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Positive Parenting Program to Improve Problem Behaviors in Preschool-age Children (PriCARE)

Statement of Problem

Behavioral problems are common in young children. Approximately 11%-20% of children in the United States meet diagnostic criteria for a behavioral health disorder at any given time. Children with behavioral problems enter kindergarten disadvantaged in language, motor, social and school readiness skills, and are at increased risk of poor long-term academic outcomes. Behavioral problems are also associated with increased risk of substance abuse, anxiety disorders, attention-deficit/hyperactivity disorder (ADHD) and suicide. Furthermore, children with behavioral problems are at increased risk of harsh parenting and physical abuse.

Problem behaviors from young children can provoke negative and reactive parenting responses, which, in turn, increases the child’s behavior problems. Parenting interventions that promote positive, authoritative parenting (characterized as reliable, dependable and nurturing) can reduce the severity and frequency of behavioral problems, decrease parental stress and reduce the risk of child maltreatment. 

The pediatric primary care setting is an ideal venue to provide parent training and support. Between 25%-50% of pediatric office visits involve behavioral or emotional concerns. While some patients may require referral to a behavioral health specialist, many children may not need intensive, ongoing behavioral health treatment, especially in the early, formative years when these problem behaviors first develop. Providing a family-centered positive parenting program in the setting of the child’s primary care pediatrician could support parents and prevent future severe behavioral health problems in their children. 


PriCARE to Improve Problem Behaviors in Preschool-Age Children 


Next Steps

Partnering with Dr. Schilling at UNC, we received a 5-year R01 grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development to evaluate PriCARE’s impact on child maltreatment. We will be collecting reports made to Philadelphia’s Department of Human Services (DHS) as long as 52 months after enrollment in the study to determine if participants randomized to receive PriCARE have fewer reports filed with DHS compared to those who did not receive the intervention. More details about this study can be found at ClinicalTrials.Gov.

As we continue to expand PriCARE, Dr. Joanne Wood and the PriCARE research team received a grant from the Annie E. Casey Foundation to explore modifying the PriCARE curriculum for caregivers who became parents before the age of 21 and their parent supports. Currently, qualitative interviews are being conducted to gather input from young parents and their parenting supports. These interviews, along with input from an expert panel, will inform curriculum changes. Pilot PriCARE groups for both caregivers and their partners using the revised curriculum are scheduled to occur in 2024.

Recently, we also launched a study funded by the Ray E. Helfer Society to examine the impact of PriCARE on foster families. This study is actively enrolling foster parents of children ages 18 months to 6 years old for virtual PriCARE classes.

Given the lessons learned by this research team, evaluating barriers and facilitators to engagement and retention in PriCARE will continue to be important. We plan to build on PriCARE's preliminary evidence by continuing to rigorously evaluate and improve this model.

For more information about PriCARE, visit

This project page was last updated in February 2024.

Suggested Citation

Children's Hospital of Philadelphia, PolicyLab. Positive Parenting Program to Improve Problem Behaviors in Preschool-Age Children (PriCARE) [Online]. Available at: [Accessed: plug in date accessed here]. 

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