Do Playful Parenting Programs Implemented at Scale Improve Caregiver Practices and Child Development?

<b>Background/Objectives</b>: As an independent research group, we examined parent and child outcomes of three different parenting programs delivered at scale. The programs were implemented in Bhutan, Serbia and Zambia by different organizations. <b>Methods</b>: Mixed methods included a caregiver interview using the HOME Inventory, a direct child assessment using the Global Scales of Early Development (GSED) and focus group discussions with caregivers (FGD). Sampled mothers and children were randomly selected for the HOME/GSED: Bhutan <i>n</i> = 432, Serbia <i>n</i> = 636, Zambia <i>n</i> = 1024. Over 40 mothers and fathers of children under 3 years were purposively selected for FGD. Intention-to-treat and secondary regression analyses of attendees and non-attendees were conducted on the HOME and GSED; FGDs were subject to content analysis. <b>Results</b>: Parenting practices were found to be minimally (Bhutan) or modestly (Zambia) higher for caregivers who attended group sessions. Caregivers in Serbia who recalled receiving play messages had higher HOME scores. Child outcomes showed small (Bhutan) or no differences (Serbia, Zambia) associated with participation. <b>Conclusions</b>: Explanations focused on limits to program participation in scaled programs, the need for pilot evaluations to ensure that the program design is effective, and the need to monitor delivery quality and other implementation processes.