A randomised controlled trial evaluating the effectiveness and cost effectiveness of 'Strengthening Families, Strengthening Communities': a community led parenting programme (TOGETHER)

Background Between 10-20% 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. Giving every child the best start in life is a key strategy to reduce inequalities. Supporting parents to develop effective parenting skills is an important preventive strategy. A range of group-based parenting programmes have been delivered in the UK and evidence from recent reviews showed these can be effective. However most parenting interventions have focused on early childhood (0-5 years) and have failed to engage with families from ethnic minority groups and those living in poverty. A parenting programme for families with children aged up to 18 years (Strengthening Families, Strengthening Communities - SFSC) has been designed by the Race Equality Foundation, a charitable community organisation focused on promoting race equality, and has been delivered across the UK for over 10 years. Small pre-post studies have produced encouraging results but no randomised controlled trials have been undertaken so far. This study aims to address this knowledge gap. Aim To assess the effectiveness and cost-effectiveness of the SFSC parenting programme in enhancing parental mental well-being and children’s social and emotional well-being at 6-months follow-up. Design This multi-centre waiting list control randomised controlled trial will evaluate the SFSC programme. The study will be conducted in 2 phases. Participants will be randomly allocated to intervention or control arms. Phase 1 will comprise of a 6-month internal pilot to determine the feasibility of the trial. Should progression criteria be met, phase 2 will comprise the main trial. A nested process evaluation will also assess the fidelity and acceptability of the intervention. Setting participants The study will be conducted across 7 urban English areas with ethnically and socially diverse populations where the programme is currently being delivered. Participants (n=676) will be parents of children aged 3-18 years who either self-refer or are referred by health/social care professionals to attend the programme. Intervention and comparator Based on social learning theory, the 13-week programme aims to develop parents’ confidence, competence and skills through interactive group based activities. Local authorities in the 7 areas will supply staff, community venues, resources and other costs associated with delivering the intervention through existing contracts. Participants randomised to the control arm will be offered the intervention after approximately a 10-month wait. Outcomes The primary outcome will be parental mental well-being (assessed by the Warwick-Edinburgh Mental Well-Being Scale). Secondary outcomes will include child socio-emotional well-being, parenting practices, family relationships, parenting stress, quality of life, and community engagement. Outcomes will be assessed at baseline, post intervention and 6 months follow-up. Potential impact If this trial demonstrates beneficial effects on both parental and child outcomes, then the potential impact, both immediate and longer term, is potentially significant. As the intervention focuses in particular 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.