Long term follow-up of a randomized controlled trial of a brief home-based parenting intervention to reduce behavioural problems in young children
Author(s)
Type
Journal Article
Abstract
Background
Behaviour problems are common in childhood and are associated with higher rates of mental health problems, educational and relationship difficulties throughout life. This study assessed whether a Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) has sustained benefit 6 years after delivery. It had previously been shown to reduce behavioural problems in children aged 2 and 4 years old.
Methods
The Healthy Start, Happy Start study was a 2-arm, multisite randomised clinical trial conducted in 6 NHS trusts in England. Participants (N= 300) were parents/caregivers of children (aged 12–36 months) at risk of behaviour problems. Participants were randomised to receive either VIPP-SD (n = 151) or usual care (n = 149). Those allocated to VIPP-SD were offered 6 home-based video-feedback sessions.
Six-year follow-up data were collected from May 2022 to July 2023. The primary outcome was the total score on Parental Account of Children’s Symptoms (PACS).
The analysis used pre-specified longitudinal Bayesian models to handle missing data, and findings are reported as posterior probabilities of superiority alongside treatment effect estimate with 95% Credible Interval.
Results
Analysis included 294 of the 300 participants, with 6-year primary outcome data available for 244/300 (81%) (106 girls [43%]; mean age, 8.2 years). The probability of superiority for VIPP-SD on PACS was 86%. The mean difference in the total PACS score was -1.23 (95% Cred.I [- 3.34, 0.90]; d = -0.11 (95% Cred.I [-.032 0.09]; with fewer behavioural problems in children in the VIPP-SD group (mean [SD] score of 25.30 [9.63] vs 26.36 [11.05]).
Conclusions
This trial found a probability of 86% that VIPP-SD was superior for reducing behaviour problems in children up to 6 years later. Taken together with the earlier positive trial findings, this suggest a small enduring positive impact of a brief early intervention with potential for scaling.
Behaviour problems are common in childhood and are associated with higher rates of mental health problems, educational and relationship difficulties throughout life. This study assessed whether a Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) has sustained benefit 6 years after delivery. It had previously been shown to reduce behavioural problems in children aged 2 and 4 years old.
Methods
The Healthy Start, Happy Start study was a 2-arm, multisite randomised clinical trial conducted in 6 NHS trusts in England. Participants (N= 300) were parents/caregivers of children (aged 12–36 months) at risk of behaviour problems. Participants were randomised to receive either VIPP-SD (n = 151) or usual care (n = 149). Those allocated to VIPP-SD were offered 6 home-based video-feedback sessions.
Six-year follow-up data were collected from May 2022 to July 2023. The primary outcome was the total score on Parental Account of Children’s Symptoms (PACS).
The analysis used pre-specified longitudinal Bayesian models to handle missing data, and findings are reported as posterior probabilities of superiority alongside treatment effect estimate with 95% Credible Interval.
Results
Analysis included 294 of the 300 participants, with 6-year primary outcome data available for 244/300 (81%) (106 girls [43%]; mean age, 8.2 years). The probability of superiority for VIPP-SD on PACS was 86%. The mean difference in the total PACS score was -1.23 (95% Cred.I [- 3.34, 0.90]; d = -0.11 (95% Cred.I [-.032 0.09]; with fewer behavioural problems in children in the VIPP-SD group (mean [SD] score of 25.30 [9.63] vs 26.36 [11.05]).
Conclusions
This trial found a probability of 86% that VIPP-SD was superior for reducing behaviour problems in children up to 6 years later. Taken together with the earlier positive trial findings, this suggest a small enduring positive impact of a brief early intervention with potential for scaling.
Date Issued
2026-03-01
Date Acceptance
2025-07-02
Citation
Journal of Child Psychology and Psychiatry, 2026, 67 (3), pp.321-332
ISSN
0021-9630
Publisher
Wiley
Start Page
321
End Page
332
Journal / Book Title
Journal of Child Psychology and Psychiatry
Volume
67
Issue
3
Copyright Statement
© 2025 The Author(s). Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Subjects
Early intervention
behavioural problems
RCT design
longitudinal studies
Publication Status
Published