Positive Parenting Program for Child Behavioral Disorders in Foster Care

Overseen By Edna Terry

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Children's Hospital of Philadelphia

Disqualifiers: Completed CARE or PriCARE training

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 4

60 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment PriCARE, Child Adult Relationship Enhancement in Primary Care, Criando Niños con CARIÑO for child behavioral disorders in foster care?

Research shows that PriCARE, a 6-session group parent training, has been effective in reducing child behavioral problems and improving positive parenting attitudes. It has also been adapted for diverse families and integrated into primary care settings, showing promise in preventing child maltreatment and improving parent-child relationships. ^{1 2 3 4 5}

Is the Positive Parenting Program for Child Behavioral Disorders in Foster Care safe for humans?

The Positive Parenting Program, also known as PriCARE or Criando Niños con CARIÑO, has been evaluated in various studies and is generally considered safe for humans, focusing on improving parenting skills and reducing child behavioral problems without reported safety concerns. ^{1 2 3 4 6}

How is the PriCARE treatment different from other treatments for child behavioral disorders in foster care?

PriCARE is unique because it is a 6-session group parenting program specifically designed for primary care settings, focusing on enhancing parent-child relationships and teaching positive discipline techniques. It was developed with input from diverse families, making it more accessible and culturally relevant, especially for low-income and minority parents. ^{1 2 3 4 7}

What is the purpose of this trial?

The purpose of the study is to evaluate early implementation outcomes of a positive parenting program, Child Adult Relationship Enhancement in Primary Care (PriCARE), in the foster care setting and to assess the efficacy of PriCARE in promoting positive parenting and increasing empathy among foster caregivers.

Research Team

Joanne Wood, MD, MSHP

Principal Investigator

Children's Hospital of Philadelphia

Eligibility Criteria

This trial is for foster caregivers over 18 years old who speak English and are parenting a foster child aged between 2 to 10. They must be willing to give informed consent to participate in the study.

Inclusion Criteria

Caregiver is a foster parent of a foster child between 2 and 10 years of age

English-speaking

Foster caregiver provides informed consent

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Initial interview conducted to obtain baseline data regarding demographic information, parenting attitudes, and parenting strategies

1 week

1 visit (in-person)

PriCARE Training

Participants attend PriCARE training sessions led by mental health providers

2-20 weeks

2-6 sessions (in-person)

Follow-up

Participants are monitored for changes in parenting attitudes and strategies post-intervention

4-10 weeks

1 visit (in-person)

Treatment Details

Interventions

• PriCARE

Trial Overview The trial is testing PriCARE, a program aimed at improving parenting skills and empathy among foster parents dealing with children's disruptive behaviors and mental health issues.

Participant Groups

Group I: Intervention Experimental Treatment 1 Intervention

All participants who enroll in the study will be assigned to a PriCARE group program that will adhere to the approximately 9 hour PriCARE curriculum.The trainings are administered to groups of approximately 4-12 caregivers at a time and are led by 2 mental health providers trained in the PriCARE curriculum. The curriculum will be delivered in 2-6 sessions over a 2-20 week period.

PriCARE is already approved in United States for the following indications:

Approved in United States as PriCARE for:

• Promoting positive parenting
• Increasing empathy among foster caregivers
• Reducing risk of child maltreatment

Who Is Running the Clinical Trial?

Children's Hospital of Philadelphia

Lead Sponsor

Trials

749

Recruited

11,400,000+

Ray E. Helfer Society

Collaborator

Trials

1

Recruited

60+

Findings from Research

In a multisite study involving 119 caregivers of children aged 2 to 6 with behavioral concerns, the PriCARE intervention significantly reduced perceived child behavior problems and parenting stress compared to a waitlist control group.

While PriCARE effectively improved caregivers' perceptions of child behavior severity and reduced parenting stress, it did not lead to significant changes in parenting attitudes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving Child Behaviors and Parental Stress: A Randomized Trial of Child Adult Relationship Enhancement in Primary Care. Wood, JN., Kratchman, D., Scribano, PV., et al.[2022]

The Cariño program, a culturally adapted version of the PriCARE parenting program, was developed specifically for Spanish-speaking Hispanic parents, incorporating culturally relevant concepts to enhance its applicability and acceptance.

