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The Hexagon: An Exploration Tool
The Hexagon can be used as a planning tool to guide selection and evaluate potential programs and practice for use.
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Core Components
Empowering Parents, Empowering Communities (EPEC) is a group parenting intervention, delivered by parents who have themselves previously participated in a parenting group and have undertaken the ten-week EPEC training programme for peer facilitation. The EPEC programme is largely targeted at families living in areas of high social deprivation and its aims centre on improving the parent-child relationship, prevention of later child behaviour difficulties and increasing parental confidence.
EPEC is available in 3 core versions:
• Baby and Us (parents of babies 0-1)
All programmes in the suite follow the same structure and flow, delivered over 8 two-hour sessions by two peer facilitator parent group leaders. Sessions 1-4 support parents to consider their hopes and expectations as parents and to support the strengthening of the parent-child relationship through positive communication and child-led play. Building on this foundation, sessions 5-7 focus on behaviour management strategies, with the final session dedicated to review and the importance of parental self-care.
The programme is clearly operationalised in the manual, with specific details of session content, delivery and estimated timings.
Fidelity
Fidelity is monitored at different stages of the overall process, from peer facilitator selection and training, to content delivery and core skills of facilitation. The programme provides comprehensive checklists for assessment of training progress, quality controls as well as supervisor observation of group delivery.
Modifiable Components
Adaptations of the programme are available for parents of children with Attention Deficit Hyperactivity Disorder (ADHD), parents of children with Autism, for parents of children with chronic health difficulties, and for families living in temporary accommodation. All programmes follow the same structure.
Within delivery of each programme, peer facilitators are encouraged to adapt to meet the specific needs of participants, for example different options are provided for exercises within the manual.
All EPEC programmes have been adapted for online delivery. Short films are available online to accompany the Being a Parent groups and Baby and Us groups. More information about adaptions, and online top up trainings, can be accessed by contacting the developers.
Empowering Parents, Empowering Communities (EPEC) national UK unit supports recruitment and training of coordinator and supervisors at each local site (the EPEC Hub), following which, all training of parent group peer facilitators is delivered on a local basis from the local EPEC Hub.
Support for Organisation/Practice
Implementation Support
Empowering Parents, Empowering Communities (EPEC) has a national Scaling Programme, which initially focusses on the programme version for parents of children 2-11 years old, before sites have the option of expanding to include other EPEC programmes. The Scaling Programme provides a full package of training and supports for one year to allow selected areas to establish a Hub, recruit and train parent group peer facilitators, and embed successful implementation approaches.
EPEC national unit have produced clear guidelines for establishing and sustaining successful local EPEC services. Sites apply for inclusion in the Scaling Programme with specific focus on their local priorities, commitment to the aims of EPEC and resources in place to support effective implementation. Following inclusion in the Scaling Programme, sites have a visit from an EPEC expert from the national programme at least one day per month, for support with any aspect of implementation. Sites also have access to a central ‘drop box’ of EPEC resources, along with their own SLACK (social media) channel to support and share practice within and between EPEC Hubs. Finally, national EPEC ‘Quality Standards’ facilitate quarterly discussions between local sites and the national unit, focussing on implementation progress and supporting any challenges which have arisen.
Data is collected across sites and collated centrally by the national unit with regards to group attendance, demographics and routine outcome data. EPEC oversee this data collection and the systems required.
Licence Requirements
Localities are required to sign up to a licence agreement to protect EPEC intellectual property and identify the roles and responsibilities of the local site and the national EPEC team.
Start-up Costs
The fee for the comprehensive package of training, support activities and materials available in the Scaling Programme is £17,600 for Year 1. This fee covers everything required to set up a site to train up to 20 parent group peer facilitators to deliver up to 10 Being a Parent groups.
At the end of year 1, teams are offered a range of ongoing support options with differing degrees of contact with the national unit, data handling and access to resources and training. Costs range from £5,000 for the ‘core’ package to £10,000 for the ‘full’ package.
Building Staff Competency
Qualifications Required
Peer Facilitator Parent Group Leaders are all parents, selected based on their previous experience of attending an EPEC or similar parenting intervention, as well as their capacity to use their own experiences in helping others. Qualitative evaluation of Group Leader attributes has highlighted that those facilitators who are enthusiastic, reflective and committed to the programme are most likely to deliver cohesive, successful groups as well as navigate any challenges which might arise.
