title: Impact of a parenting program in a high-risk, multi-ethnic community: the PALS trial.
abstract: BACKGROUND
  Parenting programs have been shown to work when delivered to motivated ethnic majority parents in demonstration projects, but comparatively little is known about their impact when delivered to high-risk, multi-ethnic populations by routine local services.
  
  
  METHODS
  The Primary Age Learning Skills (PALS) trial was a randomized controlled trial of an evidence-based parenting-group program that targeted the parent-child relationship and child literacy. Parents of 174 children were selected from a population of 672 5- and 6-year-olds attending four primary schools in a high-risk, ethnically diverse, inner-city area. Eighty-eight children were allocated to the Incredible Years preventive program plus a shortened six-week version of the SPOKES literacy program, delivered by local services; 86 to usual community services; 152/174 (87%) of families were successfully followed up. Parent-child relationship quality and child behavior were measured using direct observation and parent interview; child reading was assessed psychometrically.
  
  
  RESULTS
  Two-thirds (58/89) of those offered the parenting program attended at least one session, with similar enrollment rates across the Black African, African-Caribbean, White-British and Other ethnic groups. Mean attendance was four relationship-building sessions and one literacy-development session. Satisfaction questionnaires were completed by 43/58 starters; 93% said they were well or extremely satisfied, with equally high rates across ethnic groups. At follow-up after one year, those allocated to the intervention showed significant improvements in the parent-child relationship on observation and at interview compared to controls; effects were similar across all ethnic groups. However, child behavior problems and reading did not improve. The cost was £1,343 ($2,100) per child.
  
  
  CONCLUSIONS
  Programs can be organized to be engaging and effective in improving parenting among high-risk, multi-ethnic communities, which is of considerable value. To also be cost-effective in achieving child changes may require a set-up that enables parents to attend more sessions and/or an exclusive focus on children with clinically significant behavior problems.
authors.affiliation: King's College London, Institute of Psychiatry, London, UK. stephen.scott@iop.kcl.ac.uk
authors.forename: Stephen
authors.initials: S
authors.lastname: Scott
authors.forename: Thomas G
authors.initials: TG
authors.lastname: O'Connor
authors.forename: Annabel
authors.initials: A
authors.lastname: Futh
authors.forename: Carla
authors.initials: C
authors.lastname: Matias
authors.forename: Jenny
authors.initials: J
authors.lastname: Price
authors.forename: Moira
authors.initials: M
authors.lastname: Doolan
mesh_terms: D000328:Adult; D002648:Child; D002652:Child Behavior / Q000208:ethnology / Q000523:psychology*; D002653:Child Behavior Disorders / Q000523:psychology / Q000628:therapy*; D002675:Child, Preschool; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010287:Parent-Child Relations / Q000208:ethnology; D016487:Parenting / Q000208:ethnology / Q000523:psychology*; D010290:Parents / Q000193:education*; D011594:Psychometrics; D011932:Reading; D012111:Residence Characteristics; D012931:Social Environment