Implementing a Large-Scale Program of Parenting Prevention Research in Chile: Co-Design and Co-Adaptation

Background and Purpose: Child exposure to punitive parenting, maltreatment and neglect constitutes a significant public health problem throughout Latin American. Although evidence-based parent training (PT) interventions constitute a key alternative to prevent child maltreatment and neglect, multiple implementation barriers have prevented the large-scale dissemination of evidence-based PT interventions across Latin America. Social work researchers and scholars can offer key contributions to address this type of global mental health challenges. In this presentation, we will describe the sequential co-design and co-adaptation processes that have been followed to disseminate the evidence-based PT intervention known as GenerationPMTO in Chile.

Methods: Principles of equity implementation, as well as Bernal et al.'s Ecological Validity Model (EVM) have been implemented over the span of four years to co-design and co-adapt the GenerationPMTO intervention for the Chilean context. A strong community-based participatory research approach has informed all phases of research. The initial step consisted of the cultural adaptation of GenerationPMTO, led by cultural adaptation experts, as well as Chilean leaders and linguistic experts. The second step consisted of evaluating the cultural satisfaction with the adapted intervention in a pilot study with 24 Chilean caregivers. The third step consisted of the implementation of a rigorous pre-post quasi-experimental design with 281 Chilean caregivers to examine the initial impact of the adapted intervention on quality of parenting practices and child mental health. Currently, an implementation science project is being developed for the large-scale implementation of adapted GenerationPMTO across Chile.

Results: According to qualitative reports provided by 24 Chilean caregivers who successfully completed the culturally adapted parenting intervention, the intervention was perceived by caregivers as contextually and culturally relevant. Results from the quasi-experimental study with 281 caregivers, indicated that when compared to baseline measurements, significant improvements at intervention completion were observed. Specifically, the effect sizes for parenting outcomes were in the small to medium range (η² = .02 to η² = .08), with family adaptability and problem-solving presenting medium to large effect sizes (η² = .12 to η² = .15). The intervention's impact on children's mental health was noticeable, with medium to large effect sizes identified for both internalizing (e.g., anxiety) and externalizing behaviors (e.g., defiant behaviors) (η² = .07 to η² = .28).

Conclusions and Implications: Social work researchers and scholars can offer meaningful contributions to address global mental health challenges. This study provides promising initial empirical evidence that efficacious PT interventions developed in the US can be transported to Latin American contexts, as long as they are thoroughly adapted to achieve high contextual and cultural relevance.