Randomized Trial of a Cellular Phone-Enhanced Home Visitation Parenting Intervention

Abstract

BACKGROUND AND OBJECTIVES: Although home visiting programs have been documented to improve parenting in high-risk families, their effectiveness is diminished when parents disengage from programs. Cellular phones offer an approach to promoting parent engagement and enhancing parenting outcomes. Our objective was to examine whether mothers in a parenting intervention, Planned Activities Training (PAT), or cellular phone-enhanced version (CPAT) of the intervention would demonstrate greater use of parenting strategies after treatment and at 6 months post-treatment compared with a wait-list control (WLC). METHODS:A sample of 371 low-income mothers and their 3.5-to 5.5-year-old children were randomly assigned to condition and assessed at pre-test, post-intervention, and 6 months post-intervention. Treatment efficacy was evaluated through observations of mother-child interactions as well as maternal interviews about depression, parenting stress, and child behaviors. RESULTS:Mothers receiving PAT and CPAT demonstrated more frequent use of parenting strategies and engaged in more responsive parenting than mothers in the WLC. Mothers receiving CPAT used more PAT parenting strategies than mothers in the other 2 groups and experienced greater reductions in depression and stress. Children of mothers receiving PAT and CPAT demonstrated higher rates of positive engagement, and children of CPAT mothers demonstrated higher levels of adaptive behaviors than children in the WLC. Importantly, changes in parenting, depression, and stress predicted positive child behaviors.CONCLUSIONS: PAT and CPAT conditions improved parenting strategies and child engagement and reduced children' s challenging behaviors. The addition of cellular phones to a home visiting program enhanced maternal responsivity and reduced depression and stress. Pediatrics

Initial Findings from a Feasibility Trial Examining the SafeCare Dad to Kids Program with Marginalized Fathers

“…Hypotheses were based on the findings by Carta and colleagues (2013) which demonstrated positive changes in parent stress and parent-child interaction in mothers at-risk who participated in the SafeCare Parent-Child Interaction Module. As this is one of the first randomized trials examining an evidence-based, behavioral parenting program targeting child maltreatment prevention for fathers, many questions remain about how to most effectively serve this population.…”

“…The program teaches a variety of skills focused on positive parenting, home safety, and child health. Studies examining SafeCare have revealed statistically significant reductions in child abuse perpetration and recidivism (Chaffin, Hecht, Bard, Silovsky, & Beasley, 2012; Gershater-Molko, Lutzker, & Wesch, 2002), as well as improved parenting skills among participants (Carta, Lefever, Bigelow, Borkowski, & Warren, 2013). While there have been no randomized research trials to date examining SafeCare with fathers, two pilot studies indicate that fathers exhibit positive improvement in target parenting skills in response to the SafeCare Parent-Child Interaction module (Bigelow & Lutzker, 1998; Self-Brown et al, 2015).…”

“…The SafeCare Parent-Child Interaction module, independent of the full SafeCare model, has been shown to be effective with prevention for at-risk maternal populations (Carta et al, 2013). Based on piloting research conducted by Self-Brown and colleagues (2015) this module is thought to be most consistent with the father role in the family as the content focuses on building a strong parent-child relationship and managing behavior in daily activities, including during physical play (Lamb, 1981) and recreational activities (Child Trends, 2002).…”

“…Dad2K is an augmented version of the SafeCare Parent-Child Interaction module, a SafeCare module that has shown to be independently effective for reducing risk and improving parenting in prevention populations (Carta et al, 2013). The lack of empirical evidence on which to base the design and testing of intervention strategies that target fathers hampers effective prevention and intervention (Lee et al, 2009).…”

Service needs of adolescent parents in child welfare: Is an evidence-based, structured, in-home behavioral parent training protocol effective?

“…Specifically, SC was developed to reduce the occurrence of risk factors for child maltreatment by improving parent-child/infant relationships, parent knowledge and skills, and other contextual environmental factors (Lutzker & Bigelow, 2002). The efficacy of the SC model in reducing child maltreatment was demonstrated among multiple populations of at-risk parents, including parents referred from child protective services, substance abuse treatment programs, and agencies that serve disadvantaged families (Carta, Lefever, Bigelow, Borkowski, & Warren, 2013; Chaffin et al, 2012b; Silovsky et al, 2011). …”