Evidence-based Parenting Interventions Research Articles

A non-randomized feasibility study of a voice assistant for parents to support their children’s mental health

BackgroundMental disorders affect one in seven Australian children and although effective, evidenced based treatments exist, there is a critical shortage of mental health clinicians which has created a “treatment gap.” Artificial intelligence has the potential to address the high prevalence rates of mental disorders within overburdened mental health systems.MethodsThis was a non-randomized feasibility study to evaluate the novel application of voice technology to an evidence-based parenting intervention designed to support children’s mental health. We deployed an Amazon Alexa app to parents recruited from the community (N = 55) and to parents with children receiving psychological treatment (N = 4). Parents from the community used the app independently whereas parents from the clinical group used the app in conjunction with attending a six-week parenting program. The primary outcome measure, feasibility was assessed in terms of acceptability, via recruitment and retention rates, quantitative surveys and qualitative interviews.ResultsIn the community group, the recruitment rate was 23.8% and the retention rate 49.1%. In the clinical group, all 6 families approached for recruitment agreed to participate and 4 out of 6 completed the trial. Parents attending the parenting program spent on average, three times longer using the app than parents from the community. Overall, parents reported that the app contained easy-to-understand information on parenting, and that they could see the potential of voice technology to learn and practice parenting skills. Parents also faced several challenges, including difficulties with installation and interactions with the app and expressed privacy concerns related to voice technology. Further, parents reported that the voices used within the app sounded monotone and robotic.ConclusionWe offer specific recommendations that could foster a better voice assistant user experience for parents to support their children’s mental health. The app is highly scalable and has the potential to addresses many of the barriers faced by parents who attempt to access traditional parenting interventions.

Child Welfare Outcomes After Attachment and Biobehavioral Catch-Up Intervention Participation: A Quasi-Experimental Study.

Limited research is available examining distal child welfare outcomes after participation in evidence-based parenting interventions. To address this gap, this study employed a multi-tiered analytic approach to examine child welfare outcomes after participation in Attachment and Biobehavioral Catch-up (ABC). Using propensity score analytic techniques to establish a matched comparison group, logistic regressions examined subsequent maltreatment reports and substantiation, and survival analyses observed time to and likelihood of reunification for children who received one of three ABC curriculums compared to comparison group children (child welfare services as usual). In total, 205 children were included in the impact analysis (n = 66 treatment; n = 139 comparison); the majority of the children were White (53.7%), non-Hispanic (84.4%), males (59.5%) with an average age of 6 months (M [SD] = .50 [1.0]). Over half (56.1%) of the study sample was in out-of-home placement; 23.5% of the removed children experienced reunification. No statistically significant group differences were observed on the likelihood of subsequent or substantiated maltreatment reports. All three ABC curriculums were associated with a statistically significant increased likelihood of reunification, when compared to their matched counterpart. Additional research is warranted, though results indicate ABC may be a promising intervention to help enhance the likelihood of reunification.

An Equity-Focused Assessment of Evidence-Based Parenting Intervention Research

Evidence-based parenting interventions (EBPI) support children and families to promote resilience, address emotional and behavioral concerns, and prevent or address issues related to child maltreatment. Critiques of EBPIs include concerns about their relevance and effectiveness for diverse populations when they are implemented at population scale. Research methods that center racial equity and include community-based participatory approaches have the potential to address some of these concerns. The purpose of the present review was to document the extent to which methods associated with promoting racial equity in research have been used in studies that contribute to the evidence base for programs that meet evidentiary standards for a clearinghouse that was developed to support the Family First Prevention Services Act in the United States. We developed a coding system largely based on the Culturally Responsive Evaluation model. A sample of 47 papers that are part of the evidence base for ten in-home parent skill-based programs were reviewed and coded. Only three of 28 possible codes were observed to occur in over half of the studies (including race/ethnicity demographic characteristics, conducting measure reliability for the study sample, and including information on socioeconomic status). Although the overall presence of equity-informed methods was low, a positive trend was observed over time. This review highlights ways in which rigorous research can incorporate racial equity into the planning, design, execution, and interpretation and dissemination of programs of study. We posit that doing so improves the external validity of studies while maintaining high-quality research that can contribute to an evidence base.

