Parenting Interventions for Behavioral Problems

Overseen By Christopher J Mehus

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Minnesota

Disqualifiers: Danger to child, Psychological inability

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

Compensation: Varies

Number of Visits: Unknown

600 Participants Needed

Trial Summary

What is the purpose of this trial?

Child and adolescent behavioral health problems are related to the leading causes of youth morbidity and mortality. Parent-focused interventions effectively prevent behavioral health problems such as depression and conduct disorders and can provide a downstream economic benefit to society by reducing criminal activity, education costs, and health care use. Unfortunately, parenting programs are not widely available, accessible, nor well-attended. Pediatric primary care is a non-stigmatizing setting with nearly universal reach and, therefore, an ideal contact point to increase access. However, primary care clinicians (PCCs) often have insufficient training in behavioral health topics and typical referral practices are inadequate. There are also logistical barriers to attending in-person parenting programs, like the need for childcare and a large time-commitment. There is a need to develop effective referral practices in conjunction with increasing the accessibility of parenting programs. The study long-term goal is to prevent significant behavioral health problems through widespread access to effective and accessible parenting programs through primary care referrals. In this study there are two trials: First is the primary care clinicians "PCC" trial, testing the effectiveness of referral training (aim 1). Second is the parents "eGen" trial provided by therapists, testing the effectiveness of eGen parenting intervention (aim 2).

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on parenting interventions and does not mention medication requirements.

What data supports the effectiveness of the treatment Empowered Generations (eGen) for behavioral problems?

Research on similar parenting interventions shows that group-based programs can improve parenting skills and reduce problem behaviors in children. For example, a study on a parent education group for adolescents with ADHD found a significant decrease in parent-adolescent conflict and problem behaviors, while another study on the Coping Power program showed increased parenting efficacy and satisfaction. ^{1 2 3 4 5}

Is the parenting intervention generally safe for humans?

The studies reviewed do not report any safety concerns for the parenting interventions, suggesting they are generally safe for participants. ^{1 6 7 8 9}

How is the Empowered Generations (eGen) treatment different from other treatments for behavioral problems?

The Empowered Generations (eGen) treatment is unique because it focuses on culturally adapting parenting interventions to fit specific community contexts, which can increase the relevance and effectiveness of the program for diverse populations. This approach is particularly beneficial for immigrant families and communities with specific cultural needs, making it more accessible and acceptable compared to standard parenting interventions. ^{10 11 12 13 14}

Research Team

Christopher J Mehus

Principal Investigator

University of Minnesota

Eligibility Criteria

This trial is for pediatric primary care clinicians (PCCs) and parents of children with behavioral issues. PCCs are trained to refer patients effectively, while parents receive the eGen parenting program. Clinicians must be willing to learn new referral skills, and parents need access to participate in eGen.

Inclusion Criteria

I am the parent or caregiver of a child aged 3-8 referred to a therapist.

I am a primary care clinician who treats children aged 3-8 and have my clinic's approval to join.

Exclusion Criteria

I am mentally and emotionally capable of participating without harming my child.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Referral Training

Primary care clinicians receive training on effective referral practices

10 weeks

Weekly sessions

eGen Parenting Intervention

Parents participate in the eGen parenting intervention provided by therapists

10 weeks

Weekly sessions

Follow-up

Participants are monitored for changes in child behavior and parenting practices

1 year

Treatment Details

Interventions

• Empowered Generations (eGen)

Trial Overview The study tests two interventions: For PCCs, it's about learning better referral techniques; for parents, it's participating in the eGen program designed to help manage their child's behavior. The goal is improving access and effectiveness of parenting programs through referrals.

Participant Groups

Group I: Primary care clinicians group 1 Experimental Treatment 1 Intervention

PCCs with pediatric patients randomized to experimental group

Group II: Parent group 1 Experimental Treatment 1 Intervention

assigned to receive eGen

Group III: Primary care clinicians group 2 Active Control 1 Intervention

PCCs with pediatric patients randomized to control group

Group IV: Parents group 2 Active Control 1 Intervention

assigned to receive one-session control

Who Is Running the Clinical Trial?

University of Minnesota

Lead Sponsor

Trials

1,459

Recruited

1,623,000+

Findings from Research

The semi-structured psychoeducational group model for parents of aggressive children in Taiwan effectively enhanced the social competence of five aggressive children by promoting positive family interactions.

