Child and adolescent behavioral health problems are related to the leading causes of youth morbidity and mortality. Parent-focused interventions effectively prevent behavioral health problems such as depression and conduct disorders and can provide a downstream economic benefit to society by reducing criminal activity, education costs, and health care use. Unfortunately, parenting programs are not widely available, accessible, nor well-attended. Pediatric primary care is a non-stigmatizing setting with nearly universal reach and, therefore, an ideal contact point to increase access. However, primary care clinicians (PCCs) often have insufficient training in behavioral health topics and typical referral practices are inadequate. There are also logistical barriers to attending in-person parenting programs, like the need for childcare and a large time-commitment. There is a need to develop effective referral practices in conjunction with increasing the accessibility of parenting programs. The study long-term goal is to prevent significant behavioral health problems through widespread access to effective and accessible parenting programs through primary care referrals. In this study there are two trials: First is the primary care clinicians "PCC" trial, testing the effectiveness of referral training (aim 1). Second is the parents "eGen" trial provided by therapists, testing the effectiveness of eGen parenting intervention (aim 2).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
600
assigned to receive a brief, live, experiential training on the referral process and communication strategies.
assigned to receive only written information about the referral process
eGen is a six-session parent training program provided by therapists via video chat online to parents with a child between the ages of 3-8 years.
The control condition consists of a single scripted session, in which therapists guide the parent to the following resources: (a) a book, Raising Cooperative Kids, by GenPMTO co-developer Marion Forgatch; (b) vetted parenting advice websites; (c) information about Early Childhood and Family Education classes, which are provided for free in Minnesota through public schools; and (d) a list of culturally tailored parenting advice websites.
University of Minnesota
Minneapolis, Minnesota, United States
RECRUITINGChild behavior problems
Child externalizing and internalizing will be measured using the Behavioral Assessment System for Children - Behavioral and Emotional Screening System (BASC-3-BESS; 29 items).
Time frame: 10 weeks
Change in parenting behavior
The Alabama Parenting Questionnaire - Preschool version (APQ; 32 items) has subscales to measure positive parenting, inconsistent parenting, and punitive parenting.
Time frame: 10 weeks
Number of Completed Referrals
This is defined as the number of parents who agree to begin treatment with the therapist after a referral from a primary care provider.
Time frame: 4 years
Parent Attendance
Parent attendance will be reported as the percent of sessions attended.
Time frame: 1 year
Parents mental health: depression
The patient health questionnaire will measure parent depression (PHQ-9; 9 items)
Time frame: 10 weeks
Parents mental health: anxiety
the general anxiety disorder scale (GAD-7) will assess parent anxiety symptoms
Time frame: 10 weeks
Parents mental health: absenteeism
the WHO Health and Work Performance Questionnaire - Short Form (HPQ SF, 8 items) will assess parent absenteeism.
Time frame: 10 weeks
Parenting self-efficacy
Parenting self-efficacy will be measured with the Parent Locus of Control measure (PLOC; 24 items).
Time frame: 10 weeks
Intervention Acceptability, Appropriateness, and Feasibility Measure
Average score on the Acceptability of intervention Measure items. These measures are on a 1-5 scale from completely disagree to completely agree. A higher score indicates higher acceptability, appropriateness, or feasibility.
Time frame: 1 year
Readiness to Change - Patient Preferences Subscale Score
Average score on the Readiness to Change Assessment, patient preferences items (Helfrich, Li; Sharp, 2009). This measure is rated on a 1-5 scale from strongly disagree to strongly agree, with a sixth option for not applicable. High scores indicates greater acceptability.
Time frame: 1 year
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