Population-Wide Parenting Intervention Training: Initial Feasibility

A population-level approach to deliver parenting and family support is a necessary but neglected approach needed to reduce the high prevalence of emotional/behavioral problems in children, decrease inadequate and potentially abusive parenting practices, and to provide improved parenting support to all parents within a specified population. We examined the initial feasibility of a large-scale professional training regimen to prepare existing service providers to implement an evidence-based preventive intervention in the realm of parenting and family support. Data from the U.S. Triple P System Population Trial are used to illustrate how a parenting and family support intervention can be successfully disseminated to a large, multidisciplinary workforce. We discuss lessons learned from this dissemination effort as well as implications for population-based approaches to child and family well-being.     

Early Parenting Intervention: Family Risk and First-time Parenting Related to Intervention Effectiveness

The effects of cumulative risk and parity on the effectiveness of a home based parenting intervention were tested in a randomized controlled trial with 237 families with 1- to 3-year-old children screened for high levels of externalizing behavior. The intervention was aimed at enhancing positive parenting and decreasing externalizing behaviors. The results showed that cumulative risk was not associated with either change in child externalizing behaviors or change in positive parenting. When intervention effectiveness was compared for primiparas (i.e., first-time mothers) versus multiparas (i.e., mothers with more than one child), we found that intervention mothers of first-born children displayed an increase in their use of positive discipline strategies as compared to first-time mothers in the control group, whereas a similar effect for multiparas was absent. Among multiparas we found an intervention effect on sensitivity, with control group mothers showing an increase in sensitivity, whereas the intervention group showed a constant level of sensitivity over time. These results suggest that parity may be a moderator of intervention effectiveness. Implications for investigating moderators of intervention effectiveness are discussed.     

Parenting Intervention to Reduce Attention and Behavior Difficulties in Preschoolers: A CUIDAR Evaluation Study

In this study, we evaluated CUIDAR, a program that provides community-based 10-week parent training to reduce attention and behavior problems in preschool children. We recruited 154 predominantly low-income and Latino preschoolers and their parents to participate in this evaluation study. We collected data prior to and immediately following intervention and one year later. At the time of follow-up, we also recruited 15 parents who had initially enrolled, but never participated in the program to serve as a comparison group for a limited set of analyses. From pre to post intervention, we observed significant, positive changes in eight out of ten measured parenting behaviors. From pre intervention to follow-up, improvements in the use of transitional statements and planning ahead were significant. Children’s SDQ Total Difficulties scores significantly decreased from pre to post intervention (d = .36), and we observed significant, positive changes in all SDQ subscales. From pre intervention to follow-up, children’s SDQ Total Difficulties scores significantly decreased (d = .71) and all SDQ subscales reflected significant, positive changes. We observed no significant differences in reported barriers to participation between parents who participated in the program and those who enrolled, but never participated. Intervention gains were moderated by several factors, including history of out-of-home care and family structure. Our results should be interpreted cautiously because not all analyses included a comparison group, and a randomized trial of CUIDAR effectiveness is still needed.     

The Self-efficacy for Parenting Adolescents Scale: Development and Initial Validation

Journal of Child and Family Studies - Adolescence can be a difficult developmental period for children and their parents. During this time, parents need to develop new skills, and their perceived...     

Preparing the Field for Feasibility Testing of a Parenting Intervention for War‐Affected Mothers in Northern Uganda

In this article, we discuss the successful implementation of an adapted evidence‐based parenting intervention for families affected by two decades of war in Northern Uganda. The adaptation and adoption of such interventions to support mental health and family functioning is widely endorsed by prevention scientists and considered a priority in global mental health. The preparation and early adoption phases of engaging with a highly vulnerable community affected by war trauma are documented in this paper along with a discussion of the steps taken to adapt a parenting intervention for cultural and contextual fit. This study is a component of an overall program of research aimed at reducing the long‐term negative effects of war on parenting practices and childhood outcomes, which have considerable implications for preventing mental, neurological, and substance‐use disorders. The processes described here cover a 4‐year period culminating in the implementation of the nine‐session Enhancing Family Connection intervention piloted with a group of 14 mothers. The lessons in cultural adaptation have been valuable and the feasibility results promising for further testing the intervention.     

Potential Mediators in Parenting and Family Intervention: Quality of Mediation Analyses

Parenting and family interventions have repeatedly shown effectiveness in preventing and treating a range of youth outcomes. Accordingly, investigators in this area have conducted a number of studies using statistical mediation to examine some of the potential mechanisms of action by which these interventions work. This review examined from a methodological perspective in what ways and how well the family-based intervention studies tested statistical mediation. A systematic search identified 73 published outcome studies that tested mediation for family-based interventions across a wide range of child and adolescent outcomes (i.e., externalizing, internalizing, and substance-abuse problems; high-risk sexual activity; and academic achievement), for putative mediators pertaining to positive and negative parenting, family functioning, youth beliefs and coping skills, and peer relationships. Taken as a whole, the studies used designs that adequately addressed temporal precedence. The majority of studies used the product of coefficients approach to mediation, which is preferred, and less limiting than the causal steps approach. Statistical significance testing did not always make use of the most recently developed approaches, which would better accommodate small sample sizes and more complex functions. Specific recommendations are offered for future mediation studies in this area with respect to full longitudinal design, mediation approach, significance testing method, documentation and reporting of statistics, testing of multiple mediators, and control for Type I error.     

Disseminating a Parenting Intervention in the Community: Experiences from a Multi-Site Evaluation

Circle of Security-Parenting (COS-P) is a widely used parenting intervention that is gaining popularity globally as it is currently being delivered across several continents. Despite the global uptake of COS-P, there is limited research on its effectiveness with considerable variability in its delivery. Here we present a multi-site evaluation of the group delivery of COS-P to under-resourced mothers (n?=?131 enrolled) in an urban community as facilitated by community-based providers (n?=?12) from community sites (n?=?6) that provide maternal and child services. The feasibility and acceptability of delivering COS-P in the community are highlighted as well as characteristics of sites and providers as they relate to implementation efforts, and pre and post-intervention data examining COS-P and maternal caregiving functioning (i.e., depressive symptoms, reflective functioning) are also included. Several service delivery barriers were encountered at agency, provider and participant levels that created obstacles for program dissemination, participant retention and evaluation. Nonetheless, COS-P was successfully delivered in the community when sites embedded the program within their existing infrastructure and had the internal capacity for delivery, participant recruitment, supervision, and community presence. Mothers who participated in COS-P also reported fewer depressive symptoms following the intervention (n?=?25). This multi-site implementation and evaluation study has important implications for the delivery of parenting services to under-resourced communities globally. Implications for future research and service delivery are discussed.