Recruitment is coordinated by local Hubs through a process of application and interview.
Training Requirements
Training across EPEC roles is as follows:
• Local EPEC Hub coordinator and accountable manager attend 3-day Hub familiarisation & training event. This can take place either in person or online.
The 10-day Parent Group Leader training takes place one day a week over 10 consecutive weeks. Attendees are provided with a creche to facilitate attendance, and their accredited course is assessed based on their course participation, a reflective practice journal and their facilitation practices.
Supervision Requirements
Parent Group Leaders are supervised on a fortnightly basis. Supervisors observe group delivery and complete an observation sheet to facilitate specific supervision of group practice.
Outcomes from a UK based Randomised Control Trial indicate significant improvements in child behaviour and positive parenting practices as a result of EPEC intervention compared with a control group. No evidence yet of long-term sustainability of positive outcomes.
Theory of Change
The key to the EPEC programme is delivery by peer facilitators – parents who have themselves attended an EPEC group or similar evidence-based parenting intervention. This model has been shown to overcome many of the barriers present for professionally delivered programmes, by increasing accessibility of the programme to those families who most need it, as well as delivering significant positive benefits for those parents who train as peer facilitators.
The programme content has foundations in attachment theory and social learning theory. It is highly interactive and encourages parents to use course content at home with their children. Programme structure facilitates enhancing parent-child relationship and communication, which is then built upon with behaviour management strategies grounded in social learning principles.
Infants and Toddlers: 0-36 months - Rating: 4
Number of Research Studies & Research Design
One large (internal) RCT (n=116) in the UK (Day et al., 2012).
(NB: RCT implemented 2-11 year old programme, with mean age of participants 4.8 years. No evaluation has been undertaken with younger participants.)
In addition, there have been a range of pilot studies of community implementation in UK and Australia, along with a qualitative evaluation of parent group leader experience.
Outcomes Achieved
Child Outcomes
• Significant improvements in child externalising behaviours following EPEC intervention (as rated by parents)
Parent Outcomes
• Significant moderate effect on positive parenting in intervention group compared with control
• Positive impact on parenting stress (although this did not differ significantly from the control group)
Key References
Day, C., Michelson, D., Thomson, S., Penny, C., & Draper, L. (2012). Evaluation of a peer led parenting intervention for disruptive behaviour problems in children: community based randomised controlled trial. BMJ 344
Winter, R. (2013). Empowering Parents, Empowering Communities. Prepared for Murdoch Children’s Research Institute, Tasmania Early Years Foundation: Melbourne.
Preschool: 3 to 5 years - Rating: 4
Research Design & Number of Studies
The best evidence for EPEC for families with children aged 3 -5 years old comes from an internal Randomised Control Trial. This study included children aged 2-11 years old and therefore evidence outcomes for this age range, 3-5 years, are the same as for the 0-36 month evidence above.
Reference
Day, C., Michelson, D., Thomson, S., Penny, C., & Draper, L. (2012). Evaluation of a peer led parenting intervention for disruptive behaviour problems in children: community based randomised controlled trial. BMJ 344
Primary school: 6 to 12 years - Rating: 4
Research Design & Number of Studies
The best evidence for EPEC for families with children aged 6-12 years old comes from an internal Randomised Control Trial. This study included children aged 2-11 years old and therefore evidence outcomes for this age range, 6-12 years, are the same as for the 0-36 month & 3-5 years evidence above.
Reference
Day, C., Michelson, D., Thomson, S., Penny, C., & Draper, L. (2012). Evaluation of a peer led parenting intervention for disruptive behaviour problems in children: community based randomised controlled trial. BMJ 344
Adolescents: 13 to 18 years - Rating: 2
Research Design & Number of Studies
The best evidence for EPEC for families with children aged 13+ is an internal feasibility study for the EPEC intervention for parents of adolescents ‘Living with Teenagers’. The study sample (N=41) was comprised of parents of adolescents age 11-17 years old and outcomes are therefore relevant to this 13+ age range.
Outcomes Achieved
Significant change was demonstrated across the following domains, although as a feasibility study, there was no control group for comparison.
Parent Outcomes
Increased parenting satisfaction
Reduced negative expressed emotion
Reference
Michelson D, Ben-Zion I, James AI, et al . (2014). ‘Living with Teenagers’: feasibility study of a peer-led parenting intervention for socially disadvantaged families with adolescent children. Archives of Disease in Childhood, 99:731–737.
