Barlow, Jane, Sembi, Sukhdev, Parsons, Helen, Kim, Sungwook, Petrou, Stavros, Harnett, Paul and Dawe, Sharon (2019) A randomized controlled trial and economic evaluation of the Parents Under Pressure Program for parents in substance abuse treatment. Drug and Alcohol Dependence, 194 . pp. 184-194. doi:10.1016/j.drugalcdep.2018.08.044 ISSN 0376-8716.

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Abstract

Background

There is growing interest in the provision of parenting support to substance misusing parents.

Methods

This pragmatic, multi-center randomized controlled trial compared an intensive one-to-one parenting program (Parents under Pressure, PuP) with Treatment as Usual (TAU) in the UK. Parents were engaged in community-based substance misuse services and were primary caregivers of children less than 2.5 years of age. The primary outcome was child abuse potential, and secondary outcomes included measures of parental emotional regulation assessed at baseline, 6 and 12-months. A prospective economic evaluation was also conducted.

Results

Of 127 eligible parents, 115 met the inclusion criteria, and subsequently parents were randomly assigned to receive PuP (n = 48) or TAU (n = 52). Child abuse potential was significantly improved in those receiving the PuP program while those in TAU showed a deterioration across time in both intent-to-treat (p < 0.03) and per-protocol analyses (p < 0.01). There was also significant reliable change (recovery/improvement) in 30.6% of the PuP group compared with 10.3% of the TAU group (p < 0.02), and deterioration in 3% compared with 18% (p < 0.02). The probability that the program is cost-effective was approximately 51.8% if decision-makers are willing to pay £1000 for a unit improvement in the primary outcome, increasing to 98.0% at a £20,000 cost-effectiveness threshold for this measure.

Conclusions

Up to one-third of substance dependent parents of children under 3-years of age can be supported to improve their parenting, using a modular, one-to-one parenting program. Further research is needed.

Item Type:	Journal Article
Subjects:	H Social Sciences > HQ The family. Marriage. Woman
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Drug addiction -- Health apsects, Parents, Parenting
Journal or Publication Title:	Drug and Alcohol Dependence
Publisher:	Elsevier
ISSN:	0376-8716
Official Date:	1 January 2019
Dates:	Date Event 1 January 2019 Published 3 November 2018 Available 21 August 2018 Accepted
Volume:	194
Page Range:	pp. 184-194
DOI:	10.1016/j.drugalcdep.2018.08.044
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	6 September 2018
Date of first compliant Open Access:	18 December 2018
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID UNSPECIFIED National Society for the Prevention of Cruelty to Children http://viaf.org/viaf/148381387
Related URLs:	Publisher

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