title: Learning, Enjoying, Growing, Support model: an innovative collaborative approach to the prevention of conduct disorder in preschoolers in hard to reach rural families.
abstract: OBJECTIVE
  To develop, implement and evaluate a pilot program targeting rural families with preschool aged children at risk of conduct disorder.
  
  
  METHODS
  A prospective single group repeated measures design.
  
  
  METHODS
  Communities in four local government areas in the Mid Western Area Health Service, New South Wales.
  
  
  METHODS
  A total of 33 families were referred to the program through community services where they were established clients.
  
  
  METHODS
  The Learning, Enjoying, Growing, Support model comprised a parenting program (Incredible Years; Kids Challenge and Change); a children's social skills program (Playing and learning to Socialise) and a transition to school component. Group programs were run simultaneously over 5-10 weeks.
  
  
  METHODS
  Measures of positive parenting and child problem behaviour and social skills were conducted on referral, and at completion of the program.
  
  
  RESULTS
  There was a self-reported increase in utilisation of all positive parenting skills with significant increases in rewarding (median score on referral: 4 (range: 4-6); at completion of program 6 (4-6); (P = 0.02)) and ignoring (2 (0-6) to 3 (1-8); (P = 0.02)). Children increased their levels of social skills. Significant improvement was reported in cooperation: (median score: 24 (18-33) to 27 (19-33); (P = 0.02)); interaction (24 (6-9) to 26 (11-32); (P = 0.03)) and independence(25 (16-33) to 28 (20-33); (P = 0.008)). There was a downward trend in problem behaviour exhibited with a significant reduction in internalising behaviour (median score 19 (3-30) to 12 (0-32); (P = 0.04)).
  
  
  CONCLUSIONS
  The positive impact of the model on parenting skills and child behaviour is promising and communities are continuing to run the programs. We recommend a broader adoption through rural communities.
authors.affiliation: Mental Health Promotion and Prevention Unit, Bloomfield Hospital, Orange, New South Wales 2800, Australia. fleur.hourihan@mwahs.nsw.gov.au
authors.forename: Fleur
authors.initials: F
authors.lastname: Hourihan
authors.forename: Deb
authors.initials: D
authors.lastname: Hoban
mesh_terms: D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D003156:Community Mental Health Services / Q000458:organization & administration*; D019955:Conduct Disorder / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D017146:Models, Organizational; D020380:Needs Assessment; D009517:New South Wales; D016487:Parenting; D010290:Parents / Q000193:education / Q000523:psychology; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D011446:Prospective Studies; D002666:Psychology, Child; D012017:Referral and Consultation; D018570:Risk Assessment; D012307:Risk Factors; D019035:Rural Health Services / Q000458:organization & administration*; D012657:Self-Help Groups / Q000458:organization & administration; D012951:Socialization; D011795:Surveys and Questionnaires