Published September 7, 2021 | Version v1
Journal article Open

Preventing child mental health problems in southeastern Europe: Feasibility study (phase 1 of MOST framework)

  • 1. University of Klagenfurt
  • 2. University of Bremen
  • 3. Bangor University
  • 4. University of Oxford, University of Glasgow
  • 5. Babes-Bolyai University
  • 6. Family and Systemic Practice—ALTERNATIVA
  • 7. Health for Youth Association
  • 8. University of Cape Town
  • 9. University of Oxford
  • 10. Georgia State University


Shared senior authorship: Heather M. Foran & Nina Heinrichs.

The prevalence of child emotional and behavioral problems is an international problem but is higher in low-and middle-income countries (LMIC) where there are often less mental health supports for families. Parenting programs can be an effective means of prevention, but must be low-cost, scalable, and suitable for the local context. The RISE project aims to systematically adapt, implement, and evaluate a low-cost parenting program for preventing/ reducing child mental health problems in three middle-income countries in Southeastern Europe. This small pre–post pilot study is informed by the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework and tested the feasibility of the intervention, the implementation, and evaluation procedures: Phase 1 of the three-phase Multiphase Optimization Strategy (MOST) for program adaptation. Local facilitators delivered the Parenting for Lifelong Health (PLH) for Young Children program to parents of children aged 2–9 in North Macedonia, the Republic of Moldova and Romania in 2018. Parents completed assessments pre-and post-program. Results demonstrated positive pre–post change for participating families (N = 140) on various outcomes  including child externalizing and internalizing symptoms and parenting behavior, in all three countries, all in the expected direction. Program participation was associated with positive outcomes in participating families. Based on the experiences of this pilot study, we outline the practical implications for the successful implementation of parenting programs in the three countries that will inform our next study phases, factorial experiment, and RCT.


This is the accepted version of the following article: Preventing child mental health problems in southeastern Europe: Feasibility study (phase 1 of MOST framework), Elena Jansen et al., Family Process, 00:1–18, Copyright © [2021] Family Process Institute,, which has been published in final form at This article may be used for non-commercial purposes in accordance with the Wiley Self-Archiving Policy [].


Jansen_Preventing child mental health problems_Phase 1_final version for repositoryHF.pdf

Additional details


RISE – Prevention of child mental health problems in Southeastern Europe - Adapt, Optimize, Test, and Extend Parenting for Lifelong Health 779318
European Commission