Effectiveness Trial of Methods for Engaging Parents Into Parenting Interventions

描述（由申请人提供）：育儿技能干预已被证明有助于预防物质使用和精神健康障碍（NCR/IOM，2009; Sandler等人，2011年）。不幸的是，这些干预措施的公共卫生潜力受到严重限制，因为很少有父母参与其中。拟议的研究是一项基于理论的参与包的随机有效性试验，在一项有效性试验中发现，与对照参与条件相比，启动循证育儿干预的比率几乎翻了一番（48%对25%）。参与包对启动的影响是由目标动机结构的变化介导的（即，父母的态度，感知障碍）。参与包增加了参与高需求的家庭，通过减少单亲和讲英语的墨西哥裔美国人家庭，谁不太可能参与育儿干预的参与差距，并通过增加在课堂上遇到行为问题（BP）的儿童的父母之间的参与。拟议的试验测试这种参与包的效果时，通过与一个大的，公立学区的伙伴关系，在自然的服务提供条件下实施。幼儿园和一年级学生的家长（N = 1，350）将在三个时间点接受采访：前测试，后参与和后育儿计划。数据也将从教师、组长和客观评分员那里收集。该项目有四个具体目标：1。使用拆卸设计比较项目包组件的有效性。幼儿园和一年级教室将被随机分配到五个条件之一：1）标准小册子; 2）小册子+家庭证明传单; 3）小册子+教师认可; 4）小册子+组长参与电话（GLEC）; 5）小册子+证明传单+教师认可+ GLEC。2.检查社会文化变量（家庭结构和SES;父母种族和主要语言）和基线儿童BP作为参与条件对入学和启动的影响的调节因子。3.检查激励参与组件的暴露量和实施变异性是否解释了每种条件下的招募率和启动率的变异性。4.测试一个中介模型的参与包对父母和孩子的结果的影响。 与小册子条件相比，来自随机分配到全面参与包的教室的家庭预计将显示出更高的启动率，因此在基于证据的育儿干预中，三P积极育儿计划（Sanders，2008）的会议出席率更高;这反过来又会导致从三P前到后药物滥用风险因素的更大改善（即，儿童BPs，养育功能障碍）和儿童心理健康问题。这一发现表明，这种动机增强的参与方案可以大大增加以证据为基础的育儿干预措施对公共卫生的影响，这些干预措施可以预防药物使用和精神健康障碍。

DESCRIPTION (provided by applicant): Parenting skills interventions have been shown to help prevent substance use and mental health disorders (NCR/IOM, 2009; Sandler et al., 2011). Unfortunately, the public health potential of these interventions is severely limited because few parents engage in them. The proposed research is a randomized effectiveness trial of a theory-based engagement package that has been found in an efficacy trial to nearly double the rate of initiation into an evidence-based parenting intervention compared to a control engagement condition (48% vs. 25%). Engagement package effects on initiation were mediated by changes in targeted motivational constructs (i.e., parental attitudes, perceived obstacles). The engagement package increased participation for high-need families by reducing disparities in engagement for single-parent and English-Speaking Mexican American families, who have been less likely to participate in parenting interventions, and by increasing engagement among parents of children experiencing behavior problems (BPs) in the classroom. The proposed trial tests the effects of this engagement package when implemented under natural service delivery conditions through a partnership with a large, public school district. Parents of kindergarten and 1st grade students (N = 1,350) will be interviewed at three time-points: pre-test, post-engagement, and post-parenting program. Data will also be collected from teachers, group leaders and objective raters. The project has four specific aims: 1. Compare the effectiveness of engagement package components using a dismantling design. Kindergarten and 1st grade classrooms will be randomly assigned to one of five conditions: 1) standard brochure; 2) brochure + family testimonial flyer; 3) brochure + teacher endorsement; 4) brochure + group leader engagement call (GLEC); 5) brochure + testimonial flyer + teacher endorsement + GLEC. 2. Examine socio-cultural variables (family structure and SES; parent ethnicity and primary language) and baseline child BPs as moderators of the effects of engagement condition on enrollment and initiation. 3. Examine whether amount of exposure and implementation variability of the motivational engagement components accounts for variability in enrollment and initiation rates within each condition. 4. Test a mediation model of the effects of the engagement package on parenting and child outcomes. Compared to the brochure condition, families from classrooms randomly assigned to the full engagement package are expected to show higher initiation rates and consequently greater session attendance in an evidence-based parenting intervention, the Triple P Positive Parenting Program (Sanders, 2008); which in turn, should lead to greater improvements from pre- to post-Triple P on risk factors for substance abuse (i.e., child BPs, parenting dysfunction) and child mental health problems. Such a finding would suggest that this motivationally-enhanced engagement package could substantially increase the public health impact of evidence-based parenting interventions that prevent substance use and mental health disorders.