Pilot results showed that 62% of enrolled participants attended at least 4 out of 6 sessions, with high satisfaction ratings, indicating that the program is both feasible and well-received by the target audience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Criando Niños Con Cariño : Primary Care-Based Group Parenting Program Adaptation and Pilot. Schilling, S., Romero-Cely, D., Mebane, A., et al.[2023]

The PriCARE/CARIÑO intervention is a promising 6-session parenting program designed to improve parent-child relationships and reduce child maltreatment (CM) risk, specifically targeting low-income and minority families through primary care settings.

This multicenter randomized controlled trial will assess the effectiveness of PriCARE/CARIÑO by measuring the occurrence of CM investigations and various secondary outcomes over 48 months, making it the largest trial of its kind to explore mechanisms of change in CM prevention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Child Adult Relationship Enhancement in Primary Care (PriCARE): study design/protocol for a randomized trial of a primary care-based group parenting intervention to prevent child maltreatment. Schilling, S., Powell, BJ., Stewart, PW., et al.[2023]

The PriCARE program, which teaches positive parenting skills, effectively improved child behavior and parenting practices in preschool-aged children, as shown by significant reductions in behavior problem scores compared to a control group.

Incorporating a peer mentor into the PriCARE program reduced stigma among parents, although it did not significantly increase attendance at the sessions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Child-Adult Relationship Enhancement in Primary Care: A Randomized Trial of a Skill-Based Parent Training with Parent Mentor Adaptation. Schilling, S., Ritter, V., Wood, JN., et al.[2021]

The IntegratedCARE model, adapted from the Child-Adult Relationship Enhancement (CARE) interaction model, was successfully implemented in primary care settings, providing a brief 3-session treatment to 30 parent-child dyads.

Participants showed significant improvements in child behavior, as indicated by decreased scores on the Eyberg Childhood Behavior Inventory, and reported high satisfaction with the treatment, suggesting that IntegratedCARE is both effective and feasible for use by trained professionals in routine primary care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Integrated CARE: Adaptation of Child-Adult Relationship Enhancement (CARE) Model for Use in Integrated Behavioral Pediatric Care. Scott, B., Gurwitch, RH., Messer, EP., et al.[2021]

The PriCARE program, a 6-session group parent training, significantly reduced child behavior problems in preschool-aged children, with greater improvements in behavior scores compared to a control group.

Parents who participated in PriCARE also showed enhanced positive parenting attitudes, particularly in empathy towards children's needs and reduced reliance on corporal punishment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Child-Adult Relationship Enhancement in Primary Care (PriCARE): A Randomized Trial of a Parent Training for Child Behavior Problems. Schilling, S., French, B., Berkowitz, SJ., et al.[2019]

A systematic review of 18 studies on universal parenting programs from 2015 to 2019 found that 89% of these programs led to improved parenting outcomes, highlighting their effectiveness in enhancing parental behavior and practices.

The review also indicated that these programs not only reduced child behavior problems in 8 out of 9 evaluated variables but also positively impacted parental mental health and relationships, suggesting a comprehensive benefit of parenting interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Universal Intervention to Strengthen Parenting and Prevent Child Maltreatment: Updated Systematic Review. Branco, MSS., Altafim, ERP., Linhares, MBM.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Improving Child Behaviors and Parental Stress: A Randomized Trial of Child Adult Relationship Enhancement in Primary Care. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Criando Niños Con Cariño : Primary Care-Based Group Parenting Program Adaptation and Pilot. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Child Adult Relationship Enhancement in Primary Care (PriCARE): study design/protocol for a randomized trial of a primary care-based group parenting intervention to prevent child maltreatment. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

Child-Adult Relationship Enhancement in Primary Care: A Randomized Trial of a Skill-Based Parent Training with Parent Mentor Adaptation. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Integrated CARE: Adaptation of Child-Adult Relationship Enhancement (CARE) Model for Use in Integrated Behavioral Pediatric Care. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Child-Adult Relationship Enhancement in Primary Care (PriCARE): A Randomized Trial of a Parent Training for Child Behavior Problems. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Universal Intervention to Strengthen Parenting and Prevent Child Maltreatment: Updated Systematic Review. [2023]