A short responsive interaction scale: construction and preliminary reliability and validity

Background: Responsive interactions among caregivers and newborns are essential for positive and optimal growth and development. The aim of this cross-sectional study was to develop and validate a short responsive interaction tool (SRIS) to assess caregiver responsiveness of newly delivered mothers. Methods: The SRIS consists of twenty elements that are used to classify new-born handling, interactions, consoling techniques, engagement, and distress. High reliability and internal consistency were shown in the data gathered from 257 mothers (Cronbach's alpha=0.8354). The scale's one-dimensional structure was discovered through construct validity analysis, demonstrating the consistency of the scale's evaluation of response interactions. Results: The results indicate that the valid and reliable instrument for gauging the responsiveness of caregivers during their initial contact with neonates. It provides a useful and approachable method with possible uses in healthcare settings and research for evidence-based parenting interventions. Conclusions: To improve the tool's generalizability and usefulness in fostering early childhood development and parental engagement, further research is necessary to validate it across a variety of contexts.

Promoting Healthy Screen Media Use in Young Children With Externalizing Behavior Problems Through an Adapted Parenting Intervention: Results of an Open Trial

In this article, we describe the development of an adapted parenting intervention for caregivers of preschoolers with externalizing behavior problems, which integrates content around screen media use into an existing evidence-based parenting intervention. We also present results of an open trial examining the feasibility, acceptability, and initial outcomes of the adapted intervention in a sample of 10 low-income caregivers of children with externalizing behavior problems who were attending a community-based therapeutic summer program. Caregivers attended a once weekly (1.5-hour) intervention group, which was embedded in an 8-week community-based therapeutic program for children with externalizing behavior, and completed questionnaires at pretest, posttest, and 1 month following the intervention, and completed interviews about their experiences. Caregiver satisfaction with the adapted intervention was high, and fidelity and attendance measures suggested the intervention was feasible. Preliminary results showed postintervention improvements in caregivers’ skills in managing screen media use, including increases in caregiver self-efficacy to manage and set limits around screen media use. Results suggest that leveraging existing parenting interventions to promote healthy media use habits may be a promising avenue to maximize reach to families with children with externalizing behavior.

Child Adult Relationship Enhancement in Primary Care (PriCARE) theory of change: A promising intervention to reduce child maltreatment

Child maltreatment (CM) is a pervasive public health problem and there is a critical need for brief, effective, scalable prevention programs. Because problematic parent-child relationships lie at the core of CM, interventions targeting this relationship hold promise as CM prevention strategies. Evidence-based positive parenting interventions, as discussed here, are manualized behavioral interventions that focus on teaching caregivers positive parenting skills and techniques to improve the effectiveness of their parenting and improve their relationship with their child. In this article, we describe one specific parenting intervention, Child Adult Relationship Enhancement in Primary Care (PriCARE)/Criando Niños con CARIÑO, and review the proposed mechanisms through which PriCARE may contribute to CM prevention. PriCARE is a 6-session group parenting intervention for parents of 2-to-6-year-old children. PriCARE was developed and iteratively adapted with input from racially and ethnically diverse families, including low-income families, and was designed specifically for implementation in primary care with inclusion of strategies to align with usual care workflow to increase uptake and retention. PriCARE has the potential to reduce risk of CM directly through improving parenting behaviors and indirectly through the impact of those changes in parenting behaviors on child behaviors. PriCARE has also been shown to reduce parenting-related stress. Finally, by strengthening and bringing warmth to the parent-child relationship, PriCARE may buffer against the negative health consequences associated with CM and childhood adversity.

Making it "EASI" for pediatricians to determine when toddler tantrums are "more than the terrible twos": Proof-of-concept for primary care screening with the Multidimensional Assessment Profiles-Early Assessment Screener for Irritability (MAPS-EASI).

