Abstract: Short and Long-Term Effects of Two Brief Parenting Interventions on Promoting Positive Parenting and Reducing Coercive Parenting Practices: An RCT (Society for Social Work and Research 29th Annual Conference)

Schedule:

Friday, January 17, 2025

Seneca, Level 4 (Sheraton Grand Seattle)

* noted as presenting author

Catherine Taylor, PhD, LCSW, MPH, Professor, Boston College, Chestnut Hill, MA

Julia Fleckman, PhD, Assistant Professor, Tulane University, New Orleans, LA

Komal Brown, MPH, Doctoral Student, Tulane University, New Orleans, LA

Sophia Eisenberg, MSW, MAT, Doctoral Student, Boston College, Chestnut Hill, MA

Melissa McTernan, PhD, Senior Research Statistician, Boston College, Chestnut Hill, MA

Rong Bai, PhD, Assistant Professor, East Carolina University

Laura Whitaker, MPH, Program Manager, Tulane University, New Orleans, LA

Seth Scholer, MD, MPH, Professor of Pediatrics, Vanderbilt University, Nashville, TN

Ronald J. Prinz, PhD, Professor, University of South Carolina, Columbia, SC

Michelle Struthers, MPH, Program Manager, Tulane University, New Orleans, LA

Tallace Madina, MA, Research Coordinator, Children’s Bureau of New Orleans, New Orleans, LA

Chris Gunther, MD, Resident Physician, Natividad Medical Center, Salinas, CA

Mary Schultheis, LPN, Founder & CEO at Crescent City Family Services Inc., Crescent City Family Services, Inc, Gretna, LA

Background and Purpose: High rates of adverse childhood experiences (ACES), particularly child physical abuse and corporal punishment (CP), call for broad efforts to support parents in providing safe, non-violent, and nurturing parenting. Brief, low touch parenting education and support programs, which could be widely implemented across service settings, are promising but understudied. We assessed the short and long-term efficacy of two such programs: Play Nicely and Brief Primary Care Triple P, Level 2 (TP2). We hypothesized that, compared to a control group, each intervention group would have lasting, though attenuated, effects at 4-years (4Y) compared to 3-months (3M) follow-up.

Methods: Participants were recruited via WIC clinics and data was collected at baseline (n=823; index child mean age =3.8 yrs), 3M follow-up (n=741, 90% retention), and 4Y follow-up (n=446, 54% retention). Immediately after baseline data was collected, participants were randomized into 3 groups (Play Nicely, TP2, and control) and interventions were delivered immediately on-site. Play Nicely is a free online intervention that provides tiered pediatric recommendations (great, good, or not recommended) about twenty parenting strategies; participants in our study reviewed at least ten. TP2 was administered in our study as a 1-on-1 focused consultation with a trained parent educator. Each intervention lasted roughly 30 minutes on average. The main outcomes were: 1) parenting practices including positive parenting and coercive parenting assessed with the Parenting and Family Adjustment Scales (PAFAS); 2) frequency of CP use; 3) support for spanking via the Attitudes Toward Spanking scale, and 4) child emotional and behavioral adjustment assessed via the Child Adjustment and Parent Efficacy Scale. Short and long term effects were analyzed using linear mixed effect models and generalized estimating equations.

Results: Compared to controls, both intervention groups had significant increases in positive parenting at 3M follow-up: (Triple P, Level 2: b=0.93, p<0.001; Play Nicely: b=0.57, p=0.024); however, these effects dissipated by 4Y follow-up. Compared to controls, the Play Nicely group also showed a significant decrease in support for spanking (b= -0.41, p<0.001) and use of coercive parenting (b= -0.48, p=0.047) at 3M follow-up; the latter finding was sustained at 4Y follow-up (b= -0.60, p=0.042).

Conclusions and Implications: Findings suggest that brief parenting education programs can be efficacious in promoting use of positive parenting and reducing support for harmful parenting practices in the short-term. Some programs, such as Play Nicely, may also reduce longer-term risk for harmful parenting practices. These findings have important implications for practice, suggesting that brief, low-resource interventions could be implemented widely (e.g., in family service or health care settings) to reduce population-level risk for coercive parenting and child abuse.