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 et al, 2011）。不幸的是，这些干预措施的公共卫生潜力严重有限，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，与控制参与条件相比，以证据为基础的育儿干预的启动率几乎翻了一番（48%对25%）。目标动机构念（即父母态度、感知障碍）的改变介导了参与包对入职的影响。通过减少单亲家庭和讲英语的墨西哥裔美国家庭（这些家庭不太可能参与育儿干预）在参与方面的差异，以及通过增加在课堂上有行为问题儿童的父母的参与，参与计划增加了高需求家庭的参与。拟议的试验通过与一个大型公立学区建立伙伴关系，测试在自然服务提供条件下实施这一参与方案的效果。在三个时间点对幼儿园和一年级学生的家长（N = 1,350）进行访谈：测试前、参与后和育儿计划后。数据也将从教师、小组领导和客观评分者那里收集。该项目有四个具体目标：1。比较使用拆卸设计的接合包组件的有效性。幼儿园和一年级的教室将被随机分配到以下五个条件之一：1)标准手册；2)宣传册+家庭感言单张；3)宣传册+教师背书；4)宣传册+组长通话（GLEC）；5)宣传册+感言传单+教师背书+ GLEC。2. 检查社会文化变量（家庭结构和社会经济地位；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入学影响的调节因子。3. 检查激励参与成分的暴露量和实施可变性是否解释了每种条件下注册率和启动率的可变性。4. 测试参与包对养育子女和子女结局的影响的中介模型。与宣传册条件相比，被随机分配到全面参与一揽子计划的班级的家庭在循证育儿干预，即3p积极育儿计划中，预计会显示出更高的启动率和更高的会议出勤率（Sanders, 2008）；反过来，这应该会导致在药物滥用的风险因素（即儿童bp、养育功能障碍）和儿童心理健康问题上从3p前到3p后得到更大的改善。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.