title: A Pilot Study of a 6-Week Parenting Program for Mothers of Pre-school Children Attending Family Health Centers in Karachi, Pakistan.
abstract: BACKGROUND
  Recently, parenting programs to address behavioural and emotional problems associated with child maltreatment in developing countries have received much attention. There is a paucity of literature on effective parent education interventions in the local context of Pakistan. This study aimed to assess the feasibility of offering a 6-week parenting program for mothers of pre-school children attending family health centres (FHCs) in Karachi, the largest metropolitan city of Pakistan.
  
  
  METHODS
  A pilot quasi-experimental trial was conducted. Two FHCs were selected, one as the intervention and the second as the control. A total of 57 mothers of pre-school children (n = 30 intervention; n = 27 control) participated in this study. Mothers in the intervention group received SOS Help for parents module, while mothers in the control group received information about routine childcare. A parenting scale (PS) was administered before the program was implemented and repeated 2 weeks after the program was completed in both groups. Statistical analysis was performed to compare participants' attributes. Descriptive analysis was conducted to compare pre- and post-test mean scores along with standard deviation for parenting subscales in the intervention and control groups.
  
  
  RESULTS
  A total of 50 mothers (n = 25 intervention; n = 25 control) completed the 6-week program. Attrition was observed as 5/30 (17%) in the intervention arm and 2/27 (2%) in the control arm. Mothers commonly reported the burden of daily domestic and social responsibilities as the main reason for dropping out. Furthermore, the majority of participants in the control group recommended increasing the duration of weekly sessions from 1 to 1.5 hours, thereby decreasing the program period from 6 to 4 weeks. Mothers in intervention group reported substantial improvement in parenting skills as indicated by mean difference in their pre- and post-test scores for laxness and over-reactivity.
  
  
  CONCLUSIONS
  Parenting programs can be implemented for mothers attending FHCs in Pakistan. Mothers require positive reinforcement and constant encouragement at the participant level. Integrating such programs into primary healthcare at the population level has the potential to maximize child health benefits and to improve parenting skills at the country level.
authors.affiliation: School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Khowaja
authors.affiliation: School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan.|Community Health Sciences Department, Aga Khan University, Karachi, Pakistan.
authors.forename: Rozina
authors.initials: R
authors.lastname: Karmaliani
authors.affiliation: School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan.
authors.forename: Shela
authors.initials: S
authors.lastname: Hirani
authors.affiliation: Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
authors.forename: Asif Raza
authors.initials: AR
authors.lastname: Khowaja
authors.affiliation: Community Health Sciences Department, Aga Khan University, Karachi, Pakistan.
authors.forename: Ghazala
authors.initials: G
authors.lastname: Rafique
authors.affiliation: Health Promotion and Disease Prevention, Texas Woman's University, Houston, TX, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: McFarlane
mesh_terms: D000328:Adult; D002657:Child Development; D002675:Child, Preschool; D003151:Community Health Centers; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000193:education* / Q000523:psychology; D010154:Pakistan; D016487:Parenting / Q000523:psychology*; D010865:Pilot Projects
keywords: Child Abuse; Child Maltreatment; Education for Mothers; Parenting Program