Parenting for Lifelong Health for Parents and Teens

PLH for Parents and Teens (PLH for Teens) is a parent training programme for caregivers and their 10- to 17-year-olds. The programme seeks to establish nurturing caregiver-teen relationships and reduce the risk of violence against teens in and outside the home. It also aims to strengthen the ability of caregivers to provide a protective environment and ensures the health and well-being of their child through positive parenting techniques. Parents are taught alternative parenting strategies to reduce adolescent problem behaviours and avoid harsh disciplining techniques at home.

The programme has been or is currently being implemented in several countries, including Botswana, Cameroon, Côte d’Ivoire, Democratic Republic of Congo, Eswatini, Ethiopia, Haiti, India, Kenya, Lesotho, Malawi, Philippines, South Africa, South Sudan, Tanzania, Uganda, Zambia, and Zimbabwe.

The programme is in low-resource settings delivered by community-based workers in a group-based format with both joint parent and teen sessions (10 sessions) and separate parent and teen sessions (4 sessions). Weekly sessions introduce families to core relationship building and violence prevention skills. Delivery utilises a participatory learning approach, with activity-based learning, role-plays and home practice to strengthen skills. It actively engages caregivers and teens on improving parent-teen relationships and communication through group discussions, illustrated vignettes of parent-child interaction, role-plays to practice parenting skills, home activities assignments, and collective problem-solving. These skills include:

• establishing quality time for parents and adolescents
• specific and immediate praise
• dealing with stress and anger
• establishing rules and responsibilities
• responding to crises

The programme also includes modules around budgeting, risk identification, and conflict management. Home visit consultations and a peer support component are also incorporated into the programme.

Since 2012, PLH for Teens has been through a series of evaluations in the Eastern Cape of South Africa to determine its effectiveness. These included a small pre-post pilot with 60 parents and teens in 2012, a larger pre-post pilot with 230 parents in teens in 2014, and a large cluster randomised controlled trial that included 40 villages and urban settlements, with 1,100 parents and teens, in 2015 and 2016. These evaluations have been led by academics at the University of Oxford and the University of Cape Town in partnership with UNICEF South Africa, WHO, the South African Government and local NGOs.

The study found long-term intervention effects for reduced abuse and corporal punishment, improved positive parenting, involvement, and monitoring. Effects on secondary outcomes included reductions in adult and child substance use, parental stress and depression, parental endorsement of corporal punishment, and financial stress. Cost-effectiveness analyses also showed that the intervention had a £588 cost per case of abuse prevented, and a total of cost savings of £2,146 per case of abuse (excluding potential costs for foster care, court, and prolonged child protection management).

An adapted 9-session version of PLH for Teens has recently been piloted in the Philippines for low-income families who were part of a government-run conditional cash transfer programme. There are also prototype versions of the programme with enhanced content for HIV-prevention and sexual violence risk reduction.

PLH is also developing an app-based version of PLH for Teens which should be available for public use in 2021.

The original studies of PLH for Teens in South Africa were supported by the European Research Council (ERC) under the European Union’s Seventh Framework Programme (FP7/2007-2013) with ERC grant agreement 313421, UNICEF Innocenti Office of Research, UNICEF South Africa, the John Fell Fund, the Leverhulme Trust (PLP-2014-095), and the University of Oxford’s ESRC Impact Acceleration Account (1311-KEA-004 and 1602-KEA-189), the World Health Organization and the Canadian International Development Agency Capacity Building Technical Assistance Fund. Ongoing research is supported by the ERC under the European Union’s Horizon 2020 research and innovation programme (Grant Agreement No. 737476 and No.771468), Research England, UKRI GCRF Accelerating Achievement for Africa's Adolescents Hub (Grant Ref: ES/S008101/1), and the National Research Foundation of South Africa (Grant No.: 118571). Partners included Clowns Without Borders South Africa, the South African National Department of Social Development, the South African National Association of Child Care Workers and the Keiskamma Trust. The opinions expressed are those of the authors, and not of the funders or partners.

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