OBJECTIVE Few randomized controlled trials (RCTs) have explored the implementation and impact of early childhood parenting education programs in very fragile contexts and humanitarian settings. We tested the effects of a group-based intervention, the Mother-Child Education Program (MOCEP), on parenting stress and practices among two refugee communities and one other marginalized community in Beirut, Lebanon. METHOD A pilot wait-list RCT was conducted to assess the program's impact on maternal, child (average age: 4 years), and dyadic outcomes. A total of 106 mother-child dyads were randomly assigned to either the intervention group (n = 53) or the wait-list control group (n = 53). Analysis was conducted by modified intention-to-treat and supplemental analyses through multiple imputation of missing post-intervention data. RESULTS Forty families (38%) withdrew early from the study. After completing the program, mothers in the intervention group showed a reduction in their harsh parenting practices, as indexed by the Disciplinary Style Questionnaire (Cohen's d = -0.76, 95% CI = -1.24, -0.27) and in their level of parenting stress, as indexed by the Parenting Stress Index-Short Form (PSI-SF; Cohen's d = -0.90, 95% CI = -1.39, -0.40). Exploratory but underpowered analyses of dyadic interactions revealed reductions in the PSI were associated with a reduction in harsh parenting after the intervention. However, we did not detect any positive impact on behavioral or emotional outcomes among the children. CONCLUSION Our analyses suggest that MOCEP had a positive impact on disciplinary practices and parenting stress in a context of high fragility, but that broader effects on maternal and child outcomes may be dependent on program attendance and the availability of other services. We discuss implications of this pilot study for practice and research of a largely unexplored area of program evaluation. CLINICAL TRIAL REGISTRATION INFORMATION Mother and Child Education Program in Palestinian Refugee Camps; https://clinicaltrials.gov; NCT02402556.

中文翻译：

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母子教育计划对黎巴嫩难民和其他边缘社区的父母教养压力和纪律行为的影响：一项随机对照试验。

目的很少有随机对照试验（RCT）在非常脆弱的环境和人道主义环境中探索幼儿育儿教育计划的实施和影响。我们在黎巴嫩贝鲁特的两个难民社区和另一个边缘化社区中，测试了基于小组的干预措施-母子教育计划（MOCEP）对育儿压力和行为的影响。方法进行了一项试验性等待名单随机对照试验，以评估该计划对孕产妇，儿童（平均年龄：4岁）和二元结局的影响。总共将106个母二倍体随机分配到干预组（n = 53）或等待列表对照组（n = 53）。通过对干预后数据的缺失进行多次插补，通过改良的意向性治疗和补充分析进行了分析。结果有40个家庭（占38％）从研究中提前退出。完成该计划后，干预组的母亲表现出的严酷父母养育方式有所减少，这是由纪律风格问卷调查得出的（Cohen's d = -0.76，95％CI = -1.24，-0.27）和父母压力水平，以育儿压力指数-短格式（PSI-SF； Cohen d = -0.90，95％CI = -1.39，-0.40）进行索引。探索性的但缺乏动力的二元互动分析显示，干预后PSI的降低与严酷育儿的减少有关。但是，我们没有发现对孩子的行为或情感结果有任何积极影响。结论我们的分析表明，在高脆弱性的背景下，MOCEP对纪律做法和父母压力有积极影响，但是对母婴结局的更广泛影响可能取决于计划出勤率和其他服务的可用性。我们讨论了该试点研究对计划评估的一个尚未开发的领域的实践和研究的意义。临床试验注册信息巴勒斯坦难民营的母子教育计划；https://clinicaltrials.gov; NCT02402556。