Parents Make the Difference is a group parenting program for caregivers of young children in Liberia, developed by the International Rescue Committee with researchers at Duke University. The intervention includes ten weekly sessions of two hours, led by two trained lay facilitators, in which parents learn and practice alternatives to harsh punishment, build warmer relationships with their children, and support their children’s early emotional and pre-academic development.
The rural trial
The first trial of the intervention, in rural post-conflict communities in Lofa County, was a randomized controlled trial with 270 caregivers of children ages three to seven. It reduced caregiver-reported use of harsh punishment by more than half and improved the quality of caregiver-child interactions, as reported by caregivers and by children themselves.
The Monrovia trial
The second trial, in urban Monrovia, randomized 813 caregivers of three and four year old children to the group program, to the group program plus three home visits for individual skills practice, or to a waitlist control, and followed all three arms for a year. Three months after the program, caregivers showed reduced preference for harsh punishment, lower parental rejection, better parent-child interactions, and fewer depressive symptoms. The home visits added no further gain on the primary outcomes. Effects were largest and most durable among families of children with the highest levels of behavior problems at the outset, where they held at twelve months.
Ebola and parenting
The timing of the Monrovia trial made an additional substudy possible. Enrollment had just closed when the 2014 Ebola outbreak halted all activity, and the team returned to the same caregivers a year later. Caregivers in households that had experienced Ebola sickness or death had shifted toward markedly stronger preferences for harsh discipline, one of the few direct measures of how an epidemic changes parenting behavior.
Key Publications
Puffer, E. S., Green, E. P., Chase, R. M., Sim, A. L., Zayzay, J., Friis, E., Garcia-Rolland, E., & Boone, L. (2015). Parents Make the Difference: A randomized controlled trial of a parenting intervention in Liberia. Global Mental Health, 2, e15.
Green, E. P., Chase, R. M., Zayzay, J. O., Finnegan, A., & Puffer, E. S. (2018). The impact of the 2014 Ebola virus disease outbreak in Liberia on parent preferences for harsh discipline practices: A quasi-experimental, pre-post design. Global Mental Health, 5, e1.
Giusto, A., Friis, E., Sim, A. L., Chase, R. M., Zayzay, J. O., Green, E. P., & Puffer, E. S. (2017). A qualitative study of mechanisms underlying effects of a parenting intervention in rural Liberia. European Journal of Development Research, 29(5), 964–982.
Maloney, C., Wall, T., Giusto, A., Chase, R. M., Finnegan, A., Sim, A., Zayzay, J., & Puffer, E. S. (2024). Early childhood parenting programs as a mechanism for community peace building: A case study from post-conflict Liberia. Peace and Conflict: Journal of Peace Psychology, 30(2), 175–184.