Key topics included identifying parenting styles and fostering mutual compliance, with pre- and post-group comparisons indicating significant improvements in the children's behavior and family dynamics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A model parent group for enhancing aggressive children's social competence in Taiwan. Li, MH.[2010]

A parent skills training and education group for parents of adolescents with ADHD showed significant improvements, with 163 parents reporting decreased conflict and problem behaviors after participation.

Parents felt more confident in their parenting skills and found the program very helpful, indicating its potential effectiveness in managing ADHD-related challenges.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parenting adolescents with ADHD: evaluation of a psychoeducation group. McCleary, L., Ridley, T.[2019]

The study involved 114 parents of 9-12-year-old children with conduct problems, comparing the Coping Power program to individualized parent-child treatment.

Both interventions significantly improved parenting efficacy and satisfaction, with no notable difference in effectiveness between the two approaches, indicating that Coping Power is a valid option for enhancing parenting skills in this context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparing the Multicomponent Coping Power Program to Individualized Parent-Child Treatment for Improving the Parenting Efficacy and Satisfaction of Parents of Children with Conduct Problems. Ludmer, JA., Sanches, M., Propp, L., et al.[2018]

The adaptation of the Canadian parenting program 'Nobody's Perfect' into the Japanese public health system was successful and well-received, particularly among first-time mothers with low psychological status.

The program showed potential benefits in improving mothers' mood and their self-evaluation of societal abilities, indicating its efficacy as a supportive intervention in parenting practices in Asia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Short-term operational evaluation of a group-parenting program for Japanese mothers with poor psychological status: adopting a Canadian program into the Asian public service setting. Goto, A., Yabe, J., Sasaki, H., et al.[2019]

Behavioral Parent Training (BPT) is the standard treatment for young children (ages 3 to 8) with disruptive behavior disorders and may also help reduce internalizing problems and improve family dynamics.

The review explores the mechanisms by which BPT may lead to broader treatment effects, including alleviating caregiver depressive symptoms, suggesting that understanding these mechanisms could enhance future clinical research and practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cascading effects of BPT for child internalizing problems and caregiver depression. Gonzalez, MA., Jones, DJ.[2023]

The study identified four key components of the GenerationPMTO (GenPMTO) intervention—emotion regulation, effective communication, problem solving, and monitoring—that significantly influenced reductions in coercive parenting practices over a 2-year period among 153 participants.

While these components were effective in reducing coercive parenting, the study did not find significant predictors for improvements in positive parenting, suggesting a need for further exploration of effective strategies in that area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Investigating active ingredients of the GenerationPMTO intervention: Predictors of postintervention change trajectories in parenting practices. Holtrop, K., Durtschi, JA., Forgatch, MS.[2023]

GenerationPMTO is an effective behavioral parenting program that significantly improves parenting practices and child adjustment, as shown in a systematic review of 20 studies involving 3893 families across six countries.

The program notably enhances parental discipline and monitoring, as well as reduces child externalizing and internalizing problems, with robust effects observed despite some variability across different demographic groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of GenerationPMTO to Promote Parenting and Child Adjustment: A Meta-Analytic Review. Cai, Q., Chan, ACY., Lee, SK., et al.[2022]

Errorless compliance training effectively improved child compliance in 12 oppositional children aged 2-7 years, demonstrating significant and lasting behavioral changes after the intervention.

The training also positively impacted parent self-esteem, suggesting that it can be beneficial for parents with cognitive and behavioral challenges, making it a suitable alternative to traditional parenting methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Errorless compliance training: building a cooperative relationship between parents with brain injury and their oppositional children. Ducharme, JM., Spencer, T., Davidson, A., et al.[2019]

The PR-ESSENCE intervention, a ten-week program for children and adolescents with neurodevelopmental issues, showed significant improvement in overall symptoms and functioning, with a large effect size of 1.48 on the Clinical Global Impression-Improvement scale, indicating its efficacy compared to usual treatment.

Over half of the participants (51.4%) in the PR-ESSENCE group reported much or very much improvement, while only 5.6% of the control group experienced similar benefits, demonstrating the program's effectiveness in addressing behavior problems associated with conditions like autism and ADHD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of a new intervention in early symptomatic syndromes eliciting neurodevelopmental clinical examinations: PR-ESSENCE. Johnson, M., Gillberg, C., Vinsa, I., et al.[2023]

A culturally adapted version of the GenerationPMTO© parent training intervention was found to be acceptable and useful by 24 Chilean caregivers, indicating its relevance to local parenting practices.

