The Home-Start program is a home visiting intervention in which volunteers with child care experience give support to struggling families with children younger than five years of age. Home-Start targets families and mothers with little experience or social support network, who may have minor but not serious physical or mental health issues. Entry and exit to the Home-Start programme is entirely voluntary and all visits are at the convenience of participating families. It aims to reduce the stress of parenting and encourage families, especially families at risk for child abuse and neglect, so that a nurturing environment for their children may be created.
A Home-Start volunteer from the local community visits the family home for a few hours each week until the youngest child turns five or the family decides to exit from the program. On average, volunteers visit families for 6 months, and visits last for around 3-4 hours. The volunteers give emotional support and assistance with household tasks and outings as needed by each family. The volunteers provide friendship, encouragement, and an example of affectionate child care behaviour.
The program was founded in 1973 in the UK and has expanded into 22 countries around the world, including the Czech Republic, Denmark, Norway, Hungary, and The Netherlands. There are 314 local schemes of Home-Start UK located in the United Kingdom and in British Forces Germany and Cyprus.
The Triple P—Positive Parenting Programme is a multilevel system of family intervention that aims to prevent severe emotional and behavioral disturbances in children by promoting positive and nurturing relationships between parent and child. According to the Triple P developers, apart from improving parenting skills, "the programme aims to increase parents' sense of competence in their parenting abilities, improve couples' communication about parenting, and reduce parenting stress. The acquisition of specific parenting competencies results in improved family communication and reduced conflict that in turn reduces the risk that children will develop a variety of behavioral and emotional problems" (Sanders, Turner, et al., 2002).
The programme has five intervention levels of increasing intensity and targeting, ranging from a community-wide media information campaign designed to reach all parents to an intervention for families identified as being at risk for child maltreatment. The programme aims to engage the participating parent in the minimally sufficient intervention required in order to identify and improve parenting skills (Sanders, 1999).
This summary focuses on “Level 4” of the five levels, because this is the only level that has been evaluated in studies that meet the evidence criteria for inclusion on this site. Level 4 can be delivered as a 10 session individual training programme or an 8 session group training programme focusing on teaching parents a range of parenting skills to target behavioral problems both in and outside the home.
A Stop Smoking in School Trial (ASSIST) is an intervention aimed at spreading and sustaining non-smoking behaviours through school social networks that targets children in grade 8 (12-13 years old). The phases of the intervention include: 1) nomination of peer supporters, 2) recruitment of peer supporters,3) training of peer supporters, 4) intervention period, and 5) acknowledgement of peer supporters’ contributions. Potential peer supporters are first identified as students who received the most nominations on a questionnaire in which students identify influential peers. The 2-day training is conducted outside of school and focuses on teaching peer supporters how to have informal conversations with their peers about smoking. During the 10-week intervention period, peer supporters undertake informal conversations with other students about smoking and log their conversations. During the intervention, trainers provide additional support through four in-school visits. ASSIST was first pilot tested in 1996 in six schools in South Wales. Early Adopters started rolling out the programme in 2007 and in 2010, DECIPHer Impact Ltd, a non-profit spinout company was set up by the University of Bristol and Cardiff University to distribute ASSIST more widely. It is currently being implemented in 27 Local Authority areas across the United Kingdom including the whole of Wales, England and the Channel Islands. Scotland has recently announced that they are going to be setting up a pilot of ASSIST starting in 2014.
The Community Mothers’ Programme was first started in 1988 in Dublin by the Health Service Executive, a public organization responsible for the provision of healthcare and personal social services for everyone living in Ireland.
The programme targets first-time parents living in disadvantaged areas and is aimed at providing support and encouragement to first-time parents through home visits from “community mothers”.
It focuses on promoting parent capacity and parent empowerment, specifically by developing of parenting skills and enhancing parents’ self-esteem. Some of the methods used include the promotion of parents’ potential through a behavioural approach in which parents are encouraged to stimulate, breast-feed, and praise their children, as well as ensure their safety. The Community Mothers Programme also uses illustrated sequences to trigger discussions on healthy and developmentally appropriate means of coping with various child-rearing challenges.
Community mothers are volunteers who were first identified by local public health nurses. They are then interviewed by a regional family development nurse to assess their suitability. After being identified as suitable candidates, community mothers undergo four weeks of training before starting to work under the guidance of a family development nurse. This training focuses on health care, nutritional improvement and overall child development. The work of community mothers consists in monitoring between five and fifteen families during monthly home visits during the first year of the child’s life (Johnson, Z., Howell, F., and Molloy, B., 1993).
The European Drug Abuse Prevention Trial (EU-Dap) is an experimental evaluation of a school-based drug abuse prevention programme conducted in seven EU countries (Austria, Belgium, Germany, Greece, Italy, Spain, and Sweden).
