scholarly journals Low-Income Parents’ Perceptions of and Engagement With a Digital Behavioral Training Program: Mixed Methods Study

Iproceedings ◽  
10.2196/15090 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e15090
Author(s):  
Jenna Brager ◽  
Susan Breitenstein ◽  
Deborah Gross ◽  
Hailey Miller
Keyword(s):  
Behavior Problems ◽  
Parent Training ◽  
Training Program ◽  
Child Behavior ◽  
Low Income ◽  
Urban Poverty ◽  
Child Behavior Problems ◽  
Well Being ◽  
Ease Of Use ◽  
Perceived Usefulness

Background Parent training is a method for strengthening parenting skill, reducing child behavior problems, and promoting positive parent-child relationships. However, few parents have access to these evidence-based programs. The ezParent program, a tablet-based delivery adaptation of the group-based Chicago Parent Program (CPP), is a parent training program designed to address the needs of families raising young children in urban poverty. There is extensive evidence that positive parenting practices can be a powerful buffer against the negative effects of poverty and adversity and is one of the strongest predictors of children’s social and behavioral well-being. Objective This study aimed to explore (1) parents’ perceptions of the benefits and barriers associated with their use of the ezParent program; and (2) the ways in which the ezParent components and perceived usability varied by program use (module completion). Methods This study uses an explanatory mixed-method design. Data were collected from 92 participants recruited from two pediatric primary care clinics (PPC) based in two urban cities with a high proportion of low income and minority families: Chicago, Illinois (cohort 1) and Baltimore, Maryland (cohort 2). Cohort 1 (n=42) was recruited between October 2013 and June 2014 as part of a randomized controlled tirla. Cohort 2 (n=50) was recruited between May 2017 and July 2017 as part of a single group design. The current report focuses on a subsample from cohorts 1 and 2 who were interviewed about their experiences using the program. To explore parents’ perceptions of ezParent (ie, perceived usefulness of content, ease of use, barriers to use, qualities affecting interest, and intention), all participants were invited to participate in an individual interview after the 12th week. Based on degree of module completion, we grouped parents into two user groups: high (completed 4-6 modules) and low (completed 0-3 modules). This cut-off was chosen based on previous data showing that parents who attended at least 50% of the CPP group sessions reported greater improvements in parenting self-efficacy, use of discipline, and warmth towards their children, as well as fewer child behavior problems. Results Fifty-nine parents participated in follow-up interview: 32 (54.24%) from cohort 1 and 27 (45.76%) from cohort 2. Among those interviewed, 23 (38.9.5%) parents completed all six modules and 12 parents (20.3%) completed none of the modules. Specifically, among those interviewed, parents completed an average of 3.73 (SD 2.39) modules compared to an average of 1.79 (SD 2.38) modules completed among those not interviewed. Parents who completed more modules reported more program benefits and those who completed fewer modules reported more barriers. Conclusions Exploring users’ experience with current digital applications, researchers and application developers can better design future tablet-based interventions to be both effective and acceptable by end users. Furthering our understanding of factors associated with engagement will inform more effective tailoring and improvements of mHealth interventions, particularly those targeting vulnerable populations.

scholarly journals Does Level of Engagement in a Digital Parent Training Program Impact Improvements in Parenting and Child Outcomes?

Iproceedings ◽  
10.2196/15104 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e15104
Author(s):  
Jenna Brager ◽  
Susan Breitenstein ◽  
Chakra Budhathoki ◽  
Deborah Gross
Keyword(s):  
Behavior Problems ◽  
Parent Training ◽  
Parenting Stress ◽  
Training Program ◽  
Child Behavior ◽  
Self Efficacy ◽  
Child Outcomes ◽  
Child Behavior Problems ◽  
Parent Training Program ◽  
Usage Metrics

Background Approximately 8% to 10% of children younger than 5 years of age experience emotional, behavioral, and social relationship problems. These children are more likely to exhibit poor social interactions, problematic parent–child relationships, and school related setbacks, thus reinforcing the need for early interventions such as parent training programs. The ezParent program is a tablet-based delivery adaptation of the group-based Chicago Parent Program, a program designed to address the needs of families raising young children in urban poverty. The growing interest in and adoption of mHealth has changed the way people receive and seek treatment and the way clinicians deliver care. Despite the usefulness of mHealth apps in helping people manage various aspects of health, people’s use of those technologies often lasts only for a short period of time. This suggests a need to delve more deeply into user behaviors. Objective The purpose of this study was to (1) classify levels of engagement by identifying individual usage of ezParent based on observed user activity (ie, “metadata”) and (2) examine whether levels of ezParent engagement is associated with changes in parenting and child behavior over time (ie, parenting stress, self-efficacy, warmth, follow through, punishment, child behavior problems and intensity). Methods This study used a single-group, pre- and posttest design with repeated measures follow-up. Survey measures were collected at baseline (T1), 12 weeks postbaseline (T2) and 24 weeks postbaseline (T3). The study included 92 parents with data collected from two pediatric primary care clinics based in two urban cities with a high proportion of low income and minority families: Chicago, Illinois (cohort 1) and Baltimore, Maryland (cohort 2). Engagement was conceptualized based on total number of modules completed, amount of time spent in the program, and number of skills saved by the parent. Each outcome variable was modeled using a separate mixed-effects model to determine the model of best fit and was analyzed across time and level of engagement. Results Overall, 78 parents logged in to the ezParent program. The data aggregation resulted in 41 parents categorized as high engagers (cohort 1 n=29; cohort 2 n=12) and 37 parents as low engagers (cohort 1 n=13; cohort 2 n=24). Significant differences were across all outcome variables: parenting stress (P<.05), self-efficacy (P<.05), warmth (P<.05), punishment (P<.05), follow-through (P<.05), child behavior intensity (P<.05), and child behavior problems (P<.05). Although parenting outcomes improved, improvements were not significantly associated with levels of engagement. Conclusions This study provides insight into engagement of parents participating in a digitally delivered parent training program. Although level of engagement was not associated with improvements in parenting and child outcomes, we were able to systematically identify and test key usage metrics to ope rationalize engagement. This indicates that further study may help researchers identify other usage metrics more indicative of engagement. By exploring usage data, researchers, app developers, and clinicians can better understand how users engage with future tablet-based interventions.

