Browsing by Subject "Parenting"
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- ItemOpen AccessAccelerating Sustainable Development Goals for South African adolescents from high HIV prevalence areas: a longitudinal path analysis(2021-11-11) Meinck, Franziska; Orkin, Mark; Cluver, LucieBackground Adolescents experience a multitude of vulnerabilities which need to be addressed in order to achieve the Sustainable Development Goals (SDGs). In sub-Saharan Africa, adolescents experience high burden of HIV, violence exposure, poverty, and poor mental and physical health. This study aimed to identify interventions and circumstances associated with three or more targets (“accelerators”) within multiple SDGs relating to HIV-affected adolescents and examine cumulative effects on outcomes. Methods Prospective longitudinal data from 3401 adolescents from randomly selected census enumeration areas in two provinces with > 30% HIV prevalence carried out in 2010/11 and 2011/12 were used to examine six hypothesized accelerators (positive parenting, parental monitoring, free schooling, teacher support, food sufficiency and HIV-negative/asymptomatic caregiver) targeting twelve outcomes across four SDGs, using a multivariate (multiple outcome) path model with correlated outcomes controlling for outcome at baseline and socio-demographics. The study corrected for multiple-hypothesis testing and tested measurement invariance across sex. Percentage predicted probabilities of occurrence of the outcome in the presence of the significant accelerators were also calculated. Results Sample mean age was 13.7 years at baseline, 56.6% were female. Positive parenting, parental monitoring, food sufficiency and AIDS-free caregiver were variously associated with reductions on ten outcomes. The model was gender invariant. AIDS-free caregiver was associated with the largest reductions. Combinations of accelerators resulted in a percentage reduction of risk of up to 40%. Conclusion Positive parenting, parental monitoring, food sufficiency and AIDS-free caregivers by themselves and in combination improve adolescent outcomes across ten SDG targets. These could translate to the corresponding real-world interventions parenting programmes, cash transfers and universal access to antiretroviral treatment, which when provided together, may help governments in sub-Saharan Africa more economically to reach their SDG targets.
- ItemOpen AccessCould cash and good parenting affect child cognitive development? A cross-sectional study in South Africa and Malawi(2017) Sherr, Lorraine; Macedo, Ana; Tomlinson, Mark; Skeen, Sarah; Cluver, Lucie DaleBACKGROUND: Social protection interventions, including cash grants and care provision have been shown to effectively reduce some negative impacts of the HIV epidemic on adolescents and families. Less is known about the role of social protection on younger HIV affected populations. This study explored the impact of cash grants on children's cognitive development. Additionally, we examined whether combined cash and care (operationalised as good parenting) was associated with improved cognitive outcomes. METHODS: The sample included 854 children, aged 5 - 15, participating in community-based organisation (CBO) programmes for children affected by HIV in South Africa and Malawi. Data on child cognitive functioning were gathered by a combination of caregiver report and observer administered tests. Primary caregivers also reported on the economic situation of the family, cash receipt into the home, child and household HIV status. Parenting was measured on a 10 item scale with good parenting defined as a score of 8 or above. RESULTS: About half of families received cash (55%, n = 473), only 6% (n = 51) reported good parenting above the cut-off point but no cash, 18% (n = 151) received combined cash support and reported good parenting, and 21% (n = 179) had neither. Findings show that cash receipt was associated with enhanced child cognitive outcomes in a number of domains including verbal working memory, general cognitive functioning, and learning. Furthermore, cash plus good parenting provided an additive effect. Child HIV status had a moderating effect on the association between cash or/plus good parenting and cognitive outcomes. The association between cash and good parenting and child cognitive outcomes remained significant among both HIV positive and negative children, but overall the HIV negative group benefited more. CONCLUSIONS: This study shows the importance of cash transfers and good parenting on cognitive development of young children living in HIV affected environments. Our data clearly indicate that combined provision (cash plus good parenting) have added value.
- ItemOpen AccessHealth care provider perspectives on pregnancy and parenting in HIV-positive individuals in South Africa(BioMed Central, 2014-09-12) Moodley, Jennifer; Cooper, Diane; Mantell, Joanne E; Stern, ErinBackground: Within the health system, limited attention is given to supporting the fertility and parenting desires on HIV-positive people. In this study, we explore health care providers’ knowledge and perspectives on safer conception and alternate parenting strategies for HIV-positive people. Methods Between November 2007 and January 2008, in-depth interviews were conducted with 28 health care workers involved in providing HIV and/or antiretroviral services at public sector clinics in Cape Town, South Africa. Views on sexual and reproductive health services, pregnancy, childbearing and parenting in HIV-positive men and women were explored using a semi-structured interview guide. Data were analyzed using a thematic approach. Results: Providers recognized the sexual and reproductive rights of HIV-positive individuals, but struggled with the tension between supporting these rights and concerns about spreading infection. Limited knowledge of safer conception methods constrained their ability to counsel and support clients in realizing fertility desires. Providers believed that parenting alternatives that do not maintain biological and cultural linkage are unlikely to be acceptable options. Conclusions: Health care provider training and support is critical to providing comprehensive sexual and reproductive health care and meeting the fertility desires of HIV-positive people.
