Strengthening Prevention-Based Parenting Practices: A Public Health Approach

Background and Purpose: Evidence of the benefits of parent involvement in preventing youth substance abuse has led to a proliferation of family-based prevention programs over the past decade. Yet, getting parents to attend these programs continues to challenge service providers. Some suggest that a broader public health effort is needed, reaching out to the larger parent community through environmental strategies (e.g., social marketing) to strengthen prevention-based parenting practices. Similar to efforts at reducing auto accident fatalities by promoting seat belt use, environmental strategies targeting parenting practices may have a positive impact on preventing youth substance abuse and other problems by influencing community norms and beliefs about family management and bringing parenting behaviors into better alignment with the principles of effective prevention.

The aim of this multi-year study is to develop and test a population-based, universal preventive intervention to promote effective parenting. Drawn from our first year of research, the purpose of this presentation is to describe a public health model for strengthening prevention-based parenting practices at the population level, informed by the current state of knowledge of environmental strategies for family engagement.

Methods: To establish a baseline for the development of the population-based model, we a) synthesized relevant literature across multiple disciplines; b) employed mail and telephone procedures to survey a randomly selected sample of parents (N = 1,153) about their parenting practices; c) administered a web-based survey to gather information from other stakeholders (i.e., directors, policy makers, and researchers) about their experiences with environmental strategies for promoting parenting practices; and d) conducted focus groups with highly engaged parents to explore their perspectives on strategies for engaging families in prevention activities. These findings were then used to develop a model that depicts our theory of change.

Results: Although the literature review showed a paucity of research on environmental strategies for engaging families in prevention, several strategies have been effective in promoting population-based change in other areas, such as youth tobacco reduction. The parenting study revealed high levels of prevention-based parenting practices, although parents of children ages 6-10 reported less positive parenting and less involvement than parents of younger children. Stakeholders indicated their awareness of other environmental efforts and expressed interest in using similar strategies to support parenting changes. Focus group participants also recognized the need to strengthen parent involvement and recommended more effort toward educating parents about effective parenting techniques, with an emphasis on the consequences of youth substance abuse. We used these findings to develop an integrated, multi-level model, with ecological perspective as the overarching framework, Diffusion of Innovations theory to guide community change, and Social Cognitive theory to inform our predictions about change at the parent level.

Conclusions and Implications: The results to date provide evidence toward the development of a population-based approach to promote prevention-based parenting. These findings also support the potential and demand for a population-based model to strengthen prevention-based parenting practices as extrapolated from the literature and designed in collaboration with parents and other stakeholders.