Up to 20% of youth have impairing mental health problems as early as age 3. Early identification and intervention of mental health risks in pediatric primary care could mitigate this crisis via prevention prior to disease onset. The purpose of this study was to establish the feasibility and acceptability of implementing a brief transdiagnostic screening instrument in pediatric primary care for irritability and corollary impairment. Five pediatric clinicians in a Midwest clinic implemented the Multidimensional Assessment Profiles-Early Assessment Screener of Irritability (MAPS-EASI) for toddlers (24-30 months) and their families. MAPS-EASI (psychometrically derived from the well-validated MAPS-Scales) includes six items (scored 0-5) about symptoms (e.g., tantrums, grumpy mood), context, and frequency and two items (scored 0-3) assessed impairment. Positive screens (MAPS-EASI ≥ 5 plus impairment ≥ 2) were referred to an evidence-based parenting intervention. We assessed reach and outcomes of MAPS-EASI screening. Follow-up interviews with clinicians assessed perspectives on irritability screening and MAPS-EASI implementation. Of 201 eligible families, 100 (49.8%) completed the screener for a 24- or 30-month well-child visit. Mean MAPS-EASI scores were 5.8 (SD = 3.2), mean impairment scores were 0.9 (SD = 0.9), and 24 (24.0%) screened positive. Clinicians indicated that irritability screening for toddlers was aligned with their prevention-oriented, developmentally based practice. MAPS-EASI had face validity and increased clinician decision-making confidence. Finally, clinicians identified barriers and facilitators to large-scale implementation. MAPS-EASI proved to be feasible and acceptable in pediatric primary care. Further tailoring will be needed as the MAPS-EASI processes are scaled out to new contexts and populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Relationship between Family Characteristics and Adolescent Perception of the Quality of Family Communication

Many studies consider family communication to be one of the most important protective factors for the positive development of children and adolescents in the family environment. This paper aims to clarify whether some characteristics of the family environment influence the quality of family communication in order to provide guidelines for the planning of prevention strategies that effectively improve the quality of family communication and, thus, the positive development of adolescents. Specifically, the aim is to investigate whether there are gender- and age-related differences in the assessment of the quality of family communication and whether there are differences in the assessment of the quality of family communication depending on some family characteristics. High school students from five large Croatian cities (Zagreb, Osijek, Split, Pula, and Varazdin) took part in this study. The quota sample is stratified by three Croatian high school programs, as well as by individual program orientations within each school. The results show that there are differences in assessment of the quality of family communication in relation to gender, age, living with both or one parent, and the educational and working status of the parents. The data suggest that, in addition to the timely implementation of evidence-based parenting and/or family-based prevention interventions, there is a need to invest in high-quality social policies that could lead to a better quality of family life by increasing the chances of higher educational attainment for (future) parents as well as adequate employment opportunities.

Practitioner Review: A core competencies perspective on the evidence-based treatment of child conduct problems.

The effective treatment of child conduct problems is understood to rely on a range of therapist competencies, yet these have rarely been an explicit focus of research. In this practitioner review, we examine core competencies for the delivery of evidence-based parenting interventions for conduct problems in early-to-middle childhood. These are examined in light of research into the common elements shared by these interventions, literature regarding common challenges in these interventions, and conceptualisations of such competencies in other fields of mental health. We report on the development of a novel consensus-based model of core competencies for evidence-based practice in this field, based on consultation with an international expert panel. This includes competencies as they apply to complex presentations of conduct problems. Despite considerable variation among widely disseminated programmes in terms of content, format and skills-training practices, there is strong consensus among practitioners regarding core competencies. These relate to three broad domains: (a) generic therapeutic competencies; (b) parenting intervention competencies; (c) specific parenting skills/techniques. Practitioners working with conduct problems, particularly complex presentations thereof, require competencies for engaging not only mothers, but fathers and diverse/non-traditional caregivers and other stakeholders, in evidence-based parenting interventions. Moreover, the successful delivery of these interventions necessitates competencies that extend beyond behaviour management and encompass broader aspects of the family system and the wider ecology of the child.

Mapping the Expertise and Understanding of Menarche, Menstrual Hygiene, and Menstrual Health among Adolescent Ladies in Low- and Center-Profit Nations

Mapping the Expertise and Understanding of Menarche, Menstrual Hygiene, and Menstrual Health among Adolescent Ladies in Low- and Center-Profit Nations

The Triple P System of Evidence-Based Parenting Support: Past, Present, and Future Directions

Triple P is an integrated, multi-level system of evidence-based parenting support designed to promote the well-being of children and families to reduce prevalence rates of social, emotional, and behavioral problems in children and adolescents and to prevent child maltreatment. The system developed gradually over four decades to address the complex needs of parents and children from diverse family, socioeconomic and cultural backgrounds. It blends universal and targeted programs, a focus on developing parental self-regulation capabilities, and adopts a life span perspective with a population health framework. The Triple P system is used as a case example to discuss the past, present and future challenges, and opportunities involved in developing, evaluating, adapting, scaling and maintaining a sustainable system of evidence-based parenting intervention. Seven stages of program development are outlined from initial theory building and development of the core parenting program through to the sustained deployment of the intervention system delivered at scale. The importance of ongoing research and evaluation is highlighted so that different programs within the system evolve and adapt to address the contemporary concerns and priorities of families in diverse cultural contexts. A well-trained workforce is essential to deliver evidence-based programs, in a need-responsive manner that blends both fidelity of delivery and flexibility and is tailored to respond to the needs of individual families and local context. Programs need to be gender-sensitive, culturally informed, and attuned to the local context including relevant policies, resources, cultural factors, funding, workforce availability and their capacity to implement programs.

