The effectiveness of the Incredible Years pre-school parenting programme in the United Kingdom: a pragmatic randomised controlled trial

ABSTRACT

The prognosis for children with early-onset conduct disorder is poor. Conduct disorder also has a social cost for families and communities, and an economic cost for society through the increased use of health, education, social, legal and detention services. In this study, the Incredible Years (IY) BASIC programme was delivered to parents of pre-school children at risk of developing a conduct disorder and evaluated by pragmatic randomised controlled trial. Participants were parents of 161 children (110 intervention, 51 control) aged between 36 and 59 months (mean age 44 months, 63% boys) and scoring over the clinical cut-off on the Strengths and Difficulties Questionnaire (SDQ). At follow-up (six months post-baseline), the intent-to-treat analysis showed a mean between group difference in favour of IY on the SDQ total difficulties score of 2.23 (p < 0.05, effect size: 0.50). IY was also superior to control on the Eyberg Child Behaviour Inventory (p < 0.05, effect size: 0.37) and on the Arnold and O’Leary parenting scale (p < 0.01, effect size: 0.43). This study confirms the effectiveness of IY in a public system delivered with fidelity by regular children’s centre staff, supporting findings from a similar trial in Wales. These results support the wider roll-out of IY to similar children.

KEYWORDS:

• Incredible Years
• randomised controlled trial
• parenting
• behaviour
• conduct disorder

Acknowledgements

The authors would like to acknowledge the hard work and dedication of Birmingham City Council’s “Brighter Futures” team, including the facilitators who ran parent groups and collected fidelity data, and Judy Hutchings, who oversaw the implementation of IY and provided supervision to the group leaders. Michael Little was the project Chief Investigator. The authors thank the parents who took part in the trial, contributing valuable data on their children’s well-being. The North Wales Trials Unit (NWORTH) provided the randomisation service for this study. Pat Linck provided invaluable assistance to Rhiannon Tudor Edwards on the cost-effectiveness study. Vashti Berry’s time is supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC), and Tracey Bywater and Sarah Blower are part of the Healthy Children Healthy Families Theme of the NIHR CLAHRC Yorkshire and Humber. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical clearance

The Warren House Group Ethics Committee and the North Wales NREC (reference 10/WNo01/29).

Notes on contributors

Louise Morpeth is Chief Executive at Dartington Social Research Unit.

Sarah Blower is a Research Fellow in the Department of Health Sciences, University of York.

Kate Tobin is a Researcher at Dartington Social Research Unit.

Rod S. Taylor is Professor of Health Services Research based in the University of Exeter Medical School, University of Exeter.

Tracey Bywater is Professor of Family Well-being in the Department of Health Sciences, University of York.

Rhiannon Tudor Edwards is Professor of Health Economics and Co-Director of the Centre for Health Economics and Medicines Evaluation at Bangor University.

Nick Axford is a Senior Researcher at Dartington Social Research Unit.

Minna Lehtonen is an Associate of Dartington Social Research Unit.

Carys Jones is a Research Officer at the Centre for Health Economics and Medicines Evaluation at Bangor University.

Vashti Berry is a Senior Research Fellow based at the Institute for Health Services Research, University of Exeter, as part of the South West Peninsula Collaboration for Leadership in Applied Health Research and Care (CLAHRC). She is also an Associate of the Dartington Social Research Unit.

Notes

1. The ages of children receiving the different programmes in the portfolio were different, meaning that children whose parents were in receipt of IY would not have received any of the other three interventions.

2. The others are reported elsewhere (Berry et al., 2016; Blower et al., 2016; Robling et al., 2016).

Additional information

Funding

This study was funded by Birmingham City Council), as part of its Brighter Futures strategy for children’s services.