- ItemOpen AccessIntegrating intimate partner violence prevention content into a digital parenting chatbot intervention during COVID-19: Intervention development and remote data collection(BioMed Central, 2023-09-04) Schafer, Moa; Lachman, Jamie M.; Gardner, Frances; Zinser, Paula; Calderon, Francisco; Han, Qing; Facciola, Chiara; Clements, LilyBackground Intimate partner violence (IPV) is a serious public health issue which experienced a sharp incline during the onset of COVID-19. Increases in other forms of violence, such as violence against children (VAC), have also been linked to the pandemic, and there have been calls for greater prevention efforts that tackle both forms of violence concurrently. The COVID-19 crisis has highlighted the urgent need for evidence-based and scalable violence prevention interventions that target multiple forms of family violence. Parenting programmes have shown promising results in preventing various forms of family violence, including IPV and VAC, and have recently experienced an expansion in delivery, with digital intervention formats growing. This paper describes the development and evaluation of the IPV prevention content designed and integrated into ParentText, a chatbot parenting intervention adapted from Parenting for Lifelong Health programmes. Methods The ParentText IPV prevention content was developed using the Six Steps in Quality Intervention Development (6SQuID) framework. This involved targeted literature searches for key studies to identify causal factors associated with IPV and determining those with greatest scope for change. Findings were used to develop the intervention content and theory of change. Consultations were held with academic researchers (n = 5), practitioners (n = 5), and local community organisations (n = 7), who reviewed the content. A formative evaluation was conducted with parents in relationships (n = 96) in Jamaica to better understand patterns in user engagement with the intervention and identify strategies to further improve engagement. Results Using the 6SQuID model, five topics on IPV prevention were integrated into the ParentText chatbot. Text-messages covering each topic, including additional materials such as cartoons and videos, were also developed. The formative evaluation revealed an average user-engagement length of 14 days, 0.50 chatbot interactions per day, and over half of participants selected to view additional relationship content. Conclusions This article provides a unique contribution as the first to integrate IPV prevention content into a remotely delivered, digital parenting intervention for low-resource settings. The findings from this research and formative evaluation shed light on the promising potential of chatbots as scalable and accessible forms of violence prevention, targeting multiple types of family violence.
- ItemOpen AccessOptimising engagement in a digital parenting intervention to prevent violence against adolescents in Tanzania: protocol for a cluster randomised factorial trial(BioMed Central, 2023-06-23) Janowski, Roselinde; Green, Ohad; Shenderovich, Yulia; Stern, David; Clements, Lily; Wamoyi, Joyce; Wambura, Mwita; Lachman, Jamie M.; Melendez-Torres, G. J.; Gardner, Frances; Baerecke, Lauren; Te Winkel, Esmee; Booij, Anna; Setton, Orli; Tsoanyane, Sibongile; Mjwara, Sussie; Christine, Laetitia; Ornellas, Abigail; Chetty, Nicole; Klapwijk, Jonathan; Awah, Isang; Manjengenja, Nyasha; Sokoine, Kudely; Majikata, Sabrina; Cluver, Lucie D.Background Violence against adolescents is a universal reality, with severe individual and societal costs. There is a critical need for scalable and effective violence prevention strategies such as parenting programmes, particularly in low- and middle-income countries where rates of maltreatment are highest. Digital interventions may be a scalable and cost-effective alternative to in-person delivery, yet maximising caregiver engagement is a substantial challenge. This trial employs a cluster randomised factorial experiment and a novel mixed-methods analytic approach to assess the effectiveness, cost-effectiveness, and feasibility of intervention components designed to optimise engagement in an open-source parenting app, ParentApp for Teens. The app is based on the evidence-based Parenting for Lifelong Health for Teens programme, developed collaboratively by academic institutions in the Global South and North, the WHO, and UNICEF. Methods/design Sixteen neighbourhoods, i.e., clusters, will be randomised to one of eight experimental conditions which consist of any combination of three components (Support: self-guided/moderated WhatsApp groups; App Design: sequential workshops/non-sequential modules; Digital Literacy Training: on/off). The study will be conducted in low-income communities in Tanzania, targeting socioeconomically vulnerable caregivers of adolescents aged 10 to 17 years (16 clusters, 8 conditions, 640 caregivers, 80 per condition). The primary objective of this trial is to estimate the main effects of the three components on engagement. Secondary objectives are to explore the interactions between components, the effects of the components on caregiver behavioural outcomes, moderators and mediators of programme engagement and impact, and the cost-effectiveness of components. The study will also assess enablers and barriers to engagement qualitatively via interviews with a subset of low, medium, and high engaging participants. We will combine quantitative and qualitative data to develop an optimised ParentApp for Teens delivery package. Discussion This is the first known cluster randomised factorial trial for the optimisation of engagement in a digital parenting intervention in a low- and middle-income country. Findings will be used to inform the evaluation of the optimised app in a subsequent randomised controlled trial. Trial registration Pan African Clinical Trial Registry, PACTR202210657553944. Registered 11 October 2022, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=24051 .
