1. Dr. Tracey Bywater Dr. Judy Hutchings The Incredible Years (IY) Programmes: Programmes for children, teachers & parents were developed by Professor Webster-Stratton, University of Washington. The Programmes have been identified as achieving exceptional, long-term, evidence for violence reduction & prevention. The parent programme was originally developed & researched as a treatment programme for diagnosed conduct disordered children & its effectiveness has been demonstrated in the USA, Canada, Norway & the UK. Webster-Stratton has since established the parenting programme as an early intervention strategy with high-risk Head Start communities in Seattle. IY Programme training has been available in Wales for the last six years & many services have IY trained staff & have delivered the programmes. The IY BASIC Parenting Programme: Focuses on strengthening parenting skills with the intention of preventing, reducing, & treating conduct problems, & increasing social competence among children aged 2-8 years. Consists of 12 weekly sessions that emphasise the importance of play, relationship building, ways to help children learn, effective praise, use of incentives, limit setting, & ways to deal effectively with misbehaviour. A collaborative approach is emphasised, with skills developed through group discussion, videotape modeling, rehearsal & home assignments. Has been researched over the last 20 years using randomised controlled group studies with long-term positive results replicated by independent researchers in both academic & service settings. The Need to Evaluate the IY BASIC Parenting Programme in Wales: As yet no UK evaluation of the programme in an early intervention/preventive setting. As yet no examination of the special challenges of programme implementation to a largely bi-lingual & rural based population such as that found in Wales. The majority of Sure Start services in North & Mid Wales were implementing the programme & required evidence of effectiveness. Overview of the Project funded by The Health Foundation, October 2002 to 2007: Randomised controlled trial replication of Webster-Stratton ’ s (1998) 1 successful implementation of the programme in Head Start Centres in Seattle. Families with a child (36-59 months) ‘ at risk ’ of developing conduct problems were approached by a local Health Visitor who administered the Eyberg Child Behaviour Inventory. families were eligible if the child resided with the primary carer, scored above the clinical cut-off on the Eyberg and the primary carer was able to attend group times. Recruitment: 153 families (104 intervention, 49 control). Drop-out rate was 13% at 6 months & 24% by the last, 18-month, follow-up. Data collection: At baseline & 6 months for both the intervention & waiting list control, & again at 12 & 18 months for intervention families only. Parenting programme was delivered by accredited group leaders - the staff of collaborating Sure Start Services. 12 intervention groups were run in total from 11 Sure Start areas across North & Mid Wales. Programme delivery was standardised across centres: centres provided transport, free crèche & meal, the project provided course materials, all parenting sessions were videotaped, randomly selected tapes were monitored by an independent IY trainer for fidelity. Outcome Measures - Interview/Self report: Demographic & family risk factors Parental competencies Parental satisfaction with parenting programme Child social & verbal competence, & conduct problems Outcome Measures: Observation of parent-child interaction: Dyadic Parent-Child Interactive Coding System 30 minute observations take place in family home, 4-7pm positive parenting, parent commands, affect,critical statements child deviance, child affect, prosocial behaviour 1 Webster-Stratton, C. (1998). Preventing Conduct Problems in Head Start Children: Strengthening Parenting Competencies. Journal of Consulting and Clinical Psychology, 66(5), 715-730 The short-term findings are currently in press in the British Medical Journal 2007 Evaluation of the Webster-Stratton BASIC Parenting Programme with Parents of ‘ at risk ’ Pre- school Children in Sure Start Areas Across North & Mid Wales This research has been funded by The Health Foundation Dr. Frances Gardner & Dr. Dave Daley Short-term Results: baseline to follow-up 1 Summary of Findings  There are differences between the intervention & control groups at follow-up 1, showing statistically & clinically significant outcomes for the intervention group.  Observation data shows that: Intervention parents practice more positive parenting at follow-up 1 (Figure 1). Intervention children show less anti-social behaviour  Parent report data shows that: Intervention parents perceive their child as having fewer & less intense problem behaviours at follow-up (Figures 2 & 3) These improvements have been maintained up to the 18-month follow-up (Figure 4)  A cost-effectiveness analysis of the IY groups (Edwards et al., in press, BMJ) found that the programme improved children’s behaviour at a modest cost - even when taking into account set-up, leader training, group & supervision costs, travel, telephone calls, clerical support etcetera. Conclusions  The intervention improved parenting skills, this had a positive effect on child behaviour in both the short and long term  Positive changes for high-risk Sure Start families were demonstrated when using an effective evidenced-based parent programme delivered with fidelity Long-term Results Clinical cut-off Figure 4. Intervention Eyberg Child Problem Scores