Preschool children at social risk: Chronicity and timing of maternal depressive symptoms and child behavior problems at school and at home

1993 ◽  
Vol 5 (3) ◽  
pp. 371-387 ◽  
Author(s):  
Lisbeth Alpern ◽  
Karlen Lyons-Ruth
Keyword(s):  
Depressive Symptoms ◽  
Behavior Problems ◽  
Child Behavior ◽  
Low Income ◽  
Child Behavior Problems ◽  
Father Absence ◽  
Maternal Depressive Symptoms ◽  
Withdrawn Behavior ◽  
Depressed Mothers ◽  
At Home

AbstractThe current study investigated the relationship between previous, recent, or chronic maternal depressive symptoms and subtypes of child behavior problems rated by teachers and mothers among 64 low-income children aged 4–6 years. Sixty-nine percent of mothers with high depressive symptom levels at the preschool assessment had also reported high symptom levels during the child's infancy. Children whose mothers reported depressive symptoms at both ages exhibited significantly elevated rates of hostile behavior problems in the classroom and at home compared to children of never-depressed mothers. Children of mothers who were previously but not currently depressed showed significantly more anxious and withdrawn behavior at school and at home, while children of recently depressed mothers were more hyperactive and demanding. Child cognitive scores and father absence were also related to behavior problems, but these variables did not mediate the independent effects of chronicity and timing of maternal depressive symptoms on the types of child symptoms displayed.

Evaluation of Parent and Child Enhancement (PACE) Program

2016 ◽  
Vol 27 (1) ◽  
pp. 19-35 ◽  
Author(s):  
Cynthia Leung ◽  
Sandra Tsang ◽  
Cyrus Lo
Keyword(s):  
Behavior Problems ◽  
Child Behavior ◽  
Low Income ◽  
Parental Stress ◽  
Controlled Trial ◽  
Intervention Group ◽  
Child Behavior Problems ◽  
Control Group ◽  
Child Preschool ◽  
Child Learning

Objective: This study examined the efficacy of the Parent and Child Enhancement (PACE) program on child learning, child behavior problems, and parental stress, using randomized controlled trial design, in social services centers. Methods: Eligibility criteria were (1) children aged 2 years at program commencement, (2) low-income, new immigrant, or single-parent families, and (3) parent–child dyads being Hong Kong residents. Intervention group dyads were offered the PACE program (40 two-hour sessions on child learning and parenting). Primary outcomes included child preschool concepts, child behavior problems, and parental stress. Participants were randomly assigned to intervention (76 dyads) and control group (73 dyads) using a random number table, without blinding. Results: Intention-to-treat analysis with 149 dyads indicated improvement in child preschool concepts, decrease in child behavior problems and parental stress in the intervention group, compared with the control group ( d = 0.12–0.73). Conclusions: The results provided evidence for the efficacy of the PACE program.

Chronic Family Adversity and Early Child Behavior Problems: A Longitudinal Study of Low Income Families

1994 ◽  
Vol 35 (6) ◽  
pp. 1109-1122 ◽  
Author(s):  
Daniel S. Shaw ◽  
Joan I. Vondra ◽  
Katherine Dowdell Hommerding ◽  
Kate Keenan ◽  
Marija Dunn
Keyword(s):  
Longitudinal Study ◽  
Behavior Problems ◽  
Child Behavior ◽  
Low Income ◽  
Child Behavior Problems ◽  
Family Adversity ◽  
Early Child ◽  
Low Income Families

scholarly journals Household Chaos and Child Behavior Problems Predict Maternal Well-being

2021 ◽  
Author(s):  
Sumeyra Yalcintas ◽  
Alison Pike ◽  
Bonamy R. Oliver
Keyword(s):  
Behavior Problems ◽  
Child Behavior ◽  
Child Behavior Problems ◽  
Well Being ◽  
Future Research ◽  
Household Chaos ◽  
Stress Symptoms ◽  
Behavior Study ◽  
And Behavior ◽  
Practical Implications

AbstractThe aim of the study was to investigate predictors of maternal well-being in mothers of twins. As well as being important in its own right, maternal well-being is a crucial predictor of parenting (Belsky in Child Dev. 55(1):83, 1984). Based on previous research (Pike et al. in Int J Beh Dev. 30(1):55–66, 2006) we expected that household chaos (Confusion, Hubbub, and Order) and child behavior problems would predict maternal depression, stress and anxiety. The data for the study was taken from the Twins, Family and Behavior Study (TFaB) -- a longitudinal UK study of twins born in 2009 and 2010. One hundred and fifty-eight mothers of twins (Mchild age= 6.01 years, SDage = 0.50) reported on household chaos, child disruptive behaviors and their own well-being. Higher levels of household chaos were linked to maternal depressive, anxiety and stress related symptoms. More child behavior problems were related to more depressive and stress symptoms but not anxiety. The findings show promise for future research investigating different types of maternal well-being and suggested practical implications, such as intervening on concrete aspects of household chaos to improve maternal well-being.

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