Evaluating the Transportability of a Violence-Prevention Parenting Intervention in Challenging Contexts: Positive Discipline in Everyday Parenting in the Occupied Palestinian Territories and the Sendai Region of Japan

Background and Purpose: Physical and emotional punishment are the most pervasive forms of violence against children globally. Punitive violence is even more prevalent in regions characterized by conflict, natural disasters and resource insecurity, where stress overwhelms parents’ attempts to survive and recover. Strategies for ending punitive violence against children include evidence-based parenting interventions. However, the majority of these interventions have been designed and evaluated in Western and high-income contexts. There remains a dearth of knowledge about the transportability and effectiveness of such approaches in low- and middle-income countries, including under-resourced and fragile contexts. The purposes of this study were to: (1) describe the Positive Discipline in Everyday Parenting (PDEP) program, an intervention based on universal human rights standards and designed to reduce parents’ acceptance of physical and emotional punishment; (2) assess the transportability of PDEP to the occupied Palestinian territories, a context besieged by decades of war, and Sendai, Japan, a region recovering from a massive natural disaster; and (3) examine the relevance and effectiveness of PDEP in these two contexts.

Methods: The Dynamic Adaptation Process framework was used to assess the phases (Exploration, Preparation, Implementation, Sustainment) involved in transporting PDEP. Trained PDEP Facilitators delivered the program to 290 parents in Palestine and 192 parents in Japan. Parents were recruited from local community centres, schools, and family-serving social service agencies, and places of worship (Palestine). All parents completed a version of the Positive Discipline Pre & Post Program Questionnaires for Parents (Durrant et al., 2014). In Palestine, parents completed the simplified version of the measures including the Satisfaction subscale (α = .78); and the Attitudes toward Physical and Non-physical Punishment subscale (α = .55). In Japan, the parents completed the standard version of the measures including Satisfaction subscale (α = .80), the Attitudes towards Physical Punishment subscale (APP; α = .82) and the Attitudes towards Non-physical Punishment subscale (ANPP; α = .78).

Results: In both regions, PDEP was found to be transportable, highly relevant and effective. Relatively few program adaptations and cultural considerations were required before implementation, although outbreak of war and other political challenges influenced implementation. Nearly 100% and 90% of parents in Palestine and Japan, respectively, perceived PDEP to be relevant to the context. Similarly, parents’ support for physical and non-physical forms of punishment decreased from pre- to post-program (p < .001) in both regions.

Conclusions and Implications: PDEP is a highly transportable intervention strategy for preventing punitive violence against children in challenging contexts characterized by high stress where few parenting resources exist. The findings suggest that PDEP may be relevant and effective in other contexts characterized by violence and disaster and among diverse populations. Future research should examine the implementation of PDEP in different contexts with a high prevalence of punitive violence and few resources.