The Effectiveness of GenerationPMTO During Sustained Implementation in the Public Mental Health System: A Single-Arm Open Trial Evaluation

To support families and reduce the burden of child mental, emotional, and behavioral problems, evidence-based parenting interventions must remain effective in real-world service delivery contexts. The purpose of the current study was to evaluate the effectiveness of the GenerationPMTO (GenPMTO) intervention during sustained implementation in the Michigan public mental health system using a single-arm open trial (pre–post) design. We also examined potential predictors of treatment response. A multilevel analysis framework was utilized to evaluate data from 365 caregivers who completed GenPMTO treatment. Results revealed significant positive improvements from pretest to posttest in all four outcome domains (i.e., parenting confidence, parenting practices, caregiver depressive symptoms, child behavior problems). When compared to group-based GenPMTO delivery, the individual delivery format was associated with significantly greater improvements in overall effective parenting practices, as well as in the subdomain of skill encouragement. Caregiver gender, caregiver educational level, and child age were all implicated as predictors of GenPMTO outcomes. These findings add to the literature by supporting the effectiveness of the GenPMTO intervention when fully integrated into mental health care practice and can inform continued efforts to provide families with evidence-based services in community settings.

Features, Design, and Adherence to Evidence-Based Behavioral Parenting Principles in Commercial mHealth Parenting Apps: Systematic Review.

There is a need to disseminate evidence-based parenting interventions for adolescent externalizing concerns. Although family-based treatments have demonstrated efficacy for such concerns, they have limitations and challenges when disseminated in the community. Behavioral-based parenting techniques form an integral part of well-established, family-based interventions for adolescent behavioral problems and are ideal for dissemination through coupling with smartphone technology. Despite the vast number of "parent" apps currently available in commercial markets, there is a dearth of reviews focused on evaluating mobile health apps through the lens of behavioral parenting training (BPT). This study aimed to conduct a systematic review of commercial mobile health apps for parents to increase effective parenting skills that include behavioral components. A search of the Google Play and Apple App Stores identified 57 apps that were included in the review and coded for availability, popularity, and infrastructure. In total, 89% (51/57) of them were sufficiently functional to be assessed for app design quality (engagement, functionality, esthetics, and information), and 53% (30/57) proceeded to the final evaluation of level of adherence to BPT principles. In total, 57 apps met the initial inclusion criteria. Accessibility was high across these apps given that 44% (25/57) were available on both the Google Play and Apple App Stores and 68% (39/57) were free of charge. However, privacy concerns were addressed inconsistently among the apps. App design quality was average across the included apps, and apps with positive user star ratings or a high number of downloads received higher ratings on app design quality. In contrast, the identified apps largely fell short in providing BPT components adequately and with high interactivity, with low levels of adherence to BPT (mean 20.74%, SD 11%) across all commercial apps evaluated. Commercially popular apps did not show higher levels of adherence to BPT. Overall, a moderate relationship between app design quality and adherence to BPT was found. App features that have been found to increase user engagement, such as gamification and individualization, were only observed in a small minority of apps. Overall, there was a lack of focus on teenage development. Future app developers hoping to increase the dissemination of BPT should aim for free and accessible apps that balance high-quality design features (eg, simple esthetics, interactivity, and individualization) with content consistent with BPT principles. They should also consider key issues that are inconsistently addressed in current apps, including privacy and teenage development. Future app developments will likely benefit from multisector (industry and academic) collaboration throughout the design process and involving end users (ie, parents) during different stages of app development.