The positive feedback from caregivers suggests that this adapted intervention could be effectively disseminated across Chile to promote better parenting and prevent child behavioral issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A culturally adapted parenting intervention for the Chilean context: Qualitative indicators of participant satisfaction and contextual and cultural relevance. Parra-Cardona, R., Retamal, VM., Fajuri, PP., et al.[2023]

The adaptive recruitment strategy successfully enrolled 73% of two-parent immigrant Latino families, ensuring both caregivers participated in the parenting program, which is crucial for addressing adolescent risks.

The intervention showed high participation rates, with 75% or more of families completing it, and received positive feedback, particularly from fathers who engaged more with the one-to-one components, indicating its potential effectiveness and satisfaction among participants.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adaptive Recruitment and Parenting Interventions for Immigrant Latino Families with Adolescents. Garcia-Huidobro, D., Diaspro-Higuera, MO., Palma, D., et al.[2021]

The culturally adapted Parent Management Training intervention was feasible to implement with 73 Spanish-speaking Latino parents, showing high satisfaction and participation rates over approximately 5 months.

The intervention led to significant improvements in both parenting practices and youth behavior, reducing aggression and the likelihood of substance use among participants, with varying effects based on the nativity status of the youth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of culturally adapted parent management training on Latino youth behavioral health outcomes. Martinez, CR., Eddy, JM.[2021]

The Empowering Parents Empowering Communities (EPEC) Being a Parent (BAP) program effectively reached 930 parents in socially disadvantaged areas, demonstrating its potential to address childhood behavioral problems in communities that often lack access to traditional interventions.

Participants in the BAP program reported significant improvements in child behavior, parenting skills, and overall parent wellbeing, with effect sizes indicating meaningful benefits comparable to those seen in controlled trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of a peer-led, community-based parenting programme delivered at a national scale: an uncontrolled cohort design with benchmarking. Day, C., Harwood, J., Kendall, N., et al.[2022]

Community-based parenting skills training can effectively improve parenting knowledge and skills, leading to positive changes in challenging adolescent behaviors, as shown by systematic review results.

Both group and individual formats of parenting interventions appear to be equally effective, and involving the adolescent in the intervention does not provide additional benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review of community-based parenting interventions for adolescents with challenging behaviours. Medlow, S., Klineberg, E., Jarrett, C., et al.[2018]

References

1. England pubmed.ncbi.nlm.nih.gov

A model parent group for enhancing aggressive children's social competence in Taiwan. [2010]

2. Ireland pubmed.ncbi.nlm.nih.gov

Parenting adolescents with ADHD: evaluation of a psychoeducation group. [2019]

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

Comparing the Multicomponent Coping Power Program to Individualized Parent-Child Treatment for Improving the Parenting Efficacy and Satisfaction of Parents of Children with Conduct Problems. [2018]

4. England pubmed.ncbi.nlm.nih.gov

Short-term operational evaluation of a group-parenting program for Japanese mothers with poor psychological status: adopting a Canadian program into the Asian public service setting. [2019]

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

Cascading effects of BPT for child internalizing problems and caregiver depression. [2023]

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

Investigating active ingredients of the GenerationPMTO intervention: Predictors of postintervention change trajectories in parenting practices. [2023]

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

Effectiveness of GenerationPMTO to Promote Parenting and Child Adjustment: A Meta-Analytic Review. [2022]

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

Errorless compliance training: building a cooperative relationship between parents with brain injury and their oppositional children. [2019]

9. Germany pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of a new intervention in early symptomatic syndromes eliciting neurodevelopmental clinical examinations: PR-ESSENCE. [2023]

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

A culturally adapted parenting intervention for the Chilean context: Qualitative indicators of participant satisfaction and contextual and cultural relevance. [2023]

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

Adaptive Recruitment and Parenting Interventions for Immigrant Latino Families with Adolescents. [2021]

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

Effects of culturally adapted parent management training on Latino youth behavioral health outcomes. [2021]

13. England pubmed.ncbi.nlm.nih.gov

Impact of a peer-led, community-based parenting programme delivered at a national scale: an uncontrolled cohort design with benchmarking. [2022]

14. England pubmed.ncbi.nlm.nih.gov

A systematic review of community-based parenting interventions for adolescents with challenging behaviours. [2018]