Child behavioral concerns are extremely common and can lead to poor academic achievement, social difficulties and mental health disorders, among other negative outcomes. Many factors contribute to behavioral problems in young children, including problematic parenting, which can intensify these problems and, in turn, increase parental stress and risk for further harsh parenting.
To address this issue, our team and collaborators at Cincinnati Children’s Hospital developed PriCARE, a six-session parenting intervention hosted within pediatric primary care that teaches caregivers techniques to support the social and emotional growth of their children. The program has shown to improve child behavior, strengthen caregiver-child relationships and decrease parental stress. However, while the strategies for promoting positive behaviors and ignoring minor misbehaviors taught in the brief PriCARE intervention are sufficient for some families, others may benefit from additional training on positive discipline techniques.
To build on the success of this parenting intervention, our team will assess a new four-session Positive Discipline Module with caregivers of children 2-6 years old who have completed the PriCARE program. The additional module is a group caregiver training program that builds off of skills taught in PriCARE. It is designed to promote the use of positive discipline techniques—such as behavior reward charts and effective time-out protocols—as well as skills for handling sibling conflicts and troubleshooting difficult discipline situations.
To assess how feasible it is for individuals to access this module, we will measure enrollment by calculating the percentage of eligible caregivers who choose to enroll and the number of sessions they attend. Measuring feasibility of this module will provide insight into whether caregivers are willing to attend four additional sessions and if they view the topics covered in this module as beneficial.
Next, to understand the impact of the Positive Discipline Module on child behavior problems, parenting attitudes, quality of caregiver-child interactions and child maltreatment risk, we will conduct in-person interviews and video recordings prior to the intervention and then again two to four weeks after the program ends.
Lastly, after completion of the module, we will assess acceptability by administering the Therapeutic Attitudes Inventory, a 10-question satisfaction measure of caregiver training and caregiver-child treatment. We will also collect feedback on participants’ experiences through a brief interview to inform our curriculum and identify ways to improve the program.
To date, we have piloted the new Positive Discipline Module with two groups of about six caregivers and the participants provided both positive and constructive feedback. Currently, our team is making iterative curriculum edits in preparation for officially piloting the intervention with research participants.
This project is the first step in building evidence and creating a blueprint for providing supports to caregivers in the pediatric primary care setting for preventing child behavioral concerns. The Positive Discipline Module has the potential to reduce harsh parenting, a key risk factor for child social, emotional and behavioral problems, but also for child abuse. Through strengthening caregiver-child relationships while providing effective discipline, we can reduce these risks, improving long-term outcomes for children.
Children's Hospital of Philadelphia, PolicyLab. Making Time for Time Out: Evaluating a Discipline Education Module for Caregivers of Young Children [Online]. Available at: http://www.policylab.chop.edu [Accessed: plug in date accessed here].