About this trial
Child and adolescent behavioral health problems are related to the leading causes of youth morbidity and mortality. Parent-focused interventions effectively prevent behavioral health problems such as depression and conduct disorders and can provide a downstream economic benefit to society by reducing criminal activity, education costs, and health care use.
Unfortunately, parenting programs are not widely available, accessible, nor well-attended.
Pediatric primary care is a non-stigmatizing setting with nearly universal reach and, therefore, an ideal contact point to increase access. However, primary care clinicians (PCCs) often have insufficient training in behavioral health topics and typical referral practices are inadequate.
There are also logistical barriers to attending in-person parenting programs, like the need for childcare and a large time-commitment. There is a need to develop effective referral practices in conjunction with increasing the accessibility of parenting programs. The study long-term goal is to prevent significant behavioral health problems through widespread access to effective and accessible parenting programs through primary care referrals.
In this study there are two trials: First is the primary care clinicians "PCC" trial, testing the effectiveness of referral training (aim 1). Second is the parents "eGen" trial provided by therapists, testing the effectiveness of eGen parenting intervention (aim 2).
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Inclusion criteria for parent in the randomized controlled trial include being a parent or caregiver of a child ages 3 to 8 and having a referral to a participating therapist from a primary care provider.
The only inclusion criteria is that participants be a PCC who sees children between the ages of 3- 8 years old. PCCs must also have approval from their clinic to participate. Vulnerable populations will not be targeted from inclusion but may be included if they meet the previously stated inclusion criteria.
Disqualifiers
Parents would be excluded if there is a reasonable belief that participating could increase danger to a child or if they are psychologically unable to engage in the intervention activities.
Trial design
Parallel
Treatments tested in this trial
Referral and communication skills learning
Behavioralassigned to receive a brief, live, experiential training on the referral process and communication strategies.
Written guide to the referral process
Behavioralassigned to receive only written information about the referral process
Empowered Generations (eGen): parent training
BehavioraleGen is a six-session parent training program provided by therapists via video chat online to parents with a child between the ages of 3-8 years.
control
BehavioralThe control condition consists of a single scripted session, in which therapists guide the parent to the following resources: (a) a book, Raising Cooperative Kids, by GenPMTO co-developer Marion Forgatch; (b) vetted parenting advice websites; (c) information about Early Childhood and Family Education classes, which are provided for free in Minnesota through public schools; and (d) a list of culturally tailored parenting advice websites.
Treatment groups
Trial outcomes
Primary outcomes
Child behavior problems
Child externalizing and internalizing will be measured using the Behavioral Assessment System for Children - Behavioral and Emotional Screening System (BASC-3-BESS; 29 items).
Change in parenting behavior
The Alabama Parenting Questionnaire - Preschool version (APQ; 32 items) has subscales to measure positive parenting, inconsistent parenting, and punitive parenting.
Number of Completed Referrals
This is defined as the number of parents who agree to begin treatment with the therapist after a referral from a primary care provider.
Parent Attendance
Parent attendance will be reported as the percent of sessions attended.
Secondary outcomes
Parents mental health: depression
The patient health questionnaire will measure parent depression (PHQ-9; 9 items)
Parents mental health: anxiety
the general anxiety disorder scale (GAD-7) will assess parent anxiety symptoms
Parents mental health: absenteeism
the WHO Health and Work Performance Questionnaire - Short Form (HPQ SF, 8 items) will assess parent absenteeism.
Parenting self-efficacy
Parenting self-efficacy will be measured with the Parent Locus of Control measure (PLOC; 24 items).
Sponsors and contacts
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