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

Adult Child Child Behavior Child, Preschool Humans Parent-Child Relations Parenting Parents Primary Health Care
behavioral problems corporal punishment parent training primary care

Journal

Academic pediatrics
ISSN: 1876-2867
Titre abrégé: Acad Pediatr
Pays: United States
ID NLM: 101499145

Informations de publication

Date de publication:
Historique:
received: 04 02 2020
revised: 23 07 2020
accepted: 06 08 2020
pubmed: 14 8 2020
medline: 29 7 2021
entrez: 14 8 2020
Statut: ppublish

Résumé

Prior single-site evaluations of Child Adult Relationship Enhancement in Primary Care (PriCARE), a 6-session group parent training, demonstrated reductions in child behavioral problems and improvements in positive parenting attitudes. To measure the impact of PriCARE on disruptive child behaviors, parenting stress, and parenting attitudes in a multisite study. Caregivers of children 2- to 6-year-old with behavior concerns recruited from 4 pediatric primary care practices were randomized 2:1 to PriCARE intervention (n = 119) or waitlist control (n = 55). Seventy-nine percent of caregivers identified as Black and 59% had annual household incomes under $22,000. Child behavior, parenting stress, and parenting attitudes were measured at baseline and 2 to 3 months after intervention using the Eyberg Child Behavior Inventory, Parenting Stress Index, and Adult-Adolescent Parenting Inventory-2. Marginal standardization implemented in a linear regression compared mean change scores from baseline to follow-up by treatment arm while accounting for clustering by site. Mean change scores from baseline to follow-up demonstrated greater improvements (decreases) in Eyberg Child Behavior Inventory problem scores but not intensity scores in the PriCARE arm compared to control, (problem: -4.4 [-7.5, -1.2] vs -1.8 [-4.1, 0.4], P= .004; intensity: -17.6 [-28.3, -6.9] vs -10.4 [-18.1, -2.6], P= .255). Decreases in parenting stress were greater in the PriCARE arm compared to control (-3.3 [-4.3, -2.3] vs 0 [-2.5, 2.5], P= .025). Parenting attitudes showed no significant changes (all P> .10). PriCARE showed promise in improving parental perceptions of the severity of child behaviors and decreasing parenting stress but did not have an observed impact on parenting attitudes.

Sections du résumé

BACKGROUND
Prior single-site evaluations of Child Adult Relationship Enhancement in Primary Care (PriCARE), a 6-session group parent training, demonstrated reductions in child behavioral problems and improvements in positive parenting attitudes.
OBJECTIVE
To measure the impact of PriCARE on disruptive child behaviors, parenting stress, and parenting attitudes in a multisite study.
METHODS
Caregivers of children 2- to 6-year-old with behavior concerns recruited from 4 pediatric primary care practices were randomized 2:1 to PriCARE intervention (n = 119) or waitlist control (n = 55). Seventy-nine percent of caregivers identified as Black and 59% had annual household incomes under $22,000. Child behavior, parenting stress, and parenting attitudes were measured at baseline and 2 to 3 months after intervention using the Eyberg Child Behavior Inventory, Parenting Stress Index, and Adult-Adolescent Parenting Inventory-2. Marginal standardization implemented in a linear regression compared mean change scores from baseline to follow-up by treatment arm while accounting for clustering by site.
RESULTS
Mean change scores from baseline to follow-up demonstrated greater improvements (decreases) in Eyberg Child Behavior Inventory problem scores but not intensity scores in the PriCARE arm compared to control, (problem: -4.4 [-7.5, -1.2] vs -1.8 [-4.1, 0.4], P= .004; intensity: -17.6 [-28.3, -6.9] vs -10.4 [-18.1, -2.6], P= .255). Decreases in parenting stress were greater in the PriCARE arm compared to control (-3.3 [-4.3, -2.3] vs 0 [-2.5, 2.5], P= .025). Parenting attitudes showed no significant changes (all P> .10).
CONCLUSIONS
PriCARE showed promise in improving parental perceptions of the severity of child behaviors and decreasing parenting stress but did not have an observed impact on parenting attitudes.

Identifiants

DOI: 10.1016/j.acap.2020.08.002 PMID: 32791318
pubmed: 32791318
pii: S1876-2859(20)30476-9
doi: 10.1016/j.acap.2020.08.002
pii:
doi:

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

629-637

Informations de copyright

Copyright © 2020 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Auteurs

Joanne N Wood (JN)

Division of General Pediatrics, The Children's Hospital of Philadelphia (JN Wood and PV Scribano), Philadelphia, Pa; PolicyLab, The Children's Hospital of Philadelphia (JN Wood and D Kratchman), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (JN Wood, PV Scribano, and S Berkowitz), Philadelphia, Pa. Electronic address: woodjo@email.chop.edu.

Devon Kratchman (D)

PolicyLab, The Children's Hospital of Philadelphia (JN Wood and D Kratchman), Philadelphia, Pa.

Philip V Scribano (PV)

Division of General Pediatrics, The Children's Hospital of Philadelphia (JN Wood and PV Scribano), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (JN Wood, PV Scribano, and S Berkowitz), Philadelphia, Pa.

Steven Berkowitz (S)

Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (JN Wood, PV Scribano, and S Berkowitz), Philadelphia, Pa.

Samantha Schilling (S)

Department of Pediatrics, University of North Carolina (S Schilling), Chapel Hill, NC. Dr Berkowitz is now with Department of Psychiatry, University of Colorado, School of Medicine, Aurora, Colo.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Improving Child Behaviors and Parental Stress:...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Improving Child Behaviors and Parental Stress:...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Comportement › Comportement de l'enfant › Improving Child Behaviors and Parental Stress:...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Enfant d'âge préscolaire › Improving Child Behaviors and Parental Stress:...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Improving Child Behaviors and Parental Stress:...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Relations parent-enfant › Improving Child Behaviors and Parental Stress:...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Pratiques éducatives parentales › Improving Child Behaviors and Parental Stress:...
questionsmedicales.fr › Personnes › Parents › Improving Child Behaviors and Parental Stress:...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Improving Child Behaviors and Parental Stress:...