Skill change among Latinx families in a behavioral parenting intervention: The interactive effect of caregiver language preference and acculturation.

Abstract

Despite extensive evidence showing that Latinx caregivers' language preference and level of acculturation influence parenting practices and treatment acceptability, there is a paucity of studies examining how these individuals acquire skills taught in behavioral parenting interventions such as parent-child interaction therapy (PCIT). Previous studies have shown that Latinx families, especially those who speak Spanish, require additional sessions to complete PCIT compared with non-Latinx White families, a disparity that could lead to high attrition rates and poor treatment outcomes. This study examined whether parenting skills (i.e., do and don't skills) changed as a function of caregiver language preference and level of acculturation among Latinx families receiving a home-based adaptation of PCIT for infants. Twenty-six Latinx caregiver-child dyads received the intervention and were assessed at posttreatment and at 3-and 6-month follow-ups. Caregivers were on average 30.85 years old (SD = 5.14), mostly married (69.2%) and Spanish-speaking (57.7%). Half of these families lived below the poverty line. Moderation analyses showed that more acculturated Spanish-speaking caregivers showed fewer reductions in their use of don't skills than their English-speaking counterparts at posttreatment and at 3-and 6-month followups. No moderation effects were found for the use of do skills. Results highlight critical cultural factors that affect parenting skill change among Spanish-speaking Latinx families. These findings could inform data-driven cultural adaptations of PCIT that improve treatment engagement and reduce attrition among Latinx families, especially given existing inequities in mental health care for this population. Public Significance StatementAlthough behavioral parenting interventions (BPIs) have proven effectiveness, little is known regarding variables that impact Latinx caregivers' ability to learn BPI skills. This study shows that caregiver language preference and level of acculturation interact such that Spanish-speaking Latinx caregivers high in acculturation benefit less from treatment in terms of BPI skill learning. Based on these results, recommendations for data-driven cultural adaptations of BPIs are provided.