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Parenting Services provided at Maternal & Child Health Centres. Dr. Shirley Leung FRCP(Glasg), FHKAM(Paed) Principal Medical Officer, Family Health Service Department of Health. The Family Health Service (DH) 衞生署家庭健康服務部.
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Parenting Services provided at Maternal & Child Health Centres Dr. Shirley Leung FRCP(Glasg), FHKAM(Paed) Principal Medical Officer, Family Health Service Department of Health
The Family Health Service (DH)衞生署家庭健康服務部 • Our business: To provide a comprehensive range of health promotion and disease prevention services • for children from birth to 5 years, & • womenbelow 65 years of age. through a network of • Maternal & Child Health Centres (MCHCs), & • Woman Health Centres (WHCs)
Integrated Child Health and Development Programme幼兒健康及發展綜合計劃
Features of the Integrated Child Health & Development Programme • Accessible through a network of 31 MCHCs • Acceptable: >90% of newborns covered • Holistic health • Empowerment of parents • Partnership with parents and community • Evidence-based approach
Integrated Child Health and Development Programme (0 – 5 years) (2007) 年齡(月)Age in Months () () () () Keys註解: Immunization 免疫注射 Physical Examination身體檢查 Growth Monitoring生長監察 Developmental Surveillance Scheme發展監察 AOAE Hearing Screening聽力普查 Vision Screening視力普查 Parenting Programme親職教育計劃 If indicated如有需要 Antenatal產前 ( ) AN
Universal Parenting Programme 普及親職教育計劃
Universal Parenting Programme • Parenting: Fulfilling the roles of a parent in meeting the individual needs of the child, and nurturing the child’s physical, cognitive & socio-emotional development. • Aim: Equipping parents with the necessary knowledge and skills & supporting them to fulfill their parenting roles, to bring up healthy and well-adjusted children
Universal Parenting Programme • For expectant parents and parents of allchildren attending MCHCs • Provide anticipatory guidance to parents to increase their confidence in the parenting role • Address a range of parenting issues, including physical, cognitive, social and emotional issues.
Universal Parenting Programme Means: • Health educational resources • Staged developmental leaflets: Child Development 兒童發展 • Specific parenting issue leaflets : Childcare & Parenting 育兒及親職系列 • Video on child development 0-3: The Budding Years 寳寳成長路 • Video on parenting: Parenting Do Re Mi 親子三點式 • Series of interactive workshops共享育兒樂 • Individual counselling
Intensive Parenting Programme Positive Parenting Programme加強課程 -- 3P親子「正」策課程
Positive Parenting Programme (Triple P) Target: Families / Parents • of children with early/mild behaviour problems • with parenting difficulties
Positive Parenting Programme (Triple P) • Developed by a group of clinical psychologists in the University of Queensland, Australia over a period of 20 years • A form of behavioural family intervention (BFI) based on social learning principles
Triple P: The Evidence • Documented Efficacy of BFI in treatment & prevention of child behavioural problems, using RCT • Evidence of Effectiveness of different levels of intervention, and with a range of family types
Triple P: Local Evidence • A randomized controlled trial with Hong Kong parents • 69 parents with children between 3 and 7 years • Results • Decrease in child behaviour problems • Decrease in dysfunctional parenting practices • Increase in parenting sense of competence • Increase in marital relationship satisfaction (Leung, Sanders, Leung, Mak & Lau, 2003)
Changes in Different Child Behavior Problems Pre- & Post-intervention
Changes in Different Parenting and Marital Relationship Scales Pre- & Post-intervention
Triple P: Structured group training • 4 two-hour weekly group sessions, followed by 4 telephone sessions • Lecture, video demonstrations, role plays, group discussion, homework assignments
Implementation of TP in MCHCs • Since 2002, over 300 MCHC doctors and nurses trained and accredited to deliver Triple P • From September 2002 to October 2005: conducted 419 TP groups, with 3,777 participants
Triple P – Continuous Evaluation • Database on pre- and post- Triple P group measures of child behaviour and parenting • Effectiveness of the programme on the whole • Effectiveness of individual groups / facilitators
Triple P – Continuous Evaluation • Factors associated with clinical outcome (ECBI – intensity 子女問題行為): • Residential status 居留身分 • Mother education level 母親教育程度 • Session attendance 上課節數 • Pre-intervention parenting stress scores 課前親職壓力指標
Factors Influencing Programme Completion (Reasons) Convenience sample, n=199 • Work hours affecting participation • Family facing other problems • Difficulty in getting childcare while attending programme • Difference with partners
Way Forward • Increase accessibility of the programme Universal programme • Resource materials to be uploaded on FHS web site • Publication of a parenting book (0-3 years) • Production of more materials in audio-visual form
Way Forward Triple P • For working parents – Increase the no. of after-hours groups • 2002 to 2004 – 6 groups • 2005 – 12 groups • For new immigrant parents – flexible attendance arrangement • For single parents – give them the option of single parent groups • For parents with difficulties arranging childcare – provide information on occasional childcare and mutual help childcare centres
Way Forward • Expanding the scope of the programme Universal programme • Teaching values to young children • Supporting children’s learning • Facilitating communication between parents & grandparents Targeted programme • For new immigrant parents • For parents of low socio-economic status