Xiang Zhou, PhD, a Professor of Counseling Psychology at Purdue University, has recently published a study on the Incredible Years Attentive Parenting® Program in the Journal of Prevention and Health Promotion – the first empirical study of the Attentive Parenting® Program! His study, “Evaluating the feasibility of the Attentive Parenting® Program as universal prevention with racially diverse families,” looked at attendance rates and outcomes. Dr. Zhou has shared a summary of his research with us.
by Xiang Zhou, PhD
As a Counseling Psychologist, I am interested in parent training as a unique form of prevention and intervention which may alter the trajectories of both children and parents. I am also interested in how mental health interventions can be culturally adapted to meet the needs of diverse families. During my training at the University of Minnesota, I have worked with my graduate mentor Dr. Richard Lee, and Ms. Judy Ohm from Wilder Foundation in implementing IY® Attentive Parenting as a universal preventative intervention in a diverse local community.
In this posting, I want to share a summary of a recently published article for a wider audience. The full paper can be accessed either in the Journal of Prevention and Health Promotion (here) or a free preprint version (here).
The IY® Attentive Parenting Program is a manualized universal program (Webster-Stratton, 2012) based upon the original IY® BASIC Parenting Program (Webster-Stratton, 2001). It was developed for low-resource settings but can be used as either booster sessions for parents who have completed the IY® BASIC Parenting Program or for prevention purposes within a general population (Webster-Stratton, 2012). The core parenting concepts were introduced in successive sessions: 1) Attentive child-directed play promotes positive relationships and children’s confidence; 2) Attentive academic and persistence coaching promote children’s language and school readiness; 3) Attentive emotion coaching strengthens children’s emotional literacy and empathy; 4) Attentive social coaching promotes children’s cooperative friendships; 5) Attentive imaginative parenting promotes children’s emotional regulation skills, and 6) Attentive creative play promotes children’s problem solving and empathy.
We considered these differences between IY® Attentive Parenting Program and IY® Basic Curriculum:
We are interested in implementing IY® Attentive Parenting Program because it is more feasible to provide general parent training for ALL parents and prevent children’s socioemotional and behavioral problems BEFORE occurrence (Webster-Stratton, 2012).
More importantly, children of color under 18 are now the majority in the United States (Vespa et al., 2020). We are particularly interested in how diverse families respond to this preventative intervention. In our implementation, we have also incorporated cultural adaptation as encouraged by the IY implementation guidelines (Webster-Stratton, 2009). For example, during the first session, parents shared their own upbringing and discuss their parenting motivations (Zhou et al., 2018).
Methods: The study was implemented in a naturalist setting with a pre-post design with 155 parents. About 40% of parents were Black, 30% were Asian American (predominantly Hmong), 18% identified as White. Parents reported on their stress level (Parenting Stress Index; Abidin, 1990) and child adjustment problems (Strengths and Difficulties Questionnaire; Goodman, 2001) before and after the intervention.
Attendance: Past parenting intervention studies suggest at least 25% of parents who met the inclusion criteria did not enroll, and another 26% enrolled but dropped out before completing treatment. Additionally, the mean attendance rate was approximately 73% among those who attended at least one session, but there was high variability in attendance across studies ranging from 37% to 98% (Chacko et al., 2016).
We found parents attended 71% of all sessions. Pre-treatment conduct problems were associated with lower attendance, whereas pre-treatment hyperactivity problems were associated with higher attendance. It is thus important for clinicians to pay additional attention to engage and retain families who came to the intervention with more conduct problems in the context of a universal intervention.
In terms of treatment effects, we found:
1) IY Attentive Parenting® Program may reduce conduct problems and increase prosocial behaviors. No statistically significant pre-post changes were observed in emotional problems, hyperactivity problems, or peer problems. These results are previous work suggesting PT is better at reducing externalizing than internalizing behaviors (Leijten et al., 2018; Menting et al., 2013; Mingebach et al., 2018; Yap et al., 2016).
2) When parents reported a greater concern over conduct problems, hyperactivity problems, emotional problems, peer problems, or prosocial behaviors, they would report more benefits in these respective areas after attending IY.
3) pre-post change in parenting stress was not significant.
4) We did not find any differences across racial groups (i.e., White, Asian, Black) across attendance and treatment outcome results, suggesting IY may be culturally adapted and implemented to meet the needs of diverse families
Feel free to contact me at xiangzhou@purdue.edu for any questions or comments regarding this study. I also want to take the opportunity to commemorate Judy, who has been a long-time advocate for families in St Paul, Minnesota. She passed away in 2020 after a long battle with cancer.
Thanks to Dr. Zhou for sharing his research with us! To learn more about the Incredible Years Attentive Parenting® Program, please visit our website.
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