1. Parenting Education for Parents of Young Children
Dr Shirley Leung SL
MB,BS(HK); MPH(Auckland); FHKAM(Paed); FRCP(Glasg)
Principal Medical & Health Officer
Family Health Service
Department of Health

2. Parenting Programme in Maternal & Child Health Centres
Aim:
To equip parents with the necessary knowledge and skills to bring up healthy and well-adjusted children

3. The Universal Programme:
To provide Anticipatory Guidance to all parents on the physical & psychosocial care of the child, through various modes & channels

4. Anticipatory Guidance to Parents
Physical Issues
Newborn care
Breastfeeding
Nutrition
Home safety
Oral Health…. etc.
Psychosocial Issues
Preparing to be parents
Building parent-child relationship
Promoting child development
Improving parenting skills & efficacy
Managing behaviour in children…..etc.

5. Universal Programme: Delivered through various Modes and Channels
Leaflets
Individual Interview
AV resources
Telephone hotline
Website
Happy Parenting Workshops

6. Community-based Promotion Activities
Baby Expo
Roving exhibition
Advertising in mass transit system
TV series
API and poster campaign

7. Targetted Programmes:
Breastfeeding
Coaching
Management of complications
Support group
Child behaviour management
Positive Parenting Programme (Triple P)

8. Triple P: Principles & Strategies
Principle: To foster self efficacy & self-regulation of parents in child behaviour management
Understanding the causes of child behaviour problems
Setting goals for change in parent’s own & child’s behaviours
Keeping track of parent’s own & child’s behaviour (Behaviour diary/graph)
Acquiring the knowledge & skills of
10 positive parenting strategies (enhance parent-child relationship; encourage desirable behaviours, etc)
7 strategies to manage behaviour problems
Application of the above to solve current problems and prevent future ones

9. Group Triple P
Group discussion
Mini-lecture
Role Play
Phone follow up

10. Fiction Fact A western product suited for western culture
Does not address relationship or values
Emphasizes building of a positive parent-child relationship
Respects parent’s own values
Directed & controlled by professionals
Empowerment of parents
Facilitate self-regulation
Build self-efficacy
A western product suited for western culture
A programme for middle-class parents
Programme effectiveness has been proven in local Chinese families (RCT)
Larger magnitude of improvement in low income level & new immigrants
Universality of human psychology & Globalization
Need to respect diversity & be culturally sensitive during service provision

11. The Evidence Leung C, Sanders MR, Leung S, Mak R & Lau J.
An outcome evaluation of the implementation of the Triple P - Positive Parenting Program in Hong Kong. Fam Process 2003; 42:
A randomised controlled trial
69 parents with children 3 to 7 years
Intervention group 33
Control group
Results
Increase in parenting sense of competence
Decrease in dysfunctional parenting practices
Decrease in child behaviour problems
Decrease in marital conflicts

12. Directions & Approaches to Family Education

13. The Scope of Family Education
Family members at different life stages:
Different needs (difficulties & problems)
Programmes of different levels:
Universal programme
Anticipatory guidance
Preventive
Targetted programme
Address special needs / problems
Early intervention (primary care level)
Treatment & remedial
Provided by professionals of various disciplines in different sectors
Universal Programme
Primary Care Intervention
Secondary Care Intervention
Tertiary Care

14. Common Ground for all Professionals: Evidence-based Practices
The Cochrane Collaboration
Established in 1993
A global research network
Aims to improve healthcare decision-making through systematic reviews of the effects of healthcare interventions
Published in the Cochrane Library
[A systematic review aims to sum up the best available research on a specific question. It uses transparent procedures to find, evaluate and synthesize the results of all relevant research]

15. Common Ground for all Professionals: Evidence-based Practices
The Campbell Collaboration
established in 2000
an international research network that produces systematic reviews of the effects of social interventions in the areas of
education
crime and justice
social welfare
Published in the Campbell Library
to better inform policy and practice, and ultimately improve people's well being

16. Systematic Reviews on Parenting Programmes
Cochrane Library
Parenting interventions for the prevention of unintentional injuries in childhood Denise Kendrick, Jane Barlow, Amanda Hampshire, Leon Polnay, Sarah Stewart-Brown; 2007
Group-based parent-training programmes for improving emotional and behavioural adjustment in 0-3 year old children Jane Barlow, Jacqueline Parsons; 2003
Individual and group-based parenting programmes for the treatment of physical child abuse and neglect Jane Barlow, Isabelle Johnston, Denise Kendrick, Leon Polnay, Sarah Stewart-Brown; 2006
Individual and group-based parenting programmes for improving psychosocial outcomes for teenage parents and their children Esther Coren, Jane Barlow; 2001
Campbell Library
Group-based parent-training programmes for improving emotional and behavioural adjustment in 0-3 year old children (Social welfare) Jane Barlow and Jacqueline Parsons; 2005
Parent-training programmes for improving maternal psychosocial health (Social welfare) Jane Barlow, Sarah Stewart-Brown and Esther Coren; 2005.
Parental involvement and the academic performance of elementary school children (Education) Chad Nye, Herb Turner and Jamie Schwartz; 2006.

17. The Evidence-based Intervention Programme Development Model
Needs Assessment
Programme Design
Efficacy Testing
Effectiveness Testing
Programme Diffusion
The condition
Distribution
Determinants
Biological /
Socio-behavioural
Research
RCT
Training
Quality management
Ongoing Evaluation
Field trials 效用
效果/功效
隨機對照試驗

18. Thank You!

19. Professor Archibald Leman Cochrane CBE FRCP FFCM (1909 - 1988)
Source: Cochrane Collaboration
Effectiveness and Efficiency: Random Reflections on Health Services (1972)
Resources are always limited – should be used to provide forms of health care which has been shown in properly designed evaluations to be effective – the importance of using evidence from randomised controlled trials (RCT's)
"It is surely a great criticism of our profession that we have not organised a critical summary, by specialty or subspecialty, adapted periodically, of all relevant randomised controlled trials." (1979)
Source: The Cochrane Collaboration.

20. The Hierarchy of Evidence (of causality)
Level 1: Randomised controlled trials
Results from a systematic review (& meta-analysis) of trials
One or more individual trials
Level 2: Cohort & case-control studies
Results from a meta-analysis of such studies
One of more individual studies
Level 3: Other comparative studies
Level 4: Case series, descriptive studies. Professional experiences