Targeted Prevention of Childhood Anxiety: Engaging Parents in an Underserved Community

Abstract

Selective prevention programs hold the promise of alleviating child anxiety symptoms, decreasing the risk for emotional problems across the lifespan. Such programs have particular public health import for young children of poor, underserved communities. Identifying factors related to parent engagement, and methods to improve engagement, are paramount in the effort to develop anxiety-focused, community prevention programs. This feasibility study investigated the effect of an enhanced recruitment strategy to maximize parent engagement, as well as factors related to attendance in a single session focused on anxiety prevention. Participants were poor, ethnic minority parents of children aged 11-71 months (n = 256) who completed a survey that assessed anxiety risk according to trauma exposure, child anxiety, or parent anxiety, as well as preferences for preventive services (phase 1). Those meeting risk criteria (n = 101) were invited to a preventive group session (phase 2). Half of parents received enhanced recruitment (ER), which included personalized outreach, matching parent preferences, and community endorsement. Other parents were invited by mail. Chi square analyses indicated that ER was associated with planning to attend (49 vs. 6% of control). Parents receiving ER were 3.5 times more likely to attend. Higher sociodemographic risk was correlated with higher child anxiety symptoms but not attendance. Results highlight the need for improved strategies for engaging parents in preventive, community-based interventions.

Parental engagement in preventive parenting programs for child mental health: a systematic review of predictors and strategies to increase engagement

“…Although the inclusion criteria allowed for a broader range of study designs, only experimental trials met the additional inclusion criteria (i.e., studies assessing parent engagement). The included studies can be categorised into two not-mutually-exclusive groups: (1) studies measuring predictors of engagement ( n = 17; Baker, Arnold & Meagher, 2011 ; Brody et al, 2006 ; Byrnes et al, 2012 ; Calam et al, 2008 ; Carpentier et al, 2007 ; Eisner & Meidert, 2011 ; Fleming et al, 2015 ; Garvey et al, 2006 ; Heinrichs et al, 2005 ; Hellenthal, 2009 ; Mauricio et al, 2014 ; Mian, Eisenhower & Carter, 2015 ; Nordstrom, Dumas & Gitter, 2008 ; Plueck et al, 2010 ; Reedtz et al, 2011 ; Skärstrand et al, 2009 ; Winslow et al, 2009 ), and (2) studies that evaluated engagement methodologies ( n = 9; Aalborg et al, 2012 ; Bjørknes, Jakobsen & Nærde, 2011 ; Byrnes et al, 2012 ; Calam et al, 2008 ; Carpentier et al, 2007 ; Eisner & Meidert, 2011 ; Heinrichs, 2006 ; Helfenbaum-Kun & Ortiz, 2007 ; Mian, Eisenhower & Carter, 2015 ). Some studies had dual aims (i.e., evaluation of an engagement methodology and measurement of predictors; Calam et al, 2008 ; Carpentier et al, 2007 ; Eisner & Meidert, 2011 ; Mian, Eisenhower & Carter, 2015 ).…”

“…One study (reported in two articles) recruited through personal invitation to the study, either through researcher or professional networks ( Bjørknes, Jakobsen & Nærde, 2011 ; Bjørknes & Manger, 2013 ). Two studies used pre-screening measures to provide individualised feedback to parents and offered the program to those parents whose children were at increased risk for developing mental health problems ( Mian, Eisenhower & Carter, 2015 ; Plueck et al, 2010 ). Only one study ( Carpentier et al, 2007 ) explicitly used known psychological theories to guide their recruitment methods.…”

Una revisión sistemática de la participación en los programas de prevención familiar

“…• Streghtening Families Program, SFP (Kumpfer & Johnson, 2007) • Programa de Competencia Familiar: Versión Española del SFP (Orte et al, 2018(Orte et al, , 2016(Orte et al, , 2014 • Strengthening Families Program: For Parents and Youth 10-14 (Aalborg et al, 2010;Byrnes et al, 2012; 2018) • Mindfulness-Enhanced Strengthening Families Program 10-14 (MSFP 10-14) (Coatsworth et al, 2018) • Family Matters (FM) (Aalborg et al, 2010;Byrnes et al, 2012) • Incredible Years (Axford et al, 2012;Baker et al, 2011) • Early Risers Conduct Problems Prevention Program (Bloomquist et al, 2012) • Behavioral Parent Training Program (Chacko et al, 2009(Chacko et al, , 2012(Chacko et al, , 2016 • Strategies to Enhance Positive Parenting [STEPP] program (Chacko et al, 2009(Chacko et al, , 2012(Chacko et al, , 2016 • Adolescent Transitions Program (ATP) eb The Family Check-Up (Connell et al, 2007) • Triple P (Eisner y Meidert, 2011;Heinrichs et al, 2005) • Preventive Parent (PT) Training (Garvey et al, 2006) • Bridges to High School Program (Mauricio et al, 2014) • Healthy Families America (HFA) (McCurdy et al, 2006) • Women, Infants and Children (WIC) (Mian et al, 2015) • eHealth Familias Unidas (Perrino et al, 2018) • Early Alliance (Prinz et al, 2001) • Families Program of the Multisite Violence Prevention Project (MVPP) (Quinn et al, 2010) • FRAME-Fatherhood Relationship And Marriage Education (Rienks et al, 2011) • Strong Families program (Ross & DeVoe, 2014) • Coping Power Program (Ryan et al, 2009) Fuente: Elaboración propia.…”

“…Otra forma de reducir el rechazo y aumentar el reclutamiento es preparar a los padres para la intervención (Morawska & Sanders, 2006), mediante llamadas de reclutamiento personalizadas, cartas individuales y recordatorios (Finan, Swierzbiolek, Priest, Warren, & Yap, 2018). No obstante, estos procedimientos parecen ser menos efectivos para facilitar la retención de participantes (Mian, Eisenhower, & Carter, 2015).…”

Engaging populations living with vulnerable conditions in community‐based research: A concept mapping approach to understanding positive practices

“…To understand this diversity, researchers must engage participants living with vulnerable conditions (e.g., poverty, poor health, language difficulties). However, people living with vulnerable conditions are particularly challenging to engage in research (Lindenberg, Solorzano, Vilaro, & Westbrook, ; Mian, Eisenhower, & Carter, ; Schnirer & Stack‐Cutler, ) due to numerous, well‐documented participation barriers (Barratt, Levickis, Naughton, Gerner, & Gibbons, ; Brown, Marshall, Bower, Woodham, & Waheed, ; George, Duran, & Norris, ). People living with vulnerable conditions often do not have time, childcare, and transportation supports to participate in research, as well as they may experience language or literacy barriers and harbour feelings of mistrust and stigma related to research.…”