College of Nursing RWJF Scholars Develop Program to Benefit Low-Income Parents

Sunday, June 2, 2013

A parenting skills program designed for economically disadvantaged African-American and Latino families living in urban communities has lasting benefits, according to an award-winning study co-authored by scholars affiliated with the Robert Wood Johnson Foundation (RWJF).

The Chicago Parent Program tweaks strategies that have been found to be effective in middle-class families so that they are culturally and socio-economically relevant to Latino and African American parents raising children in low-income, urban communities. Parents who participated in the study remained more confident and competent than peers in a control group a year after completing the program, and their children continued to exhibit more positive behavior.

The program is “a big success,” said lead author Susan Breitenstein, PhD, RN, an assistant professor at Rush University College of Nursing and an RWJF Nurse Faculty Scholar (2012 - 2014). “All parents want to be good parents. Some have more challenges than others, or different sets of challenges. This program addresses some of those different challenges.”

Co-author Sharon Tucker, PhD, RN, an RWJF Executive Nurse Fellows program alumna (2007 - 2010) and the director for research and evidence-based practice in the Department of Nursing at the University of Iowa Hospitals & Clinics, called the Chicago Parent Program “a good return on investment.”

For the study, Breitenstein analyzed two sets of data about the effectiveness of the program, which was developed in 2001 by another alumna of the RWJF Executive Nurse Fellows program, Deborah Gross, DNSc, RN, FAAN, the Leonard and Helen Stulman Professor in Mental Health and Psychiatric Nursing at Johns Hopkins University. Gross and her colleagues developed the Chicago program to correct for bias in mainstream parenting skills programs to make them more relevant to low-income African American and Latino communities, which experience higher rates of child behavior problems.

Among her strategies was to create an advisory board of African American and Latino parents, who suggested tweaks to the program such as the elimination of an anti-spanking policy. Many parents, they advised, view corporal punishment as an effective corrective tool of last resort and would not participate in a program that taught otherwise.

Using those types of insights, Gross and her colleagues combined video-recorded parenting scenarios with group discussions, take-home materials, practice assignments and parent evaluations over a period of three months. Topics cover child-centered time, routines and traditions, praise and encouragement, rewards, limits, consistency, consequences, disciplinary strategies, stress management and problem solving.

Breitenstein’s study found that the program’s benefits are long-lasting, and reinforced earlier studies that have shown that it is effective for its target population.

But others benefit from the program, too, Gross said. Health educators who lead the program improve their skills and knowledge, and can pass that information on to family and friends. Nursing students and junior nursing faculty invested in the program learn as well. “It’s like the gift that keeps on giving,” Gross said.

The study, published in the October 2012 issue of Research in Nursing & Health, was named the journal’s best research article in 2012. “It’s a nice validation of the importance of the work we are doing,” Breitenstein said.

The three scholars met at the Rush University College of Nursing, where Gross was working as a professor. Gross taught Breitenstein and Tucker, both of whom were star pupils, and has served as a dissertation advisor and mentor to both. “Once you’re part of my team, you pretty much have to get a restraining order to get away from me,” Gross joked.

All three RWJF scholars continue to focus on supporting children and families. Breitenstein’s next step is to tackle a key problem plaguing parent education programs: poor attendance. She is exploring ways to solve that problem via an RWJF-funded study of digital applications of the Chicago Parent Program. Gross is working on projects to enhance parent participation by bringing the program to pre-schools and testing its effectiveness as a treatment for young children with more serious behavior problems. And Tucker is researching behavioral techniques to prevent childhood obesity.

To learn more about RWJF, visit their website.