Child Behavior Problem, Parenting
Conditions
Keywords
child behavior problem, parenting, parental capacity
Brief summary
Interventions that promote safe, stable, and nurturing relationships between caregivers and children are key to improving healthy family relationships, reducing child socioemotional and behaviour problems, and preventing child maltreatment. Although a broad range of parenting programs are currently implemented in communities across Ontario, most programs are inadequately evaluated, or else not evaluated at all. Using a three-armed randomized controlled trial, the aim of the current study is to evaluate the effectiveness of two parenting programs, the Triple P - Positive Parenting Program (group - level 4) and the Circle of Security Parenting Program (group) compared to treatment as usual in Ontario, Canada.
Detailed description
The overall goal of the evaluation is to provide robust evidence about the implementation and effectiveness of two parenting programs, the Triple P and Circle of Security Parenting (COSP), in the province of Ontario, on parenting practices and functioning, and child emotional behaviour problems outcomes, and secondary outcomes including selected child maltreatment-related outcomes. These objectives will be achieved in two phases. The investigators will conduct a multi-site, three-arm randomized controlled trial of 600 participating caregivers and their children to compare Triple P (level 4 group) and COSP to treatment as usual (TAU) with respect to improving positive practices and child outcomes. Participants will be randomly assigned to one of the three conditions using stratified (by site) block randomization. All participants will undergo screening and a baseline assessment before randomization. Once randomized, the Triple P and COSP caregivers will receive 8-week session. The TAU group will receive a different program, or short therapy sessions depending on the organization. Caregivers will complete follow-up assessments at post-treatment, 6- and 12-months.
Interventions
BEHAVIORALTriple P
Triple P - level 4 group is a group-based parenting intervention for families with children who exhibit behavioural or emotional difficulties. Group sessions typically focus on topics such as positive parenting, helping children develop, managing misbehaviour, and planning ahead. Practitioners then provide individual feedback on progress using positive parenting strategies and goal setting. Trained practitioners will deliver the program according to the manualized protocol (Turner, Markie-Dadds, & Sanders, 2010). This will include eight weekly sessions with maximum of 12 parents. The first four sessions will be as group sessions. These four group sessions will be followed by three one-to-one practical and personalised telephone consultations. Finally, there will be one group session, which will complete the programme and parents' contact with the Triple P practitioners. The main aim of this session is to review progress and plan for the future.
BEHAVIORALCircle of Security Parenting
Circle of Security - Parenting (COS-P) will be delivered according to the protocol outlined by Cooper, Hoffman and Powell (Cooper et al., 2009). COS-P is a manualized eight-session parent-education group program which has the same broad aims and core components of the COS-Intensive model from which it was developed (i.e., to increase caregiver sensitivity and responsiveness to child cues, empathy for the child by supporting parental reflective functioning, recognition and understanding of child attachment cues, and awareness of the impact of the caregiver's own attachment history on caregiving patterns). The program is led by one or two facilitators and includes 10-12 caregivers. The program uses clinical DVD clips of problematic parent-child interaction and healthy alternatives to illustrate attachment patterns and parenting styles, and to promote group discussion.
Sponsors
University of Manitoba
Institute for Clinical Evaluative Sciences
Public Health Agency of Canada (PHAC)
University of Exeter
McMaster University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
2 Years to 6 Years
Healthy volunteers
Yes
Inclusion criteria
Caregivers of children are eligible for inclusion if: * Custodial caregiver of child is aged 2 to 6 years at time of screening. * Families with sufficient knowledge of English needed for assessment measures. * Caregivers capable of giving informed, written consent. * Definition of 'at-risk' as measured by one of the following criteria as outlined below: * Elevated child emotional behavioural problems as indexed by above- population mean total scores on the Strengths and Difficulties Questionnaire (SDQ); OR * One of the following family or contextual risk factor * Parental challenge - parental mental health problems, as indexed by score on K6 distress scale ≥ 13; adolescent parent status (less than 20 years of age); single parent status; OR Sociodemographic risk factor - parent with less than grade 12 education; parent on social assistance; * Expressed difficulties with parenting: Do you often feel like your child is difficult to take care of?
Exclusion criteria
• Children with suspected severe to profound developmental delay.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Child emotional/behavioural problems | 6-months | The investigators will measure change in child emotional and behavioural problems across time points. |
| Parenting Practices | 6-months | Discipline style measured using the Parenting Scale |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Observed Parenting | Baseline, 6-months. | Video-taped caregiver-child interactions |
Other
| Measure | Time frame | Description |
|---|---|---|
| Caregiver Emotion Regulation | Baseline, 6- and 12-months. | Change in Parental Emotional Regulation will be measured using the Difficulties in Emotion Regulation Scale. |
Countries
Canada
Outcome results
None listed