Parenting Interventions Implementation Science: How Delivery Format Impacts the Parenting Wisely Program

Background/Purpose: Parenting Wisely [PW] is an interactive computer-based parent-training program that is designed to improve family communication and teach parents effective disciplinary strategies for use with adolescents. PW focuses on improving the competence and skills of parents whose adolescent children are engaging in or at risk for problem behaviors, including aggression, substance abuse, and delinquency. A significant advantage of PW is the flexibility with which the intervention can be delivered. PW has previously been implemented in an individual format and a small group format. Although the intervention was designed to be implemented with parents, PW has also been used in groups in which parents and adolescents participate together. This study examines the implementation and effectiveness of PW. The study assesses whether parents benefit from PW participation, and whether the delivery format influences program effectiveness. Specifically, PW was delivered in four formats: (a) a parents-only 1- to 2-day workshop, (b) a parents and adolescents 5-week group, (c) a parents-only 5-week group, and (d) a self-paced online format for individual parent–adolescent dyads. As compared with the two parents-only PW formats, we hypothesized that the two formats that included adolescents as participants would result in greater positive changes in family functioning, adolescent behavior, and parenting confidence. Second, we hypothesized that delivery in a group format over 5 weeks in a setting that provided parents with enhanced activities, time, and support to practice new skills would be more effective than delivery of PW through the online or workshop formats.

Methods:  A sample of 144 low-income, rural parents participated in the study. The majority of the sample was female (77.08%) and the average age of participants was 40 years. The sample was exceptionally racially diverse, consisting of 53% Native American, 27% African American, 10% Hispanic, 8% White, and 2% multiracial. Five subscales from the McMaster Family Assessment Device (i.e., problem solving, family roles, affective involvement, behavior control, and general family functioning) were used to measure family processes. In addition, parenting measures (i.e., parenting sense of competence, parenting self-efficacy, and parent-adolescent conflict) and adolescent behavior measures (i.e., violent behavior and externalizing behavior) were collected. A series of paired-sample t-tests were conducted to measure mean differences between pretest and posttest for each delivery format.

Results: Findings showed statistically significant changes between pretest and posttest in family problem-solving, family roles, family involvement, parenting self-efficacy, parenting sense of competence, and decreased adolescent violent behavior. Integrating adolescents in program delivery was more effective for family roles, adolescent violent behavior, externalizing problems, and parent-child conflict, but not for other outcomes. Delivery in a group setting over 5-weeks was more effective than either online delivery or as a 1- or 2-day group workshop.

Conclusions/Implications: The current study makes an important contribution to implementation science literature as it explores the effectiveness of PW when implemented with differing delivery formats, which is a previously unstudied influence on program effectiveness. The current study also contributes to scholarship on PW by testing the intervention effects on adolescent aggressive behavior and violence.