- ItemOpen AccessPrevention of child mental health problems through parenting interventions in Southeastern Europe (RISE): study protocol for a multi-site randomised controlled trial(2021-12-27) Tăut, Diana; Băban, Adriana; Frantz, Inga; Dănilă, Ingrid; Lachman, Jamie M; Heinrichs, Nina; Ward, Catherine L; Gardner, Frances; Fang, Xiangming; Hutchings, Judy; Raleva, Marija; Lesco, Galina; Murphy, Hugh; Foran, HeatherBackground Childhood adversities, such as poor parental practices, exposure to violence, and risk behaviours strongly impact children’s future mental and behavioural problems. Adversities affect families living in disadvantaged environments and low- and middle-income countries (LMICs) to a greater extent than in high-income countries. Parenting programmes are an effective way to alleviate them, although their outreach and scalability is still limited in LMICs. Methods/design A multi-site randomised controlled trial will be conducted in North Macedonia, Republic of Moldova and Romania to test the efficacy and cost-effectiveness of an optimised version of the promising Parenting for Lifelong Health Programme for Young Children (PLH-YC, 5 sessions), against a standard lecture on parenting issues (control group, 1 session). At least 864 participants who report having children between 2 and 9 years old who display elevated levels of behavioural difficulties will be randomised on a 1:1 basis to the intervention and control groups. The primary outcome will consist of parent report of child oppositional aggressive behaviour. Post-test (four months) and follow-up (12 months) assessments will provide information on short- and longer-term effects of PLH-YC compared to the parenting lecture in the control group. Discussion This randomised trial will test the efficacy of PLH-YC in alleviating child behavioural problems and assess the cost-effectiveness, transportability across three different cultural contexts, and potential for scalability of the programme. Trial registration ClinicalTrials.gov ., Registration number: NCT04721730 ( https://clinicaltrials.gov/ct2/show/NCT04721730 ). Registered 13.01.2021
- ItemOpen AccessProtective factors for adolescent sexual risk behaviours and experiences linked to HIV infection in South Africa: a three-wave longitudinal analysis of caregiving, education, food security, and social protection(BioMed Central, 2023-07-29) Rudgard, William E.; Saminathen, Maria G.; Orkin, Mark; Banougnin, Boladé H.; Shenderovich, Yulia; Toska, ElonaAbstract Background Structural interventions are endorsed to enhance biomedical and behavioural HIV prevention programmes for adolescents. Aiming to inform future interventions, we evaluated longitudinal associations between six protective factors that link closely to existing structural HIV prevention interventions, and five sexual risk behaviours for HIV transmission in a cohort of adolescents in South Africa. Methods We used three rounds of data between 2014–2018 on 1046 adolescents living with HIV and 473 age-matched community peers in South Africa’s Eastern Cape (Observations = 4402). We estimated sex-specific associations between six time-varying protective factors − number of social grants, education enrolment, days with enough food, caregiver supervision, positive caregiving, and adolescent-caregiver communication; and five HIV risk behaviours − multiple sexual partners, transactional sex, age-disparate sex, condomless sex, and sex on substances. HIV risk behaviours were analysed separately in multivariable random effects within-between logistic regression models that accounted for correlation of repeated observations on the same individual. We calculated prevalence ratios (PR), contrasting adjusted probabilities of HIV risk behaviours at ‘No’ and ‘Yes’ for education enrolment, and average and maximum values for the other five protective factors. Results The sample mean age was 15.29 (SD: 3.23) years and 58% were girls. Among girls, within-individuals, increases from mean to maximum scores in positive caregiving were associated with lower probability of transactional sex (PR = 0.79; 95%CI = 0.67–0.91); in caregiver supervision were associated with lower probability of transactional sex (PR = 0.75; 95%CI = 0.66–0.84), and age-disparate sex (PR = 0.84; 95%CI = 0.73–0.95); in adolescent-caregiver communication were associated with higher probability of transactional sex (PR = 1.70; 95%CI = 1.08–2.32); and in days with enough food at home were associated with lower probability of multiple sexual partners (PR = 0.89; 95%CI = 0.81–0.97), and transactional sex (PR = 0.82; 95%CI = 0.72–0.92). Change from non-enrolment in education to enrolment was associated with lower probability of age-disparate sex (PR = 0.49; 95%CI = 0.26–0.73). Between-individuals, relative to mean caregiver supervision scores, maximum scores were associated with lower probability of multiple sexual partners (PR = 0.59; 95%CI = 0.46–0.72), condomless