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Child Adult Relationship Enhancement in Primary Care: A randomized trial of a parent training for child behavior problems

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OBJECTIVE: Child Adult Relationship Enhancement in Primary Care (PriCARE) is a 6-session group parent training designed to teach positive parenting skills. Our objective was to measure PriCARE’s impact on child behavior and parenting attitudes.

METHODS: Parents of children 2 to 6 years old with behavior concerns were randomized to PriCARE (n=80) or control (n=40). Child behavior and parenting attitudes were measured at baseline (0 weeks), program completion (9 weeks), and 7 weeks following program completion (16 weeks) using the Eyberg Child Behavior Inventory (ECBI) and the Adult Adolescent Parenting Inventory-2 (AAPI2). Linear regression models compared mean ECBI and AAPI2 change scores from 0 to 16 weeks in the PriCARE and control groups, adjusted for baseline scores.

RESULTS: Of those randomized to PriCARE, 43% attended 3 or more sessions. Decreases in mean ECBI intensity and problem scores between 0 and 16 weeks were greater in the PriCARE group, reflecting a larger improvement in behavior problems [intensity: -22 (-16, -29) vs -7 (2, -17), p=0.012; problem: -5 (-4, -7) vs -2 (0, -4), p=0.014]. Scores on 3 of the 5 AAPI2 sub-scales reflected greater improvements in parenting attitudes in the PriCARE group compared to control in the following areas: empathy towards children’s needs [0.82 (1.14, 0.51) vs 0.25 (0.70, -0.19), p=0.04], corporal punishment [0.22 (0.45, 0.00) vs -0.30 (0.02, -0.61), p=0.009], and power and independence [0.37 (0.76, -0.02) vs -0.64 (-0.09, -1.19), p=0.003].

CONCLUSIONS: PriCARE shows promise in improving parent-reported child-behavior problems in preschool-aged children and increasing positive parenting attitudes.


Schilling S, French B, Berkowitz SJ, Dougherty SL, Scribano PV, Wood JN