Need
Comparable Population
EPEC is targeted at families with children 0-17 years old, living in significant social deprivation.
Is this an identified population of particular concern to your organisation? Do you have a commitment for investing in a programme which overcomes barriers commonly experienced by professionally delivered parenting interventions and allows accessibility for those families who most need input? Desired Outcome
EPEC with parents of children 2-11 years old has been shown to strengthen the parent-child relationship and equip parents with the skills and confidence to increase their sensitivity to their child’s communication and appropriately manage their child’s behaviour.
EPEC ‘Living with Teenagers’ has been shown to increase parenting satisfaction and reduce parental negative expressed emotion.
In addition, for programmes for all age ranges, EPEC Peer Facilitators have been shown to benefit across a number of domains through the experience of being trained and delivering parent groups.
For implementation with parents of children 2-11 years old, are the improvements of children’s behaviour and parental skills and wellbeing priority outcomes for your organisation? Are the improvements of increased parenting satisfaction and reduced negative expressed emotion in adolescents priority outcomes for your organisation? Are the improvements of parental self-efficacy, confidence and motivation for change, which have been evidenced for EPEC Parent Group Leaders, key priority outcomes for your organisation? Do you have a drive for a programme embedded within the community, delivered by parents, for parents? Do you have other existing initiatives that would be supportive of addressing this need and achieving these outcomes? Do you have strong links with a range of local commissioners, community resources and service providers to ensure EPEC can become grounded within a community network?
Need Score
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Fit
Values
EPEC is delivered within the community by parents who have themselves previously participated in a parenting intervention.
Is the delivery of a community-based parent-group intervention aligned with the key values and priorities of your organisation? Are you committed to delivering improved outcomes for those parents and children who most need support and intervention? Priorities
EPEC is targeted to families of children 0-17 years old, living in high social deprivation. The aim is to improve the parent-child relationship and prevent later child behaviour difficulties.
Is working with parents of babies and young children in an early intervention approach aligned with the key values and priorities of your organisation? Existing Initiatives
Does your service already provide early intervention programmes aiming to improve child development? Does your service already work in tandem with other community resources, offering a joined-up approach to parenting interventions?
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Capacity
Workforce
EPEC Peer Facilitators – parents who have themselves undertaken a parenting group intervention – must undertake a ten-week training programme to be able to deliver EPEC groups. Each EPEC site also requires an EPEC Hub coordinator who will undertake 10 days of training in order to deliver training and support to the local Peer Facilitators. In addition, each site must recruit supervisor(s) to provide fortnightly supervision.
Do you have a local network of parents who have successfully attended an evidence-based parenting group? Do these parents have the enthusiasm and reflective capacity to inspire others to engage with the EPEC programme? Would these parents have the capacity and motivation to undertake the ten-week training programme and then commit to co-facilitating EPEC groups upon completion? Do you have practitioners within your service who are experienced in the delivery of parenting interventions and skilled in motivating and supporting others? Do you have practitioners within your service who are committed to a community initiative of changing the current experiences of parents and families? Would these practitioners have capacity within their current roles to take on the training and work as an EPEC Hub coordinator or supervisor? Technology Support
EPEC collects basic data from all Hubs to collate on a national basis.
Do you have the technology to support practitioners to input basic data collection for collation by the EPEC national unit? Administrative Support
EPEC delivery requires some administrative support with securing appropriate spaces for group and creche delivery and provision of group materials such as handouts.
Do your current administrative procedures support your practitioners to implement a programme like this? Financial Support
Inclusion in the EPEC Scaling Programme costs £17,600 for year one. This fee includes a comprehensive package of training, support activities and materials to deliver up to ten groups. At the end of year 1, teams are offered a range of ongoing support options with differing degrees of contact with the national unit, data handling and access to resources and training. Costs range from £5,000 for the ‘core’ package to £10,000 for the ‘full’ package.
Does your organisation have the finances to pay for inclusion in the EPEC Scaling Programme? Do you have the finances to pay for the printing of worksheets, leaflets and handouts for the delivery of the programme? Do you have a commitment to allocating finances to further investment in the EPEC programme after the first year of establishing implementation has been completed?
Capacity Score
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