sex (PR = 0.80; 95%CI = 0.69–0.91), and sex on substances (PR = 0.42; 95%CI = 0.26–0.59); and relative to non-enrolment, education enrolment was associated with lower probability of condomless sex (PR = 0.59; 95%CI = 0.39–0.78). Among boys, within-individuals, increases from mean to maximum scores in positive caregiving were associated with lower probability of transactional sex (PR = 0.77; 95%CI = 0.59–0.96), and higher probability of condomless sex (PR = 1.26; 95%CI = 1.08–1.43); in caregiver supervision were associated with lower probability of multiple sexual partners (PR = 0.73; 95%CI = 0.64–0.82), transactional sex (PR = 0.63; 95%CI = 0.50–0.76), age-disparate sex (PR = 0.67; 95%CI = 0.49–0.85), and sex on substances (PR = 0.61; 95%CI = 0.45–0.78), and in days with enough food at home were associated with lower probability of transactional sex (PR = 0.91; 95%CI = 0.84–0.98). Conclusion Effective structural interventions to improve food security and education enrolment among adolescent girls, and positive and supervisory caregiving among adolescent girls and boys are likely to translate into crucial reductions in sexual risk behaviours linked to HIV transmission in this population.
- ItemOpen AccessSpare the rod and save the child: Assessing the impact of parenting on child behaviour and mental health(2015) Ward, Catherine L; Gould, Chandré; Kelly, Jane; Mauff, KatyaParenting has a considerable impact on children’s behaviour and mental health. Improving child health and behaviour requires an understanding of the relationship between parenting practices; contexual factors such as parental mental health, intimate partner violence, substance abuse and poverty; and children’s behaviour. In this article the authors report the findings of a survey of parenting and child behaviour in a small rural South African community. The findings show that corporal punishment, the stress of parenting and parental mental health are significantly associated with both children’s internalising (depression and anxiety) and externalising (rulebreaking and aggression) symptoms. Intimate partner violence in the home was also associated with children’s externalising symptoms. These findings imply that parent support and training, and an increase in services to address intimate partner violence and mental health problems, should be prioritised as part of a national violence reduction strategy.
- ItemOpen Access'We are actually raising South Africans''. Raising immigrant families: The parenting experiences of Zimbabweans in South Africa(2019) Finos, Shuvai T.; Tame, BiancaSouth Africa is the most popular international destination for Zimbabwean migrants escaping the economic crisis of their country. It has been estimated that by 2016, one and a half million Zimbabwean nationals were living in South Africa. However, little research explores the lived experience of Zimbabweans in South Africa in the context of family. This is despite scholars highlighting an increase in family migration from Zimbabwe to South Africa in recent years. This study explores the parenting experiences of immigrant Zimbabwean parents raising their children in South Africa. Specifically, it investigates the ways in which raising children in a different country and cultural context influences parents’ understanding of and approaches to parenting. Nine Zimbabwean mothers and fathers living with their spouses and children in Cape Town participated in a qualitative study, with semi-structured interviews. Data was collected and analysed using thematic analysis. The study found that the participants’ overarching experience of parenting was that they were ultimately raising ‘South Africans’. Participants framed their children’s ‘South African-ness’ positively, identifying the children as cosmopolitan and empowered, which they celebrated. However, they also lamented the children’s loss of identity as the most problematic aspect of ‘South African-ness’. To navigate the resultant tensions, participants relaxed some of their existing beliefs while simultaneously implementing measures to reinforce some non-negotiable values and beliefs in their children. This dissertation argues that while parents’ understanding of parenting is strongly rooted in their cultural background and values, they adapt their parenting styles and practices according to what they calculate will enable their families to thrive. The study adds to the body of knowledge on immigrant Zimbabwean families who have become part of South African society. This is especially relevant in light of the South African government’s laudable initiatives towards regularising the stay of Zimbabweans in South Africa, such as the Dispensation of Zimbabweans Project (DZP) of 2009 and its successive permits. This study can therefore contribute to the body of knowledge that informs the ways in which South Africa can continue to respond to the reality of migration from Zimbabwe.