Parent Training in Pediatric Primary Care: A Self-Directed Tablet-Based Approach

Research Team

Susan M. Breitenstein, Principal Investigator, Rush University College of Nursing
Michael Schoeny, Co-Investigator, Rush University College of Nursing
Tricia Johnson, Co-Investigator, Rush University
Louis Fogg, Statistician, Rush University College of Nursing

Award Period

09/01/15-06/30/19

Funding Source

Agency for Healthcare Research and Quality (AHRQ)
Health Services Research Project (R01)

Abstract

One in four young children in the United States faces poverty-associated risks that make her or him more likely to have mental health and behavior problems. These problems, left untreated, can have long-term social, emotional, and behavioral consequences. Positive and effective parenting in the preschool years can substantially buffer the negative effects of socioeconomic adversity on children’s mental health and behavior.
However, most parent training programs use face-to-face delivery models resulting in barriers to participation and limited reach to those most in need. Testing the efficacy and implementation of alternative delivery models is needed to (a) increase the reach and sustainability of parent training interventions and (b) address the barriers to parent participation and implementation of such programs, specifically in primary health care settings. The parent training program proposed in this study is a digital adaptation (tablet-based) of the evidence-based based Chicago Parent Program (CPP) called the electronicCPP (eCPP). The purpose of this study is to evaluate the efficacy, cost-effectiveness, and implementation process of delivering the eCPP in pediatric primary care practices serving low-income, urban families. The specific aims of the study are: (1) Test the direct effects of the 6-module eCPP on parenting outcomes (parenting behavior, parenting self- efficacy, and parenting stress) and child outcomes (child problem and prosocial behavior) compared to an enhanced usual care control condition among low-income parents with young children seen in primary care settings; (2) Compare the cost-effectiveness of the eCPP intervention relative to the control condition for the parenting and child outcomes; and (3) Quantify the levels of program implementation of the eCPP in primary care using the RE-AIM framework. The efficacy of the eCPP will be tested using a randomized clinical trial design with 312 parents of 2- to 5-year-old children from 4 pediatric primary care sites. Data on parenting and child behavior outcomes will be obtained from all participants at baseline, and 3, 6, and 12 months post baseline. A descriptive design guided by the RE-AIM framework and cost-effectiveness analysis will evaluate the implementation of the eCPP in the pediatric primary care sites.

This proposal focuses on the AHRQ research emphasis for (a) implementation of interventions to reduce disparities in priority populations (low-income, urban, racial and ethnic minorities) and (b) improving health care quality by implementing innovative service delivery models within the settings where these priority populations receive care. Integrating and evaluating the implementation of the eCPP is an innovative opportunity to promote parenting with potential for universal access to the preschool (2- to 5-year-olds) population and potential         for low cost by building on existing infrastructure. Findings from this study will lay the foundation for full-scale implementation of the eCPP in pediatric primary care settings and subsequent implementation and dissemination research.

For more information about this project, please contact Susan M. Breitenstein.