Effectiveness of a blended in-person and online parenting programme in reducing violence against children in rural Thailand: a cluster randomised controlled trial

Lancet Reg Health Southeast Asia. 2026 May 28;50:100789. doi: 10.1016/j.lansea.2026.100789. eCollection 2026 Jul.

ABSTRACT

BACKGROUND: Violence against children remains a substantial public health concern in Thailand. We evaluated whether a blended in-person and online messaging-based parenting programme could reduce child maltreatment.

METHODS: We conducted a parallel, two-arm, cluster-randomised, assessor-blinded trial in 12 sub-district health-promoting hospitals in Udon Thani, Thailand. Primary caregivers aged 18 years or older living with a child aged 2-17 were enrolled and randomised 1:1 to intervention or control (n = 240; approximately 20 per cluster). The nine-week intervention combined two brief in-person meetings with facilitated LINE™ (a widely used messaging application in Thailand) group chats. The primary outcome was the frequency of physical or emotional abuse in the past four weeks, assessed at one-month post-programme. Analyses were conducted on an intention-to-treat (ITT) basis using mixed-effects negative binomial models. Registered with the Open Science Framework (May 18, 2024; DOI 10.17605/OSF.IO/AB7GR; protocol available at https://osf.io/ysrku/overview?view_only=f0165cd340ef40e7ba2b0c5c79b6cbbf).

FINDINGS: Between 18 May and 2 June 2024, 240 caregivers were enrolled (120 per arm; 97.1% women). One-month follow-up was 90.0% (108/120) in the intervention and 91.7% (110/120) in the control arms. Overall child maltreatment showed no significant differences between groups (incidence rate ratio [IRR] 1.46, 95% confidence interval [CI] 0.83-2.57). No differences were observed for physical abuse (IRR 0.70, 95% CI 0.30-1.62). The relative estimates for emotional abuse was higher in the intervention arm (IRR 2.57, 95% CI 1.27-5.20).

INTERPRETATION: Results suggest no reductions in child maltreatment in the intervention group at one-month follow-up. The higher estimate for emotional abuse may reflect differential reporting or changes in awareness between groups. These findings suggest areas for refinement in intervention content and delivery. Future trials should target higher-risk participants and assess longer-term outcomes.

FUNDING: The LEGO Foundation, Oak Foundation, and World Childhood Foundation via the Global Parenting Initiative.

PMID:42256521 | PMC:PMC13235521 | DOI:10.1016/j.lansea.2026.100789