adapt and test PLH 2-9 with low-income families in Thailand. In order to determine the cultural appropriateness, feasibility, and effectiveness of PLH 2-9 in reducing the risk of violence against children and improving positive parenting behaviour in the Thai context, the project partners propose a feasibility study project to be implemented in a selected province in North Eastern Thailand in close collaboration with the Provincial Public Health Office, the Department of Social Development and Human Security, the Department of Local Administration, Thai parenting professionals, and parents and primary caregivers  themselves. Project funded by UNICEF Thailand and the University of Oxford.
- To determine the needs of parents, primary caregivers, and public health practitioners in receiving and providing parenting services for violence prevention and improving positive parenting behaviour;
- To adapt the PLH 2-9 programme format and materials so that they are appropriate to the cultural context and the capacity for public health services in Thailand;
- To test the adapted programme in hospital/clinic or community settings in Thailand in order to assess intervention acceptability, impact on parenting behaviours, and potential for scaling-up; and
- To build the knowledge and skills of public health practitioners to deliver high quality parenting education and support.
Phase 1: Prototype development
1.1 Formative evaluation
A qualitative study will be conducted with policymakers and designated public health practitioners, in order to capture their views on the PLH 2-9 key parenting principles, how the materials could be best adapted to suit Thai cultural norms, and how the group education format with occasional home visits may be compatible with the existing service delivery system.
1.2 Cultural & contextual adaptation
Based on the findings from the formative evaluation, and in consultation with a reference group of Thai parenting experts, the project team will adapt the PLH 2-9 programme materials to reflect Thai cultural norms and the public health service delivery context. Adaptation will involve tailoring the key principles to the appropriate target group; adjusting the format and frequency of trainings to meet the needs of parents/primary caregivers and service providers; developing a facilitator’s manual; and designing and producing materials for parent/primary caregiver participants.
1.3 Capacity building
A team of six facilitators and two supervisors will be identified within the designated local health service in collaboration with the Provincial Public Health Office, and will undergo a week-long training led by a Master Trainer from the PLH-Prototype Implementation Network (PIN). A team of 10 data collectors will also be trained to conduct interviews and collect observational data.
1.4 Feasibility pilot
The feasibility pilot will test the degree to which the adapted version of PLH 2-9 is accepted by a small group of 30 parents/primary caregivers, whether there are preliminary signs of effectiveness, and whether the intervention can be delivered with a high degree of fidelity.
Phase 2: Small RCT
2.1 Community mobilization, recruitment & logistical support
In order to prepare for the small randomized controlled trial (RCT), the project partners will work closely with the Provincial Public Health Office, other local government counterparts, and target communities to manage intervention facilitators, supervisors, and data collectors, as well as to recruit and retain 120 parents and primary caregivers for the trial.
2.2 Group sessions for parents/primary caregivers
The trial participants will be randomly allocated to intervention and control groups, followed by the collection of pre-intervention baseline data. Intervention group families will receive the intervention through a weekly group session format, with assigned weekly home practice activities and home visits for those families who missed a session or who are in need of additional support.
2.3 Outcome evaluation
The University of Oxford will evaluate the effectiveness of the intervention by comparing the outcome effects between the intervention group (60 families) and the control group (60 families) at two time points post-intervention: two weeks and four months. The outcomes to be assessed include reductions in incidents of violence against children; reductions in risk factors for violence, including negative child behaviours; and improvements in parent-child interactions.
Phase 3: Dissemination & planning for scale up
The findings from the outcome evaluation will be shared with the Thai Government and other stakeholders at the national and provincial levels to discuss the impact of the programme, any revisions that may be needed, and strategy for scale up throughout 7 provinces in the region.