A cluster randomised controlled trial evaluating a combined in-person and online parenting intervention in rural Thailand found no significant reduction in violence against children at one-month follow-up, according to research published in The Lancet Regional Health – Southeast Asia.
Trial design and methodology
The cluster randomised controlled trial recruited 480 parents from rural communities in Thailand, randomly assigning them to receive either a blended parenting programme or standard care. The intervention combined face-to-face group sessions with online modules delivered through mobile technology.
Researchers measured child maltreatment outcomes using validated questionnaires at baseline and one-month post-intervention. The study specifically examined physical punishment and emotional abuse as primary endpoints, reflecting WHO priorities for violence prevention.
Study findings reveal no reduction in child maltreatment
While physical punishment rates showed no significant difference between groups, the intervention group reported higher rates of emotional abuse compared to controls at follow-up. According to the study authors, this finding may reflect increased awareness of emotional abuse among parents who received the intervention, rather than an actual increase in abusive behaviours.
The study authors suggest this pattern indicates differential reporting between groups, where parents in the intervention arm became more sensitive to recognising and reporting emotional abuse.
Implications for violence prevention programmes
The study’s authors recommend targeting higher-risk families in future trials, as the current sample included many families with relatively low baseline violence levels. The short follow-up period of one month may have been insufficient to detect meaningful behavioural changes, the researchers note.
The blended delivery model faced implementation barriers in rural Thai communities, where internet connectivity and smartphone literacy varied considerably among participants, according to the study.
Results suggest no reductions in child maltreatment in the intervention group at one-month follow-up, with higher estimates for emotional abuse potentially reflecting differential reporting or changes in awareness between groups.
— The Lancet Regional Health – Southeast Asia study authors
Key takeaways
- Blended parenting programme showed no significant reduction in child violence at one-month follow-up in rural Thailand
- Higher reported emotional abuse in intervention group may reflect increased awareness rather than actual harm
- Study authors recommend targeting higher-risk populations and assessing longer-term outcomes beyond one month
Frequently asked questions
Why did the intervention show no effect on child maltreatment?
According to the study authors, multiple factors may explain the null findings, including short follow-up duration, low baseline violence levels in the study population, and implementation challenges with digital components in rural settings.
What does the increase in reported emotional abuse mean?
The study authors suggest the higher emotional abuse reporting in the intervention group likely reflects increased awareness and recognition of emotional maltreatment among parents who received training, rather than an actual increase in abusive behaviours.
How should future parenting programmes be designed based on these findings?
The study authors recommend targeting higher-risk families, extending follow-up periods beyond one month, and addressing technology integration challenges for rural populations.
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Medically reviewed by Prof. Giorgi Pkhakadze, MD, MPH, PhD. Spotted an error? Contact the editorial team.
