Childhood adversities are prevalent around the world. Within Europe, Eastern European countries appear to be more vulnerable for these experiences to occur, with physical abuse, domestic violence towards the mother, and emotional neglect as the most common reported adversities in these low- and middle income countries (LMIC)1. Their impact on mental health may be pervasive, and there is a clear association between these adversities and substance use, suicidality as well as an increased risk for unemployment or a lower labor force in later adulthood1,2. The significance of adverse experiences for the development of mental health problems in children indicates a strong need to identify, implement, and disseminate evidence-based interventions to support children raised in the context of adversity.

Early intervention programs have been evaluated extensively in high-income countries and represent an efficacious and cost-effective approach to addressing key risk factors for chronic mental health problems. Nevertheless, these types of interventions are almost non-existent in LMIC. Parenting for Lifelong Health (PLH) is one of the first programs to extend early intervention parenting programs to prevent adverse childhood experiences in LMIC3.

The aim of the RISE project is to implement cost-effective parenting interventions for the prevention of child mental health problems in LMICs in Eastern Europe. Therefore, the following specific objectives will be addressed:

1. Adapt and implement a low-cost parenting program PLH in three LMICs without existing efficacious parenting interventions: Romania, Macedonia, and Moldova
2. Develop a text-based adjunct program to increase outreach in underserved areas and among families with cultural, economic, or structural barriers to care.
3. Optimize the Parenting for Lifelong Health program within the three countries by determining which components are efficacious and cost-effective.
4. Test the optimized PLH programs in three RCTS in the countries.
5. Determine the economic impacts of the PLH program and the potential costs of future dissemination and scaling up.
6. Systematically evaluate key barriers and facilitators at the local, national and international levels that impact prevention of child behavioral disorders.
7. Identify and address socioeconomic and contextual factors of relevance to each targeted region and community.
8. Develop strategies to embed PLH into practice and policy and to sustain the intervention after the end of the project by including local authorities, policy makers, and other stakeholders such as community groups and caregivers in the intervention from each country.

RISE Study Profile General (download link)

Footnotes:

1. Bellis, M. A., Hughes, K., Leckenby, N., Jones, L., Baban, A., Kachaeva, M., … & Raleva, M. (2014). Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries. Bulletin of the World Health Organization, 92(9), 641-655.
2. Clark, C., Smuk, M., Lain, D., Stansfeld, S. A., Carr, E., Head, J., & Vickerstaff, S. (2017). Impact of childhood and adulthood psychological health on labour force participation and exit in later life. Psychological Medicine, 1, 1-12.
3. Ward, C. L., Mikton, C., Cluver, L., Cooper, P., Gardner, F., Hutchings, J., . . . Wessels, I. M. (2014). Parenting for Lifelong Health: From South Africa to other low-and middle-income countries. Early Childhood Matters: Responsive Parenting: A Strategy to Prevent Violence, 49.