Evidence-based parenting programmes delivered through community organisations can support family wellbeing and should be considered as part of wider strategies to reduce health inequalities, a landmark UCL study has found.
In a new paper published in The Lancet Public Health, the researchers assessed the effectiveness and value for money of the Race Equality Foundation-designed Strengthening Families, Strengthening Communities (SFSC) programme, which has been run for parents and children aged up to 18 in the UK for the last two decades.
Previous evaluations of parenting programmes have produced mixed results and have sometimes failed to distinguish between the specific benefits of the programme and those derived from greater interaction with health and social care professionals.
This five-year study, funded by the National Institute for Health and Care Research, aimed to address that by using a randomised control trial to objectively assess the health benefits of the SFSC programme.
The study involved 674 parents and caregivers of children aged three to 18 living in disadvantaged and ethnically diverse communities across England. Parents attended weekly group sessions, led by a trained facilitator, focused on topics such as emotional social skills, discipline and parent-child relationships.
Parents who participated in the programme reported higher levels of mental wellbeing than those in the waiting list control group both immediately after the 13-week programme and at a six-month follow-up.
The study also found improvements in several secondary outcomes, including children’s socioemotional wellbeing, parenting practices, family conflict and relationship quality. The benefits of the programme were consistent across different groups, suggesting the programme worked well for families across a wide range of backgrounds.
The economic analysis found no major cost savings from the programme, although there were some indications that reduced use of services helped to offset its cost. Overall, the authors conclude that the relatively low cost of the programme, alongside the positive outcomes seen, suggests it may still represent reasonable value for money.
First author Professor Richard Watt (UCL Institute of Epidemiology and Health Care) said: "People who have done the programme are almost evangelical about the way it has changed their lives for the better.
"We know that parental mental wellbeing is a critical foundation for healthy family relationships and children’s development and that even modest improvements can make a meaningful difference to how parents cope with everyday pressures and support their children.
"What our study has shown is that community-based parenting programmes such as SFSC can successfully engage diverse families and improve wellbeing."
The researchers said that in terms of the primary outcome, better mental wellbeing, although the effect size - the measure of their findings’ significance in practice, as opposed to in statistical terms - was small, their findings were statistically significant.
Participants who took part in the programme reported better mental wellbeing both immediately after the programme and at the six-month follow-up, whereas a deterioration in the mental health of those in the control group was observed.
Other outcomes which improved - both immediately after the programme and at the six-month follow-up stage - included higher positive and fewer negative parenting practices and fewer conflicts in child-parent relationships. Improved closeness in child-parent relationships compared with those in the control group was reported at the six-month follow-up.
Co-author Dr Anita Mehay (City St Georges, University of London) said: "Small improvements can be meaningful; for instance, a parent shifting from rarely to some of the time in feeling confident or close to others can make a real difference in their ability to cope and manage daily demands for their families.
"Evidence also shows that even small individual benefits can lead to substantial benefits across an entire population when introduced at scale and may contribute to reducing health inequalities."
A couple who took part in the programme, Salma and Tamym, said: "Taking part in the programme really changed how we communicate and support each other as parents and as a couple.
"It helped us understand our children and each other better and feel more confident in how we handle challenges day to day.
"Also just being that support for one another. Connecting with other families and reflecting on our different cultures and values was a big part of that. It’s made a real difference to our family life."
Race Equality Foundation chief executive Jabeer Butt OBE said: "We are delighted that this study confirms what we have seen over many years of delivering Strengthening Families, Strengthening Communities: that inclusive, community-led support can have a profound impact on parents and children.
"We have consistently seen improvements in parental confidence, stronger relationships within families and improvements in children’s wellbeing.
"Crucially, this evidence shows the programme works for Black, Asian and minoritised ethnic families who are often under-served by mainstream provision, demonstrating that universal interventions can also be equitable.
"The priority now is to scale up delivery so that more families, particularly those facing the greatest disadvantage, can benefit as part of a wider strategy to improve child health and advance race equity."
The SFSC programme is delivered through a structured 13-week curriculum, consisting of weekly three-hour group sessions with 10 to 12 parents or carers.
The curriculum is organised into five thematic components: ethnic, cultural, spiritual, and family identity; rites of passage; enhancing relationships; process of discipline and behaviour management; and community involvement.
Within these, parents engage with topics such as understanding children’s developmental stages, building positive discipline strategies, strengthening parent-child relationships, promoting emotional and social skills, and supporting active community participation.
Each programme is delivered by two trained facilitators who have completed the Race Equality Foundation’s five-day training. The overall programme is commissioned by local authority agencies, healthcare trusts and other statutory agencies across England and Wales.
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