Evidence-based Parenting Programs Research Articles

A Factorial Randomized Controlled Trial to Optimize User Engagement With a Chatbot-Led Parenting Intervention: Protocol for the ParentText Optimisation Trial.

Violence against children (VAC) is a serious public health concern with long-lasting adverse effects. Evidence-based parenting programs are one effective means to prevent VAC; however, these interventions are not scalable in their typical in-person group format, especially in low- and middle-income countries where the need is greatest. While digital delivery, including via chatbots, offers a scalable and cost-effective means to scale up parenting programs within these settings, it is crucial to understand the key pillars of user engagement to ensure their effective implementation. This study aims to investigate the most effective and cost-effective combination of external components to optimize user engagement with ParentText, an open-source chatbot-led parenting intervention to prevent VAC in Mpumalanga, South Africa. This study will use a mixed methods design incorporating a 2 × 2 factorial cluster-randomized controlled trial and qualitative interviews. Parents of adolescent girls (32 clusters, 120 participants [60 parents and 60 girls aged 10 to 17 years] per cluster; N=3840 total participants) will be recruited from the Ehlanzeni and Nkangala districts of Mpumalanga. Clusters will be randomly assigned to receive 1 of the 4 engagement packages that include ParentText alone or combined with in-person sessions and a facilitated WhatsApp support group. Quantitative data collected will include pretest-posttest parent- and adolescent-reported surveys, facilitator-reported implementation data, and digitally tracked engagement data. Qualitative data will be collected from parents and facilitators through in-person or over-the-phone individual semistructured interviews and used to expand the interpretation and understanding of the quantitative findings. Recruitment and data collection started in August 2023 and were finalized in November 2023. The total number of participants enrolled in the study is 1009, with 744 caregivers having completed onboarding to the chatbot-led intervention. Female participants represent 92.96% (938/1009) of the sample population, whereas male participants represent 7.03% (71/1009). The average participant age is 43 (SD 9) years. The ParentText Optimisation Trial is the first study to rigorously test engagement with a chatbot-led parenting intervention in a low- or middle-income country. The results of this study will inform the final selection of external delivery components to support engagement with ParentText in preparation for further evaluation in a randomized controlled trial in 2024. Open Science Framework (OSF); https://doi.org/10.17605/OSF.IO/WFXNE. DERR1-10.2196/52145.

Effectiveness of Remote Implementation of the ACT Raising Safe Kids Program: A Pilot Study

AbstractThe objective of the study was to evaluate the effectiveness of remote implementation of the ACT Raising Safe Kids (ACT-RSK) program. The ACT-RSK program is an evidence-based group parenting program designed to promote positive parenting. The COVID-19 pandemic precipitated the creation of a remote implementation guide to deliver the program via telehealth. A small (N = 21) sample of caregivers of children aged 1 to 10 living in the USA participated in the 9-week program and completed pre- and post-intervention questionnaires. ACT Facilitators provided feasibility and fidelity feedback through a focus group and questionnaires. There was a significant improvement in positive parenting skills and a decrease in verbal and physical punishment. There were no improvements in parental nurturing or limiting and monitoring children’s media use. Facilitators and participants found remote implementation to be feasible and acceptable. Facilitators were able to maintain high fidelity to the model. The remote implementation of the ACT-RSK program has benefits to positive parental behaviors and discipline, but possibly not limiting and monitoring of children’s media use and nurturing behavior. However, characteristics of families’ experiences during the COVID-19 pandemic may have influenced these results. Remote implementation of the ACT-RSK program can be useful for promoting positive parental behaviors and discipline.

Fidelity-consistency and deliberateness of modifications in parenting programs

BackgroundEvidence-based interventions (EBIs) are frequently modified in practice. It is recommended that decisions to modify EBIs should be made deliberately to ensure fidelity-consistency, yet the relationship between fidelity-consistency and deliberateness is not well understood. This study aims to explore modifications in a sample of practitioners delivering evidence-based parenting programs (i.e., interventions to strengthen parent–child relationships, reduce harmful interactions, and improve child health and well-being). The study investigated three research questions: (1) What kind of modifications are made during the delivery of parenting programs? (2) To what degree are the identified modifications consistent with the core functions of each program? and (3) Is deliberateness associated with the fidelity-consistency of the identified modifications?MethodsIn total, 28 group leaders of five widely disseminated parenting programs in Sweden participated in five focus groups, and two participants from each group also participated in individual interviews (n = 10). A content analysis approach was used where the identification of modifications was directed by the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) and then assessed for fidelity-consistency and four levels of deliberateness (universal, situational, conditional, and unintentional). Chi-square tests were performed to compare consistent and inconsistent modifications, and logistic regression was performed to explore whether deliberateness predicted consistency.ResultsA total of 137 content modifications were identified, covering most of the content modification categories in FRAME. The most common were tailoring/tweaking/refining, adding elements, shortening/condensing, lengthening/extending, and integrating another treatment. Modifications were mostly fidelity-consistent but consistency varied greatly among categories. Furthermore, modifications made unintentionally or situationally were more likely to be fidelity-inconsistent.ConclusionsThese results indicate that explicit consideration of modifications and their impact could be essential for sustaining the fidelity-consistent use of EBIs, even as such interventions are continuously modified.

