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Mixed-methods approaches included quantitative caregiver-report and observational data from standardized instruments, and qualitative data from individual and group interviews with caregivers and program facilitators. Analyses involved Wilcoxon signed-rank tests, paired t-tests, Friedman\u2019s ANOVA, and thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants reported that most (65%) were grandparents or great-grandparents. Study retention and response rates were high, and enrolled caregivers attended an average of 93% of sessions. Primary outcomes showed caregiver-reported pre-post reductions in overall child maltreatment (\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u2009\u2212\u20090.58,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u20090.001), as well as reductions in physical (\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u2009\u2212\u20090.58,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u20090.001) and emotional abuse (\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u2009\u2212\u20090.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u20090.001). Combined caregiver report and observational assessments using the HOME Inventory showed reductions in abusive and harsh parenting (\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u2009\u2212\u20090.52,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u20090.001). Secondary outcomes demonstrated decreases in child neglect; dysfunctional parenting; poor child monitoring and supervision; parental sense of inefficacy; child behavior problems; daily report on child problem behavior; parent overall depression, anxiety, and stress; and attitudes supporting physical punishment and harsh discipline. There were increases in overall positive parenting, daily positive parenting behavior, as well as HOME Inventory assessments on parent-child relationships. Thematic analyses from interviews and focus group data identified six key program themes associated with strengthened parent-child relationships, reduced child behavior problems, improved attitudes and strategies toward discipline, and improved management of parental stress.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study represents one of few evaluations to test the feasibility of an evidence-based parenting program embedded within routine public health service delivery in a low- or middle-income country. Findings show preliminary effectiveness in reducing child maltreatment, improvements on 22 of 24 secondary outcomes, and perceived mechanisms of change that support quantitative findings. Prospects are promising for program scalability, pending randomized controlled trial results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      11\/01\/2019, ClinicalTrials.gov, ID#\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03539341?term=NCT03539341&amp;draw=2&amp;rank=1\">NCT03539341<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-021-11081-4","type":"journal-article","created":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T01:04:30Z","timestamp":1622250270000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Feasibility pilot of an adapted parenting program embedded within the Thai public health system"],"prefix":"10.1186","volume":"21","author":[{"given":"Amalee","family":"McCoy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie M.","family":"Lachman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine L.","family":"Ward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sombat","family":"Tapanya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tassawan","family":"Poomchaichote","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mavuto","family":"Mukaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phaik Yeong","family":"Cheah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Gardner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,29]]},"reference":[{"key":"11081_CR1","unstructured":"United Nations General Assembly. 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All methods were performed in accordance with the relevant guidelines and regulations. Researchers obtained written informed consent from all participants via signature, including from all parents and\/or legal guardians of children (aged under 18\u2009years) who participated in the observational assessments.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"AM, JML, CLW, ST, TP, JK, and FG were employed either as consultants or for university staff time as part of this project. In addition, this paper focuses on the Parenting for Lifelong Health Young Children (PLH-YC) program, developed by the PLH partnership (\n                      \n                      ). This is a research, practice and policy collaboration dedicated to adapting and testing low-cost, non-commercial, sustainable, and evidence-based parenting programs in low- and middle-income countries. We would like to disclose that the JML, CLW, and FG are PLH co-founders and developers. MM and PYC have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1009"}}