The Irie Homes Toolbox: A cluster randomized controlled trial of an early childhood parenting program to prevent violence against children in Jamaica

Background: We tested whether a universal, violence-prevention, early childhood, parenting program (The Irie Homes Toolbox) reduced parents' use of harsh punishment and increased parents' involvement with their child. Methods: A cluster randomized trial was conducted in eighteen preschools situated in inner-city neighbourhoods in Kingston, Jamaica. Schools were randomized to intervention (n = 9) or control (n = 9) and a minimum of twelve parent/child dyads were recruited in each school (n = 223, 115 intervention, 108 control). The Irie Homes Toolbox consists of eight, ninety-minute sessions with groups of six parents. The primary outcomes were parent-reported harsh punishment and involvement with their child. Secondary outcomes were parent and teacher-reported child behavior difficulties and prosocial behavior and child school readiness by direct testing. Results: The attendance rate in the intervention group was 68.8%. Benefits of intervention included significant reductions in parents' use of harsh punishment (ES = -0.29, 95%CI: -0.52,-0.05, p = 0.036) and increases in parents' involvement (ES = 0.30, 95%CI: 0.03, 0.57, p = 0.036). There was a dose-response relationship between number of sessions attended and reduction in harsh punishment with greater reductions as parent attendance increased. No main effects were found child behavior at home and at school and school readiness. However, there was a significant interaction effect between baseline behavior difficulties and intervention group (p = 0.002); significant reductions in behavior difficulties were found for children at or above the 50th percentile on initial behavior difficulties (ES = -0.36, p = 0.031). Conclusion: The Irie Homes Toolbox led to reduced harsh punishment by parents, increased parental involvement and decreased behavior difficulties for higher-risk children.