Poster #80 - Parenting program for violence against children prevention: From scientific evidence-based to implementation at large scale

• In Event: Poster Session 18

Abstract

Violence against children is a huge worldwide problem, that impact negatively on child development, especially in Low-and Middle-Income countries (LMIC). According to the World Health Organization (2020), nearly three in four children frequently suffer physical punishment and/or psychological violence from their parents. Exposure to maltreatment in childhood is a toxic stressful experience that could provokes an intergenerational cycle of violence (Lotto, Altafim & Linhares, 2021). Parenting programs constitute a recommended strategy to promote positive interactions and parental practices and prevent violence against children. Besides the evidences of efficacy of certain program, the implementation process of evidence-based parenting programs at large scale with sustainability and fidelity in public systems should be examined systematically. The Science of Implementation contributes to better understand this process. The aim of the present study is to share the findings and learnings with the first implementation process of the ACT- Raising Safe Kids program at large scale in a public policy system. The ACT - Raising Safe Kids Program (American Psychological Association; Silva, 2011) is a low-cost, well-stablished, and scientific evidence-based program, that is recommended by the INSPIRE report (WHO, 2016) as a good strategy for violence against children prevention. In the present study the ACT was implemented simultaneously in 24 cities of the Ceará state (Northwest of Brazil, LMIC), according to an agreement between policymakers, investigators, and foundations that support the study. The methodology of implementation comprised the following steps: (i) Training the ACT-facilitators, including theoretical and practical activities, and supervision with psychologist specialists for certification; (ii) Nucleation the local team with frontline professionals of Social Protection Services in each city, including one coordinator of logistics, one psychologist-supervisor, and at least 5 ACT-facilitators; (iii) Implementation the ACT in the routine actions of the social assistance of vulnerable families. The results showed that 190 ACT facilitators participated in the theoretical training. From these, 119 professionals concluded the practical training and were certified, 30 are ongoing, 11 did not conclude the practice, 16 gave up to participate in the project, and 14 changed the positions in the services and had to be dismissed. In the 24 cities in urban or rural areas, the nucleation was created in the cities with professionals of the public services of social protection area. From these cities, 16 cities are yet implementing the ACT Program with the families as a psycho-educational strategy for violence prevention against children. Then, the data collection is ongoing with family-caregivers of 2-to-6-year-old children, including the eight dynamic- and interactive- sessions of the ACT. Also, the parental practices and child behaviors assessments were done at pre- and post-intervention by the facilitators, using an App customized for the study. The present implementation study of an evidence-based program of violence against children prevention in a public policy system allowed us to better understand the strengthens and barriers that occurred depending on the facilitators, the family characteristics, and the contexts of implementation at municipal level.

Authors

• Maria Beatriz Martins Linhares, Universidade de São Paulo (USP)
  Presenting Author

• Elisa Rachel Pisani Altafim, Universidade de São Paulo (USP)

• Rebeca Cristina de OLIVEIRA, Universidade de São Paulo (USP)

• Luiza MAchado Santos, USP