Parenting in the Preschool System in Malaysia

The primary aims of the study are to:

Evaluate the effectiveness of NK-Hybrid on positive parenting at three months post-baseline in comparison to wait-list controls Evaluate the effectiveness of NK-Hybrid on child learning and development, as measured by parent and teacher reports of language and communication, literacy, socioemotional, and numeracy skills, and by direct assessments of literacy and numeracy skills, at approximately 12 months post-baseline in comparison to wait-list controls

Secondary aims of the study include:

Evaluate the sustained effectiveness of NK-Hybrid on positive parenting at approximately 12 months post-baseline.

Evaluate the effectiveness of NK-Hybrid on children's learning, namely their literacy and numeracy skills, in comparison to the control group, at three months post-baseline Evaluate the effectiveness of NK-Hybrid on secondary outcomes - parent involvement in playful learning, child maltreatment (physical and emotional abuse), caregiver anxiety and depression, parenting stress, child externalising symptoms, child learning and development, caregiver financial stress, intimate partner violence, marital health, co-parenting support, father involvement, and gender equitable behaviours - at approximately three months post-baseline and 12 months post-baseline.

Evaluate the intervention costs and cost-effectiveness of NK-Hybrid on primary outcomes of positive parenting and child literacy and numeracy skills.

Evaluate the association between engagement in the NK-Hybrid intervention and primary and secondary outcomes.

Explore potential mediators of positive parenting, child literacy and numeracy skills, child maltreatment, child externalising symptoms, and caregiver depression and anxiety at 12 months post-baseline.

Explore potential moderators of positive parenting, child literacy and numeracy skills, child maltreatment, child externalising symptoms, and caregiver depression and anxiety based on socio-demographics and psychosocial assessments at baseline

In line with the study's primary and secondary objectives, the following hypotheses have been defined a priori and will be evaluated using the methods outlined in this statistical analysis plan.

Hypothesis 1a: Caregivers in the treatment group will show higher levels of positive parenting, in comparison to the control group, at 3 months post-baseline.

Hypothesis 1b: Children in the treatment group will show greater improvements in early learning and development, namely their literacy and numeracy skills, in comparison to the control group, at 12 months post-baseline.

Hypothesis 2a: Caregivers in the treatment group will show higher levels of positive parenting, in comparison to the control group, at 12 months post-baseline.

Hypothesis 2b: Children in the treatment group will show greater improvements in learning, namely their literacy and numeracy skills, in comparison to the control group, at three months post-baseline.

Hypothesis 2c: Caregivers in the treatment group will show lower levels of child maltreatment (physical and emotional abuse), anxiety and depression, parenting stress, child externalising symptoms, financial stress, and intimate partner violence, in comparison to the control group, at 3 months and 12 months post-baseline.

Hypothesis 2d: Caregivers in the treatment group will show higher levels of parent involvement in playful learning, marital health, co-parenting support, father involvement, and gender equitable behaviours in comparison to the control group, at 3 months and 12 months post-baseline.

Hypothesis 3a: The intervention will be more cost-effective than the control condition for the primary outcomes, yielding a cost per unit of effect that supports decision-making by relevant stakeholders.

Hypothesis 3b: Higher engagement with intervention components (i.e., in-person onboarding, NKText, and WhatsApp support groups) will be associated with greater improvements in the aforementioned primary and secondary outcomes.

Inclusion criteria

Preschools (clusters):

• Registered Ministry of Rural Development (KEMAS) preschool
• Has a class of 20 or more children aged 4-6 years
• Selected by KEMAS leadership as available to participate
• Class teacher is willing to deliver the programme and participates in programme training

Parents/Caregivers:

• Responsible for a child aged 4-6 years enrolled in a participating KEMAS preschool
• Aged 18 years or older
• Has access to a mobile phone compatible with WhatsApp
• Provides informed consent

Children:

• Enrolled in a participating KEMAS preschool
• Aged 4-6 years
• Parent provides consent
• Provides verbal assent

Teachers (Facilitators):

• Registered employee with a KEMAS preschool
• Aged 18 years or older
• Diploma/certificate in Early Childhood Education (ECE) or equivalent
• Provides consent
• Completed training
• Available to deliver intervention

Exclusion criteria

• Parents/caregivers who do not meet inclusion criteria
• Children who do not meet inclusion criteria