title: Enhancing the early home learning environment through a brief group parenting intervention: study protocol for a cluster randomised controlled trial.
abstract: The quality of the home learning environment has a significant influence on children's language and communication skills during the early years with children from disadvantaged families disproportionately affected. This paper describes the protocol and participant baseline characteristics of a community-based effectiveness study. It evaluates the effects of 'smalltalk', a brief group parenting intervention (with or without home coaching) on the quality of the early childhood home learning environment.
  
  
  
  The study comprises two cluster randomised controlled superiority trials (one for infants and one for toddlers) designed and conducted in parallel. In 20 local government areas (LGAs) in Victoria, Australia, six locations (clusters) were randomised to one of three conditions: standard care (control); smalltalk group-only program; or smalltalk plus (group program plus home coaching). Programs were delivered to parents experiencing socioeconomic disadvantage through two existing age-based services, the maternal and child health service (infant program, ages 6-12 months), and facilitated playgroups (toddler program, ages 12-36 months). Outcomes were assessed by parent report and direct observation at baseline (0 weeks), post-intervention (12 weeks) and follow-up (32 weeks). Primary outcomes were parent verbal responsivity and home activities with child at 32 weeks. Secondary outcomes included parenting confidence, parent wellbeing and children's communication, socio-emotional and general development skills. Analyses will use intention-to-treat random effects ("multilevel") models to account for clustering.
  
  
  
  Across the 20 LGAs, 986 parents of infants and 1200 parents of toddlers enrolled and completed baseline measures. Eighty four percent of families demonstrated one or more of the targeted risk factors for poor child development (low income; receives government benefits; single, socially isolated or young parent; culturally or linguistically diverse background).
  
  
  
  This study will provide unique data on the effectiveness of a brief group parenting intervention for enhancing the early home learning environment of young children from disadvantaged families. It will also provide evidence of the extent to which additional one-on-one support is required to achieve change and whether there are greater benefits when delivered in the 1st year of life or later. The program has been designed for scale-up across existing early childhood services if proven effective.
  
  
  
  8 September 2011; ACTRN12611000965909 .
authors.affiliation: Parenting Research Centre, Melbourne, Australia. j.nicholson@latrobe.edu.au.|Judith Lumley Centre, La Trobe University, 215 Franklin St, Melbourne, 3000, VIC, Australia. j.nicholson@latrobe.edu.au.|Murdoch Childrens Research Institute, Melbourne, Australia. j.nicholson@latrobe.edu.au.|School of Early Childhood, Queensland University of Technology, Brisbane, Australia. j.nicholson@latrobe.edu.au.
authors.forename: Jan M
authors.initials: JM
authors.lastname: Nicholson
authors.affiliation: Parenting Research Centre, Melbourne, Australia.
authors.forename: Warren
authors.initials: W
authors.lastname: Cann
authors.affiliation: Parenting Research Centre, Melbourne, Australia.
authors.forename: Jan
authors.initials: J
authors.lastname: Matthews
authors.affiliation: School of Early Childhood, Queensland University of Technology, Brisbane, Australia.
authors.forename: Donna
authors.initials: D
authors.lastname: Berthelsen
authors.affiliation: NIHR CLARHC South West Peninsula (PenCLAHRC), University of Exeter, Exeter, UK.
authors.forename: Obioha C
authors.initials: OC
authors.lastname: Ukoumunne
authors.affiliation: Parenting Research Centre, Melbourne, Australia.
authors.forename: Misel
authors.initials: M
authors.lastname: Trajanovska
authors.affiliation: Parenting Research Centre, Melbourne, Australia.|Judith Lumley Centre, La Trobe University, 215 Franklin St, Melbourne, 3000, VIC, Australia.|Murdoch Childrens Research Institute, Melbourne, Australia.|Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
authors.forename: Shannon K
authors.initials: SK
authors.lastname: Bennetts
authors.affiliation: The Fred Hollows Foundation, Melbourne, Australia.
authors.forename: Tessa
authors.initials: T
authors.lastname: Hillgrove
authors.affiliation: Parenting Research Centre, Melbourne, Australia.
authors.forename: Victoria
authors.initials: V
authors.lastname: Hamilton
authors.affiliation: Parenting Research Centre, Melbourne, Australia.|Judith Lumley Centre, La Trobe University, 215 Franklin St, Melbourne, 3000, VIC, Australia.|Murdoch Childrens Research Institute, Melbourne, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Westrupp
authors.affiliation: Parenting Research Centre, Melbourne, Australia.|Judith Lumley Centre, La Trobe University, 215 Franklin St, Melbourne, 3000, VIC, Australia.|Murdoch Childrens Research Institute, Melbourne, Australia.
authors.forename: Naomi J
authors.initials: NJ
authors.lastname: Hackworth
mesh_terms: D001315:Australia; D002657:Child Development; D002675:Child, Preschool; D002985:Clinical Protocols; D018479:Early Intervention, Educational / Q000379:methods*; D004505:Education, Nonprofessional / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D057194:Intention to Treat Analysis; D007858:Learning; D008297:Male; D016487:Parenting; D011203:Poverty; D012931:Social Environment
keywords: Cluster randomised controlled trial; Early childhood; Home coaching; Home learning environment; Parenting group intervention; Playgroups; Socioeconomic disadvantage