A mixed-method evaluation of Cradle to Kinder: An Australian intensive home visitation program for families experiencing significant disadvantage

Cradle to Kinder is an Australian intensive, long-term, home visitation program that supports young families experiencing multiple stressors, including poverty, family violence, mental illness, substance use, childhood trauma, intellectual disability, child projection involvement, teenage pregnancy, or social isolation, which places them at high risk of child removal. The program adopts a multidisciplinary, whole-of-family and trauma-informed approach to provide families with long-term case management, practical support and evidence-based therapeutic parenting interventions from pregnancy for up to four years to address these underlying risk factors. The aim of this study was to evaluate: (1) the extent to which families experienced improvements in family, caregiver and infant wellbeing outcomes after 24 months engagement; and (2) caregivers’ experiences of the program. A mixed-method evaluation was employed, which included two components: (1) uncontrolled pre-post quantitative assessment for 57 families using the North Carolina Family Assessment Scale and Brigance Early Child Development Assessment, completed every six months; and (2) qualitative interviews with 14 caregivers engaged in the program. The quantitative findings showed significant improvements in key domains of family functioning, parenting capabilities, infant development, and family preservation. The qualitative results validated these findings as caregivers reported favourable outcomes via participation in the program, including improved parenting skills and confidence, personal wellbeing, and child development. Suggestions for program development included greater support for fathers, increased cultural awareness, and consistency in workers. This mixed-methods study provides support for Cradle to Kinder as a promising model of family support that can improve family functioning, caregiver and child wellbeing, and prevent child removal among families experiencing significant disadvantage. These findings support the ongoing delivery of Cradle to Kinder in Australia to ensure families at greatest risk receive the support they urgently need.

Adaptation of an evidence-based parenting intervention for integration into maternal-child home-visiting programs: Challenges and solutions.

The objective of this study was to assess potential challenges, prioritize adaptations, and develop an implementation and research approach to integrate and study a parenting intervention for mothers in recovery from substance use disorders in community-based home-visiting programs. An explanatory mixed-methods design, guided by process mapping with Failure Modes and Effects Analysis tools, and an Advisory Panel of 15 community members, identified potential implementation challenges and recommended solutions for the proposed intervention within five pre-specified domains. Thematic content analysis identified themes from detailed field notes. The Advisory Panel identified 44 potential challenges across all domains. They determined that the recruitment domain was most likely to create challenges. Regarding the potential challenges, two cross-domain themes emerged: (1) development of mistrust in the community and (2) difficulty initiating and sustaining engagement. Potential solutions and adaptations to protocols are reported. Mistrust in the community was cited as a potentially important challenge for the delivery and study of an evidence-based parenting intervention for mothers in recovery through home-visiting programs. Adaptations to research protocols and intervention delivery strategies are needed to prioritize the psychological safety of families, particularly for groups that have been historically stigmatized.

Internet-administered, low-intensity cognitive behavioral therapy for parents of children treated for cancer: A feasibility trial (ENGAGE).

Parents of children treated for cancer may experience mental health difficulties, such as depression and anxiety. There is a lack of evidence-based psychological interventions for parents, with psychological support needs unmet. An internet-administered, guided, low-intensity cognitive behavioral therapy-based (LICBT) self-help intervention may provide a solution. The feasibility and acceptability of such an intervention was examined using a single-arm feasibility trial (ENGAGE). Primary objectives examined: (1) estimates of recruitment and retention rates; (2) feasibility and acceptability of data collection instruments and procedures; and (3) intervention feasibility and acceptability. Clinical outcomes were collected at baseline, post-treatment (12 weeks), and follow-up (6months). The following progression criteria were met: sample size was exceeded within 5months, with 11.0% enrolled of total population invited, study dropout rate was 24.0%, intervention dropout was 23.6%, missing data remained at ≤10% per measure, and no substantial negative consequences related to participation were reported. Intervention adherence was slightly lower than progression criteria (47.9%). Findings suggest an internet-administered, guided, LICBT self-help intervention may represent a feasible and acceptable solution for parents of children treated for cancer. With minor study protocol and intervention modifications, progression to a pilot randomized controlled trial (RCT) and subsequent superiority RCT is warranted.

‘Tipping the balance' – an evaluation of COVID-19 parenting resources developed and adapted for child protection during global emergency responses