The programme, Unplugged, uses a comprehensive social-influence approach to reduce use of alcohol, tobacco, and illegal drugs among 12-14 year old students. In the literature, this approach has been repeatedly shown to “reduce onset of use or significantly reduce cigarette, alcohol, and marijuana consumption” among young people (Sussman 2004). Specifically, the Unplugged programme consists of 12 one-hour units taught by classroom teachers who have previously received a 2.5 day training course on the programme material.
The Incredible Years programme consists of twelve weeks of 2-2.5 hour parenting sessions designed to teach parents how to recognize and treat their child’s emotional and behavioural problems through positive parenting. This programme can be used for parents of both pre-school and school-aged children who already have or are at risk of developing conduct problems (including antisocial behaviour, frequent anger, and a propensity towards violence).
The KiVa programme is a school-wide approach to decreasing the incidence and negative effects of bullying on student well-being at school. The programme’s impact is measured through self and peer-rated reports of bullying, victimization, defending victims, feeling empathy towards victims, bystanders reinforcing bullying behaviour, anxiety, self-esteem, depression, liking school, and academic motivation and performance, among other factors. The programme is based on the idea that how peer bystanders behave when witnessing bullying plays a critical role in perpetuating or ending the incident. As a result, the intervention is designed to modify peer attitudes, perceptions, and understanding of bullying. The programme specifically encourages students to support victimised peers rather than embolden bullying behaviour and, furthermore, provides teachers and parents with information about how to prevent and address the incidence of bullying.
The North Karelia Youth Project offered a community and school-based educational intervention for seventh graders (students aged 13) to decrease the social desirability of smoking and coach them to resist peer, adult, and media pressure to smoke. The goal of the program was to decrease the number of children who would start smoking for the first time and reduce all the lifetime exposure to tobacco for all children in the program area. Two versions of the intervention were each implemented at an urban and a rural school in North Karelia County in Finland.
In the first version of the intervention, peer leaders from the eighth and ninth grades (students aged 14 and 15) and program staff delivered 10 sessions of the program. In the second version, teachers were trained and instructed to deliver 5 sessions of the program. The program included information about a nutritionally healthy diet and the health hazards of smoking as well as demonstration and role-playing to handle social pressure to smoke. During the time of the school intervention, a community intervention for adults was taking place through mass media channels and community organizations.
A second North Karelia Youth Project involving smoking, alcohol abuse, exercise and nutrition was implemented subsequently, and a description of that program can be found in the user registry.
Sweden has implemented several reforms to their parental leave policy, with the aim of increasing the sharing of parental leave among mothers and fathers. Since 1974, Swedish parents have been able to take up to six months of paid leave after the birth of a child under the country’s parental leave insurance. The pay was equivalent to 90-percent of the parent’s earnings or was set at a flat rate if the parent had no prior earnings. Initially, parents could share this leave time as they preferred (i.e., one parent could take six months leave, both parents could take three months leave, or some other combination adding up to six months). By the 1990s, the allotted time had been extended to twelve months paid leave based on earnings and an additional three months paid at a flat rate. From the mid-nineties through 2008, Sweden enacted several additional reforms to parental leave insurance aimed at encouraging more gender equality in leave time among fathers and mothers. In 1995, one month of leave was reserved for each parent (i.e., if a given parent chose not to use his or her month of leave, that month was forfeited and the other parent could take only eleven months of leave). In 2002, this reserved leave was extended to two months per parent. Also in 2002, however, the full amount of leave time was increased to sixteen months (thirteen months at the earnings-related rate plus three months at a flat rate). This implied that although an additional month was reserved for each parent, the other parent could still take up to fourteen months of leave (Duvander and Johansson, 2010).
This National Department of Health screening program in the Netherlands applied a diagnostic questionnaire (the VroegTijdige Onderkenning Ontwikkelingsstoornissen Language Screening instrument; VTO) for language delays to parents and their toddlers aged 15-18 months and again at 24 months. Children with positive screening indications were sent to speech and hearing centres for further assessment. The speech and hearing centres then referred children to standard early treatment services as necessary. 55 child health centres in six geographic regions participated. The child health centres provide free services from the Department of Health and are available to all Dutch children.
The Smokefree Class Competition program began in Finland in 1989 and has been initiated in 22 European countries between 1997 and 2008. The program gives classes of pupils aged 11-14 years old the choice to become a ‘nonsmoking class’ for six months, in return for being entered in a lottery to win a class trip if at least 90% of the class remains smoke-free in each month of the competition period. The students monitor and report their own participation on a weekly basis. In some of the countries they also receive health education lessons about the effects of smoking. The rules and prizes of the competition vary slightly by country but are generally similar. The intervention is intended to reduce the number of adolescents who currently smoke or will ever smoke and delay the age at which adolescents become smokers by applying positive reinforcement to nonsmoking, making nonsmoking a popular behavior and adjusting social norms within peer groups.