Preliminary examination of the effects of an early parenting intervention on amygdala-orbitofrontal cortex resting-state functional connectivity among high-risk children: A randomized clinical trial.

We examined the long-term causal effects of an evidence-based parenting program delivered in infancy on children's emotion regulation and resting-state functional connectivity (rs-fc) during middle childhood. Families were referred to the study by Child Protective Services (CPS) as part of a diversion from a foster care program. A low-risk group of families was also recruited. CPS-involved families were randomly assigned to receive the target (Attachment and Biobehavioral Catch-up, ABC) or a control intervention (Developmental Education for Families, DEF) before infants turned 2. Both interventions were home-based, manualized, and 10-sessions long. During middle childhood, children underwent a 6-min resting-state functional MRI scan. Amygdala seed-based rs-fc analysis was completed with intervention group as the group-level predictor of interest. Fifty-seven children (NABC = 21; NDEF = 17; NCOMP = 19; Mage = 10.02 years, range = 8.08-12.14) were scanned successfully. The DEF group evidenced negative left amygdala↔OFC connectivity, whereas connectivity was near zero in the ABC and comparison groups (ABCvsDEF: Cohen's d = 1.17). ABC may enhance high-risk children's regulatory neurobiology outcomes ∼8 years after the intervention was completed.

Facilitators and Barriers of Implementation of Evidence-Based Parenting Support in Educational Settings

Improving child behavior and promoting family well-being is a key objective of evidence-based parenting programs, such as the Triple P–Positive Parenting Program. To achieve this goal, parenting programs are delivered using a multidisciplinary workforce. Previous researchers have collectively examined the entire workforce of parenting practitioners to determine the factors that influence program delivery, primarily using self-report measures. However, these findings did not highlight the unique factors relevant to specific practitioner disciplines. Educators are one practitioner discipline that play an integral role in delivering parenting programs through schools and early childhood learning settings. This study aimed at exploring the facilitators and barriers that impact frequency of program use for educator practitioners using both qualitative and quantitative analyses. Data from 404 Triple P educator practitioners were extracted from a larger dataset of 1202 practitioners from English-speaking countries who completed self-report questionnaires and responded to three open-ended questions. Hierarchical multiple regressions were conducted using eight independent variables (with participant characteristics as control variables), revealing seven positive and one negative predictor for frequency of use. A thematic analysis was then conducted on the qualitative responses, producing 11 themes and 28 subthemes. The quantitative analysis revealed organisational support, perceived usefulness, and practitioner self-regulation were the most important positive predictors. The qualitative analysis supported these findings and revealed novel barriers including Covid-19/work from home, online delivery, parent factors, and specific organisational factors. These findings highlight the need for online resources, reliable virtual delivery methods, improved ways to reach and engage families, and additional trained education practitioners to distribute high workloads.

A randomized waitlist control trial of the Make the Connection® online program for caregivers of infants and young children: Study protocol.

A positive child-caregiver relationship is one of the strongest determinants of child health and development, yet many caregivers report challenges in establishing a positive relationship with their child. For over 20 years, Make the Connection® (MTC), an evidence-based parenting program, has been delivered in-person by child-caring professionals to over 120,000 parents to improve positive parenting behaviours and attitudes. Recently, MTC has been adapted into a 'direct to caregiver' online platform to increase scalability and accessibility. The purpose of this study is to evaluate the effectiveness of the online modality of MTC in increasing parenting knowledge, attitudes, and the perceived relationship with their child, and to understand barriers and facilitators to its access. Two hundred caregivers with children aged 0-3 years old will be recruited through Public Health agencies in Ontario, Canada. Participants will be randomly placed in the intervention or waitlist control group. Both groups will complete a battery of questionnaires at study enrolment and 8 weeks later. The intervention group will receive the MTC online program during the 8-week period, while the waitlist group will receive the program after an 8-week wait. The study questionnaires will address demographic information, caregivers' relational attitudes towards their infant, self-competence in their caregiver role, depression, and caregiver stress, as well as caregivers' and infants' emotion regulation. Results from this study will add critical knowledge to the development, scaling, and roll out of the MTC online program, thus increasing its capacity to reach a greater number of families. The study was registered with ClinicalTrials.gov on 15 March 2023 (NCT05770414).

