1. Evaluating the EPaS 2014 programme and an e-version of the Little Parent Handbook Margiad Elen Williams CEBEI, Bangor University

2. Content Study 1: EPaS 2014 project  Background  Proposed research project Study 2: e-version of Little Parent Handbook  Background  Proposed research project

3. Enhancing Parenting Skills (EPaS) Developed in 1990s Three core components:  Structured assessment of child behaviour, family circumstances and assets  Case analysis  Intervention strategies

4. Intensive Treatment trial Intervention with CAMHS-referred children Compared to Standard CAMHS management advice Significant improvements child behaviour, maternal depression, positive parenting skills Maintained at 4-year follow-up See Hutchings et al. (2002, 2004)

5. Health visitor training Adapted for health visitors 24 health visitors, 36 families (24 I & 12 C) 12 weekly two-hour training sessions for HVs Significant improvements child behaviour & parental mental health Increased knowledge & use of behaviour principles High levels satisfaction See Lane & Hutchings (2002)

6. Waterloo Foundation grant – to evaluate a shorter version of the EPaS training delivered across Wales Rationale: the original EPaS course was not designed in a format for wide-scale dissemination Training for staff working with children facing developmental challenges Underlying principles work for all children Re-designed programme  Two-day training course  Detailed intervention manual  Parent help sheets

7. Waterloo Foundation study Five locations across Wales 62 attended day 1 (assessment) 42 attended day 2 (case analysis & intervention strategies) High levels of satisfaction with training & content Increased use of behaviour principles

8. Waterloo Foundation study Data from 25 families (10 complete) Children with behaviour problems, parents with low mental well-being and problematic parenting skills Significant improvements in child behaviour, parental mental well-being, and parenting skills Parents rated programme as useful and would recommend to others

9. Limitations Two days not enough Staff had varied backgrounds & experience Small sample No control comparison group

10. EPaS 2014 trial Aims to address limitations Course redesigned to be delivered in three days and manual improved and expanded (based on feedback form Waterloo trial)  Day 1 – assessment  Day 2 – case analysis  Day 3 – intervention strategies Tailored to support health visitors who already have good child development understanding (as with initial EPaS training).

11. EPaS 2014 trial Hypotheses  Three days of detailed assessment, case analysis and behavioural intervention skills training will enable HVs to effectively support families of high challenge pre-school children and achieve positive outcomes. This will demonstrate a scalable model for dissemination of effective training for HVs in core behavioural case planning and intervention strategies

12. EPaS 2014 trial Multi-centre randomised controlled trial Recruit 60 health visitors Screen for child behaviour problems in children aged 30 – 48 months (above clinical cut-off ECBI) Recruit two families each (n=120) Baseline, 4-month FU, 8-month FU (intervention only) Child behaviour, parental mental health, parenting skills, child language skills, observation parent-child interaction

13. Little Parent Handbook Booklet for parents introducing effective core parenting skills Covers variety of behaviours problems Based on parent help sheets from the Waterloo Foundation project Published November 2013

14. Why web-based version? Group-based programmes inappropriate and/or inaccessible to some One-to-one support is resource intensive and not accessible to all parents 83% of UK households have internet access (ONS, 2013) 70% of people own smartphone with internet access

15. Web-based trial Aim to develop and evaluate a web-based version Weekly chapters, worksheets, video vignettes, quizzes with feedback Randomised controlled trial Health visitors to recruit families Target parents of children at-risk of behaviour problems (aged 3 – 8 years)

16. Thank you for listening Email: margiad.williams@bangor.ac.ukmargiad.williams@bangor.ac.uk Tel: 01248 383 627