Pathways to Parenting Stress Reduction: Impact of the Parenting for Lifelong Health Program on Parents and Adolescents in South Africa

Background and purpose: Parenting stress has a range of effects on parents and their children. Higher levels of parenting stress are associated with negative outcomes among children, negative parental practices and increased risk for child maltreatment. Due to the physical, emotional and social changes experienced by adolescents, parenting stress may be particularly salient when the children reach adolescence, especially in high-risk communities.

The findings of a randomized controlled trial conducted in South-Africa have shown that the Parenting for Lifelong Health (PLH) program for the parents of teens (Sinonuyo Teen PLH) was effective at reducing parenting stress among the parents\caregivers of adolescents (aged 12-18) in low and middle-income countries. Employing an ecological perspective, the current study investigated a mechanism of parenting stress reduction through potential mediators at the levels of the child (parent-child relationship), the parent (parental depression) and the social context (family poverty).

Methods: A pragmatic cluster randomized controlled trial was conducted among a total sample of 552 families (dyads for parents\caregivers M = 49.37; SD = 14.69 and adolescents M = 13.84; SD = 2.38) who were recruited from 40 communities (located in 34 rural villages and three large peri-urban townships) located in South Africa’s Eastern Cape province. A PROCESS statistical analysis was performed using was conducted to investigate direct and indirect effects (mediation analyses).

Results: The findings of the study show that parenting stress reduction operates via three significant mediators: improved parent-child relationship (ß = .546, P < .001), reduced parental depression (ß = .893, P <. 001), and reduced family poverty (ß = .438, P < .001).

Conclusions and implications:

To the best of our knowledge, the current study is among the first to investigate the effectiveness of family-based intervention in reducing parenting stress within LMICs through potential mediation pathways at the levels of the child, the parent and the social context.

The results of the study show that factors at the levels of the child (parent-child relationship), the parent (parental depression) and the social-context (family poverty) serve as mediators between PLH intervention effect and parenting stress reduction.

This study provides valuable insight for evidence-based practices that target negative parenting outcomes among vulnerable families in low and middle-income settings. These results will be especially applicable to families with adolescent age children in vulnerable communities. Based on a social-ecological perspective, the findings of the study highlight the importance of considering adolescent, parental and contextual factors in the design and development of interventions to reduce parenting stress in highly vulnerable families, particularly those with adolescent children, one of the most challenging developmental stages that parents face. The findings are of high importance for social workers and practitioners who work with vulnerable communities.