Background: Parenting was severely affected by lockdown, school closure, illness, movement restrictions and the many sudden changes wrought by the global emergence of COVID-19. Responding to the need for a rapid emergency response to support parents and caregivers, a consortium of providers developed a suite of COVID-19 parenting resources based on evidence-based parenting interventions. Launched in March 2020, these were adapted for online use, with versions in over 100 languages, and the possibility for downloading, radio, and oral provision. A rapid qualitative evaluation initiative was conducted from September 2020 to February 2021 to inform the procedure, understand the impact and to drive future provision. Methods: The evaluation collected openended responses surveys (n = 495 participants) and in-depth interviews with parents, providers, and adolescent children (n = 22) from 14 countries and one global source. Data were gathered on parenting challenges during COVID-19 and the utility of the COVID-19 parenting resources. In-depth, semi-structured interviews explored the same concepts and elaborated on challenges, utility of the resources, and recommendations for the future. Data were coded in a hierarchy from basic, organising and global theme generation.Results: The parenting resources equipped parents with information and practices transforming everyday lives, and interactions. The tips provided prompts and permissions related to children’s behaviour, enabled communications, and offered ways to reduce stress, monitor behaviour and navigate discipline challenges. The timeliness of the resources as well as the clarity and ease of use were seen as advantages. Future direction and possible hurdles related to adaptations needed according to recipient, child age, local context, culture, and new challenges. Conclusions: Overall findings point to the value and utility of this unprecedented global response to theCOVID-19 pandemic. Results suggest that rapid provision of parenting resources at scale is feasible and of use and opens a pathway for providing evidence-based interventions under COVID-19 constraints.

Behavioral, Affective, and Cognitive Parenting Mechanisms of Child Internalizing and Externalizing Problems during the COVID-19 Pandemic.

The COVID-19 pandemic has led to increased mental health concerns, including depression and anxiety among parents and internalizing and externalizing problems among youth. To better understand the mechanisms and moderators of child mental health during the pandemic, the current study tested two moderated mediation models in which parent depression and anxiety indirectly impacted child internalizing and externalizing problems through negative effects on multiple parenting variables, with these associations moderated by families’ exposure to COVID-19-stressors. A national sample representative of U.S. parents (N = 796, 48.2% female, Mage = 38.87 years, 60.3% Non-Hispanic white, 18.1% Hispanic/Latinx, 13.2% Non-Hispanic Black/African-American, 5.7% Asian, 2.8% Other Race) completed a cross-sectional online survey in February-April 2021. Children ranged from 5–16 years old (Mage = 10.35 years, 59.8% Non-Hispanic white, 17.2% Hispanic/Latinx, 13.7% Non-Hispanic Black/African-American, 4.5% Asian, 4.8% Other Race). Parent depression/anxiety was directly and indirectly associated with child internalizing and externalizing problems. For both internalizing and externalizing problems, indirect associations occurred by means of increased parent hostility and inconsistent discipline and decreased routines and parent supportiveness. There were also specific indirect effects through decreased monitoring (internalizing problems) and parenting self-efficacy (externalizing problems). Multiple indirect effects were moderated by number of COVID-19-stressors experienced. Notably, COVID-19-stressors did not have direct effects on child mental health when other variables were considered. Findings highlight the buffering effects of parents for child mental health, the need to address parent depression/anxiety in child interventions, the utility of existing evidence-based parent interventions during the pandemic, and the need to assess families’ level of exposure to COVID-19-stressors.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10802-022-00920-6.

Developing and applying synergistic multilevel implementation strategies to promote reach of an evidence-based parenting intervention in primary care

Developing and applying synergistic multilevel implementation strategies to promote reach of an evidence-based parenting intervention in primary care

Investigating active ingredients of the GenerationPMTO intervention: Predictors of postintervention change trajectories in parenting practices.

Empirically determining the active ingredients of evidence-based parenting interventions is a promising means for strengthening interventions and enhancing their public health impact. This study aimed to determine which distinct ingredients of the GenerationPMTO (GenPMTO) intervention were associated with subsequent changes in parenting practices. Using a sample of 153 participants randomly assigned to the GenPMTO condition, we employed multilevel modeling to identify intervention ingredients empirically linked with change trajectories in parenting practices observed across the 2 years following intervention exposure. Coercive parenting and positive parenting outcomes were examined. Study results indicated that emotion regulation, effective communication, problem solving, and monitoring each demonstrated a significant pattern of findings for coercive parenting. Differential exposure to each of these ingredients significantly predicted the level of coercive parenting immediately postintervention and/or trajectories of change in coercive parenting across the subsequent 2-year period, controlling for coercive parenting at baseline. No significant predictors were found for positive parenting trajectories. Our findings suggest four components as active ingredients of the GenPMTO intervention for coercive parenting. Identification of these active ingredients may lead to strengthening future iterations of GenPMTO by expanding the set of core components specified in the model, which may further improve public health benefits. Implications for further understanding change stemming from evidence-based parenting interventions are also discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).