Aktion Glasklar is an intervention program to combat youth drinking in Germany. It was first implemented in the state of Schleswig-Holstein in early 2006 and has since been continued under the leadership of Deutsche Angestellten Krankenkasse (DAK) all throughout Germany. The focus of the program is to interact with students and to actively deter them from consuming alcohol at a young age.
The Early Years program is an integrated daycare facility that delivers flexible daycare services for children younger than 5 years of age, the age at which they can enroll in school. The intervention aimed to facilitate an increase in family earnings by supporting child daycare services for families. The program did not have a set curriculum, but emphasized the incorporation of qualified teachers and a formal education component into the services.
The gesunde KITAs – starke Kinder, or Healthy Nursery Centers - Strong Children program’s goal is to fight the childhood obesity epidemic in Germany by prevention, particularly among pre-school children. In order to do so, the program teaches children a mix of balanced nutrition, movement, and relaxation, and also fosters an ongoing health dialogue with parents. As opposed to previous anti-obesity programs, Healthy Nurseries puts a strong emphasis on ex-ante prevention and teaching of a healthy way of living, by connecting and integrating the four project components outlined above. After an initial introductory phase of 12-15 months, the components become part of the center’s daily routine. Final implementation is at the discretion of the program staff at a particular site.
La Mallette des parents' [the parents' briefcase] is an ongoing project that aims to involve parents more in their children's education in around 80 schools in France. It is run by the Academie de Creteil, which comes under the direct authority of the France's Ministry for Education. The programme was set up to improve relations between parents and teachers and to help parents understand more about how their child is taught so that they can contribute to their child's success at school.
Programa Juego (Play Program) for preschool children is a cooperative-creative play program designed to support creative thinking in children 4 to 6 years old. The program consists of a once-weekly 75-minute play session which is directed by the children’s regular teacher. During the session, the teacher promotes creative thinking, cooperation among children, and the importance of experimentation. The 24-session program is manualized with defined games, instructions for the teacher, and suggested questions to promote debate after the games conclude. There are a total of four Play programs, additionally including the Play program for children 6-8 years, 8-10 years, and 10-12 years, however only the preschool program is described here. The program has been in operation since 1992 in various regions of Spain.
In March of 2006, Scotland introduced legislation that prohibited smoking in most enclosed public places. Enclosed public places are those that are more than 50% covered, including for example bars, restaurants, offices and sports stadiums. Businesses covered by the smoking ban were required to have a smoke-free policy and to display a non-smoking sign at the building’s entrance. The effects of this ban on smoking in public places on schildren’s secondhand smoke expoure were evaluated in two longitudinal studies. Study authors examined whether children’s secondhand smoke exposure decreased subsequent to the legislation. They also examined whether the ban was associated with a displacement of smoking from public places into the home, an effect which would have deleterious consequences for children’s secondhand smoke exposure. Authors found a reduction in secondhand smoke exposure and did not find a concomitant increase in smoking in the home.
This smoking cessation program was available to pregnant women smokers in two provinces of the Netherlands. Midwives from 21 midwife practices were trained on how to approach the subject of smoking and smoking cessation with their clients and supplied with a brief manual and intervention card explaining the seven-step protocol for effective counseling. The seven-step protocol includes identifying smoking behavior in the client and her partner, providing information on the short-term advantages of not smoking, discussing barriers to quitting, goal setting, providing self-help materials, agreeing on aftercare, and then following up at 8 months gestation. Midwives in the intervention gave pregnant women smokers a video, a self-help manual and a booklet for their partner about non-smoking and health counseling, in addition to a general folder from the Dutch Smoking and Health Foundation which is available online to all Dutch women beginning a pregnancy. All intervention materials were delivered upon the pregnant smoker’s first visit to her midwife.
The Social Influence Decision-Making (SI-DM) smoking prevention program was based upon the idea that attitudes, social influences and belief in one’s ability to abstain from smoking predict the intention to smoke, and ultimately smoking itself. The program aimed to educate adolescents and build skills in order to promote healthy attitudes and beliefs related to smoking.
The Social Influence Plus Boosters (SI+) smoking prevention program was based upon the idea that attitudes, social influences and belief in one’s ability to abstain from smoking predict the intention to smoke, and ultimately smoking itself. The program aimed to educate adolescents and build skills in order to promote healthy attitudes and beliefs related to smoking.
The Social Influence (SI) smoking prevention program was based upon the idea that attitudes, social influences and belief in one’s ability to abstain from smoking predict the intention to smoke, and ultimately smoking itself. The program aimed to educate adolescents and build skills in order to promote healthy attitudes and beliefs related to smoking.