Epidemiological results from the DHA-Oxford-Learning-and-Behaviour study (DOLAB).
Presented at the International Society for the Study of Fatty Acids and Lipids (ISSFAL) conference 2012 in Vancouver.
Background: Parenting programmes may reduce risk of violence against children and improve child wellbeing. However, additional economic support may be necessary in highly-deprived low-income countries.Methods: A parallel cluster randomised controlled trial examined the combined and separate effects of parenting and economic strengthening on reducing violence against children ages 0 to 18 years in impoverished farming communities in Tanzania (N =248 families). Eight villages were randomly assigned to four conditions (2:2:2:2 ratio): 1) 12-session parenting programme (N =60); 2) agribusiness training (N =56); 3) parenting and agribusiness combined (N =72); 4) control (N =60). Parent-report, child-report, and early childhood observation assessments were conducted at baseline, mid-treatment, and post-treatment. Primary outcomes included child maltreatment, parenting behaviour, and corporal punishment endorsement. Secondary outcomes included parenting stress, parent/child depression, child behaviour, economic wellbeing, and child development (ClinicalTrials.gov: NCT02633319). Assessors were blind to allocation status at baseline; the data analyst was also blind to allocation until after initial intention-to-treat analyses.Findings: At post-treatment, parents and children receiving the combined interventions reported less maltreatment (parents: IRR=0.40, 95%CI [0.24,0.65]; children: IRR=0.40, 95%CI [0.17,0.92]). Parents also reported reduced endorsement of corporal punishment (Dw =-0.43, 95%CI [-0.79,0.07]), and less child behaviour problems (Dw =-0.41, 95%CI [-0.77,-0.05]). Parents in parenting-only villages reported less abuse (IRR=0.36, 95%CI [0.21,0.63]) and less child behaviour problems (Dw =-0.47, 95%CI [-0.84,-0.11]). Parents in agribusiness-only villages reported less child behaviour problems (Dw =-0.43, 95%CI [-0.77,-0.08]) and greater household wealth (Dw =0.57, 95%CI [0.08,1.06]). However, children in agribusiness-only villages reported increased physical abuse (IRR=2.26, 95%CI [1.00,5.12]) and less positive parenting (Dw =-0.50, 95%CI [-0.91,-0.10]). There were no other adverse effects.Interpretation: Results suggest that the parenting component may be the active ingredient in reducing maltreatment, and that agribusiness training programmes may have unintended negative consequences on children when delivered alone.Trial Registration: (ClinicalTrials.gov: NCT02633319; Pan African Clinical Trials: PACTR201610001267268).Funding Statement: The Skilful Parenting and Agribusiness Child Abuse Prevention Study (SPACAPS) was supported by the UBS Optimus Foundation (Grant: 7849.09), the Netherlands Ministry of Foreign Affairs, and the Complexity in Health Improvement Programme of the Medical Research Council MRC UK (Grant: MC_UU_12017/14).Declaration of Interests: The authors declare no competing interests.Ethics Approval Statement: Ethical approval was received from the Tanzania Lake Zone Institutional Review Board (03.09.2015) and the University of Oxford Social Sciences and Humanities Interdivisional Research Ethics Committee (SSD/CUREC1A/14-SSH_C2_15_023).
Der Band thematisiert die postsozialistischen Transformationen in Mittelosteuropa und ihre Verknupfung mit der EU-Osterweiterung sowie den Integrationsprozessen innerhalb der Europaischen Union. Neben ubergreifenden Darstellungen und theoretisch-konzeptuellen Beitragen zu Transformation, Modernisierung und Integration erhalt der Band Fallstudien u.a. zu Tschechien, Estland, Rumanien und Ostdeutschland.
