Evaluating an Evidence-Based Parenting Intervention Among Filipino Parents: Protocol for a Pilot Randomized Controlled Trial (Preprint)

Abstract

BACKGROUND Filipino Americans underutilize mental health and preventive care services even though studies have indicated that Filipino youth experience high rates of suicidal ideation, substance abuse and teen pregnancy, while adults experience immigration stress, discrimination, and depression. Evidence-based parenting interventions provided in early childhood have proven to be effective in preventing the onset and escalation of child mental health disorders. In a pilot randomized controlled trial, we found that participation in the Incredible Years® (IY) Parent Training Program improved parenting stress and positive parenting practices and decreased child internalizing and externalizing symptoms among Filipino families. A fully powered trial is needed to determine the efficacy of IY as a prevention program among Filipino families. OBJECTIVE The aims of this manuscript are to 1) describe the design and rationale of a randomized controlled trial evaluating the effects of the on-line IY program among parents recruited from multiple community-based settings and its impact on parenting practices, parenting stress, and child problem behavior among Filipino Americans and 2) describe the impact of COVID-19 on our study protocols. METHODS This study uses a randomized controlled two-arm individually randomized group treatment pretest posttest design for 180 parent-child dyads. Individuals are eligible if they are 18 years or older, live in California, and have at least one Filipino child aged 8-12 years old. Consenting participants are randomly allocated to receive: (1) the 12-week Incredible Years parenting intervention (intervention arm), or (2) American Academy of Pediatrics’ Bright Future handouts and placed on a waitlist to receive IY post-trial (waitlist control arm). Primary outcomes include the Parent Practices Interview (PPI) and Parenting Stress Index (PSI). Secondary outcomes will be measured by the Child Behavior Checklist (CBCL, completed by Parent and Child) and will include child externalizing and externalizing behaviors, and total problems. Data is collected at baseline, 3-month and 6-month follow-ups. RESULTS Recruitment is currently ongoing. Changes made to the protocol due to COVID-19 include administration of surveys remotely and implementation of the intervention online. The pandemic has provided an opportunity to evaluate the effectiveness of an online version of IY that may improve access and increase use of the intervention. Recruitment and data collection procedures are still ongoing and are expected to be completed in one year. CONCLUSIONS Our research will determine whether IY promotes positive parenting practices and prevents child internalizing and externalizing behaviors among Filipino families with children ages 8-12 years old. It will also uplift cultural narratives and add to the evidence based supporting online parenting programs and their implementation in real-world settings. If found efficacious, IY has the potential to prevent behavioral health disparities in this understudied and high-risk Filipino population and can be scaled, adapted, and implemented in other at-risk ethnic minority communities. CLINICALTRIAL ClinicalTrials.gov NCT04031170; https://clinicaltrials.gov/ct2/show/NCT04031170