Skar 2021.

Study characteristics
Methods	Study design: RCT Duration of study: the study was conducted between August 2012 and August 2015. Country: Colombia Income classification: upper‐middle income country in 2012‐2015 Geographical scope: Chocó department Healthcare setting: community‐based child centres
Participants	1. Age: caregivers had an average age of 31.89 years (range 18‐64). 2. Gender: both 3. Socioeconomic background: low‐income families—almost half of the caregivers (48.3%) lived in low‐income households (< US$197 per month), and 40.3% of employed caregivers received a salary of US$33 per month or less. 4. Educational background: nearly half of caregivers (47.1%) had higher education. Inclusion criteria: a. families belonging to six social service child centres run by Instituto Colombiano de Bienestar Familiar (ICBF). Parents attended the health‐promoting entity called Entidades Promotoras de Salud, which offers health services subsidized by the government to low‐income families. b. All registered parents were eligible for inclusion in the study if they had a child within the relevant age group (3 to 4 years). Exclusion criteria: not specified. Note: at baseline, the total group prevalence for scores above clinical cut‐off (> 8) of the Shona Symptom Questionnaire (SSQ) was 19.2% (N = 33). Stated purpose: to investigate whether the International Child Development Programme (ICDP), by focusing on strengthening positive caregiving and familial relationships, is effective as a violence preventive measure and whether a specific violence prevention curriculum (element b and c in Cook 2017) will add to the effect, when compared with participation in regular social programme activities at child care centres. An additional aim of the study is to investigate potential predictors of violence and mental health problems.
Interventions	Name: community activities (CA) + ICDP; violence curriculum (VC) CA + ICDP Title/name of PW and number: local care persons within a society 1. Selection: not specified 2. Educational background: not specified 3. Training: yes, provided by certified ICDP trainers, but not specified 4. Supervision: not specified 5. Incentives/remuneration: not specified Prevention type: indicated – 19.2% participants presented with some level of distress as indicated by SSQ scores. Intervention details CA + ICDP: CA + ICDP groups followed the general recommendations of ICDP, in which two ICDP‐trained facilitators were to initiate discussions and activities related to the three dialogues for good caregiver‐child interaction in ICDP, namely emotions, communication, and regulation. ICDP methods include caregiver self‐activation through group discussions, role‐play, home practice between the group meetings, and reporting back to the group. There were 12 ICDP group meetings. VC CA + ICDP: the CA + ICDP + VC groups were run in the same way as the ICDP groups; however, the ICDP part was more intensive, as it was implemented over six group meetings rather than 12. Following that, the caregivers attended six group meetings with a preventive VC through informative workshops where the aims are to (a) sensitize and train community stakeholders on child development, effects of violence, legislation and policy frameworks, and their role in protecting children, and (b) develop formal and informal child protection systems, followed by a plan of action to protect children from violence. VC methods include caregiver self‐activation in form of designing protective strategies and developing monitoring tools to follow‐up on the two aims. Control: usual care (all participants attended the child centres, which had a number of health, nutrition, and educational facilities available. The comparison group received no additional intervention).
Outcomes	Participants’outcomes of interest for this review Diagnosis of mental disorders – SSQ, score above clinical cut‐off (> 8) Note: we included data from the “VC CA + ICDP” intervention and control group. Carers’ outcomes of interest for this review Nil Economic outcomes Nil Time points: baseline, post‐intervention (1‐6 months)
Notes	Source of funding: the evaluation project has been supported by the Children and Violence Evaluation Challenge Fund, a joint initiative funded by Bernhard van leer Foundation, Oak Foundation, and UBS Optimus Foundation and hosted by NEF. Notes on validation of instruments (screening and outcomes): SSQ has been validated in low‐income settings in Zimbabwe. It has a satisfactory sensitivity against a diagnosis of depression (84%) and anxiety (73%), and internal reliability ranging from α = 0.74 (Chibanda 2016) to α = 0.85 (Patel 1997). Additional information: none Handling the data: not applicable Prospective trial registration number: Regional Committees for Medical and Health Research Ethics (reference number 2012/1169/REK Sør‐Øst A)