Introduction Parenting programmes may reduce the risk of violence against children and improve child well-being. However, additional economic support may be necessary in highly deprived rural communities in sub-Saharan Africa. Furthermore, delivering programmes within farmer groups may increase male caregiver recruitment and engagement. Methods A parallel cluster randomised controlled trial examined the combined and separate effects of parenting and economic strengthening programmes on reducing violence against children aged 0–18 years in farming communities in Tanzania (n=248 families; 63% male caregivers). Eight villages were randomly assigned to four conditions (2:2:2:2): (1) 12-session parenting programme (n=60); (2) agribusiness training (n=56); (3) parenting and agribusiness combined (n=72); (4) control (n=60). Parent-report, child-report and early childhood observation assessments were conducted at baseline, mid-treatment and post-treatment. Primary outcomes were child maltreatment and parenting behaviour. Secondary outcomes included corporal punishment endorsement, parenting stress, parent/child depression, child behaviour, economic well-being and child development. Results At post-treatment, parents and children receiving the combined interventions reported less maltreatment (parents: incidence rate ratio (IRR=0.40, 95% CI 0.24 to 0.65; children: IRR=0.40, 95% CI 0.17 to 0.92). Parents reported reduced endorsement of corporal punishment ( D w =−0.43, 95% CI −0.79 to 0.07) and fewer child behaviour problems ( D w =−0.41, 95% CI −0.77 to 0.05). Parents in parenting-only villages reported less abuse (IRR=0.36, 95% CI 0.21 to 0.63) and fewer child behaviour problems ( D w =−0.47, 95% CI −0.84 to 0.11). Parents in agribusiness-only villages reported fewer child behaviour problems ( D w =−0.43, 95% CI −0.77 to 0.08) and greater household wealth ( D w =0.57, 95% CI 0.08 to 1.06). However, children in agribusiness-only villages reported increased physical abuse (IRR=2.26, 95% CI 1.00 to 5.12) and less positive parenting ( D w =−0.50, 95% CI −0.91 to 0.10). There were no other adverse effects. Conclusion Parent training may be the active ingredient in reducing maltreatment in farmer groups with majority male caregivers, while agribusiness training programmes may have unintended negative consequences on children when delivered alone. Locating parenting support in existing farmer groups can engage much higher proportions of fathers than stand-alone programmes. ClinicalTrials.gov: NCT02633319
Interrupted time series (ITS) designs are a valuable quasi-experimental approach for evaluating public health interventions. ITS extends a single group pre-post comparison by using multiple timepoints to control for underlying trends. But history bias – confounding by unexpected events occurring at the same time of the intervention – threatens the validity of this design and limits causal inference. Synthetic control methodology (SCM), a popular data-driven technique for deriving a control series from a pool of unexposed populations, is increasingly recommended. We aimed to evaluate if and when SCM can strengthen an ITS design.
Methods/Approach
First, we summarise the main observational study designs used in evaluative research, highlighting their respective uses, strengths, biases, and design extensions. Second, we outline when the use of SCM can strengthen ITS studies and when their combined use may be problematic. Third, we provide recommendations for using SCM in ITS and, using a real-world example of an evaluation of Florida's Stand Your Ground laws on homicides, we illustrate the potential pitfalls of using a data-driven approach to identify a suitable control series.
Results
Our real-world evaluation demonstrates that the benefits of SCM in ITS depends on the nature of the time-varying confounding which presents the most plausible threat to the study's validity. We emphasise the importance of theoretical approaches for informing study design and argue that synthetic control methods are not always well-suited for minimising critical threats to ITS studies.
Conclusions
Advances in SCM bring new opportunities to conduct rigorous research in evaluating public health interventions. However, incorporating synthetic controls in ITS studies may not always nullify important threats to validity nor improve causal inference.
Significance and Contributions to Injury and Violence Prevention Science
We provide important methodological recommendations to guide advancement in the science of injury and violence prevention.
The 2004/2007 EU enlargements rendered CEE citizens legally equal to EU labour market participants. However, CEE migrants still face 'racialisation' and segmentation in North-Western European labour markets. Similar processes might extend to EU-South migrants, giving rise to a division of labour, whereby CEE and EU-South migrants end up in poor-quality, low-pay jobs. We compare the labour market integration of recent intra-EU migrants (EU8, EU2, EU-South, EU-West/EEA) in the UK, Germany and Denmark. Using labour force, microcensus and register data, we model quantitative and qualitative integration through labour force participation and wages. We find no significant differences in labour force participation between nationals and migrants in the UK. Whilst in both Denmark and Germany, the labour force participation of EU-migrants is significantly lower. Notwithstanding differences in migration trends, labour markets and welfare regimes, we find evidence of a division of labour along occupational and industry lines − that translates into wage differences. EU-West/EEA migrants occupy better jobs (even outperforming nationals), followed by EU-South and CEE migrants. In Denmark and Germany, EU8 and EU2 migrants' wages are lower than those of nationals even after controlling for differences in occupations. These findings suggest that inequalities across the EU are reproduced rather than converging.
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