Parenting Practices and Parenting Program Preferences of Chinese Immigrant Parents in New Zealand

Participation in evidence-based parenting programs benefits parents and children, but these programs have limited reach. This study utilized a mixed-method design to investigate the parenting concerns and parenting program needs of Chinese immigrant parents in New Zealand. Parents (n = 159) were surveyed about their perceived levels of child adjustment problems, parenting confidence, and parenting risk and protective factors. Parents’ knowledge and experience with parenting programs, and their program preferences were also examined. Eight Chinese parenting practitioners were interviewed about parenting challenges, parental concerns, and barriers to program participation of Chinese immigrant parents. Survey results showed that parents who gave their child higher ratings on behavior problems reported less parental self-efficacy, and more parental adjustment, family relationship, teamwork, and parenting difficulties. Parents’ knowledge and experience of available parenting programs was low. Barriers to program participation included time constraints, lack of program awareness, cultural and language barriers, and no childcare provision. Parents indicated a preference for a range of delivery options including group-based, seminar, and individually tailored programs. Program features most likely to influence attendance were content that addresses personally relevant issues and children’s self-development (such as coping with failure, managing negative emotions, and increasing confidence), and convenient location of program. Practitioners indicated that managing difficult child behavior and maintaining positive parent-child relationships were key parenting challenges. These concerns were linked to cultural expectations about child obedience, academic performance, and parent/grandparent relationships. Findings highlight program preferences that could be offered to meet Chinese immigrant parenting support needs and increase program participation.

The efficacy of an evidence-based parenting program in preventing child maltreatment in mainland China

BackgroundThere is limited evidence regarding the effectiveness of online parenting programs for preventing child maltreatment in low- and middle-income countries. Therefore, this study aimed to examine the effectiveness of the online Parenting for Lifelong Health for Young Children (PLH-YC) program in preventing child maltreatment among Chinese families specifically. MethodsA quasi-experiment was conducted, wherein 274 parents with children aged 2–9 years were assigned to either the online PLH-YC group (n = 135) or a waitlist control group (n = 139). Data were collected at baseline and one week after intervention. A difference-in-differences (DiD) design with propensity score weighting was used to estimate the between-group difference for child maltreatment as well as the associated risk and protective factors. ResultsCompared to the parents in the control group, parents in the online PLH-YC intervention reported a significant reduction in the occurrence of corporal punishment (b = −1.21; 95 % CI [−2.37, −0.03]), emotional abuse (b = −3.09; 95 % CI [−5.36, −0.82]), and general maltreatment (b = −4.94; 95 % CI [−8.86, −1.02]) as well as an increased frequency of positive parenting strategies (b = 6.46; 95 % CI [2.21, 10.72]). Additionally, parents with high levels of depressive symptoms were significantly more likely to drop out of the program, and those with lower education levels engaged in fewer sessions. ConclusionThe online PLH-YC program can benefit families with young children by reducing the incidence of child maltreatment through improved positive parenting strategies. More randomized controlled trials with long-term follow-ups are required to further verify the accuracy of the results obtained in this study.

Jandu Yani U (for all families): evaluating Indigenous Triple P, a community-tailored parenting support program in remote Aboriginal communities

ABSTRACT Objectives Although evidence-based parenting programs are widely available, they remain inaccessible to many families of children with social, emotional and behavioural problems, particularly in remote settings. In partnership with Aboriginal communities in the remote Fitzroy Valley, Western Australia, we introduced and evaluated the Indigenous Triple P – Positive Parenting Program, with additional Stepping Stones Triple P strategies (for children with complex needs). Implementation followed community consultation and program adaptation to acknowledge local culture, social complexities and language. The initiative was named Jandu Yani U, meaning “for all families” in the local Bunuba language. Method Local practitioners (parent coaches) were trained to deliver Triple P. Parents and carers (henceforth carers) of children up to 15 years of age were invited to participate. Families attending the program reported on child behaviour, parenting practices, self-efficacy, wellbeing and empowerment pre- and post-intervention and at 8-month follow-up using standardised assessment tools delivered by local community navigators. Results Of 30 participating families, 100% completed Triple P and reported the program was culturally appropriate. Of the index children, 93% were Aboriginal, 63% boys, median age 6.83 years. Following the program, carers reported high levels of empowerment and reaching goals for behaviour change (p < .001) and less use of unhelpful parenting strategies (over-reactivity and hostility; p < .05), and this maintained at 8-month follow-up (p < .001). At follow-up, improvement in carer self-efficacy (p < .001) and reduced anxiety (p < .001) were documented. Significant improvements in prosocial behaviour, reductions in challenging behaviour and decreased intensity and frequency of behavioural problems (all p < .05) were reported in children at follow-up. The average level of goal attainment was 65% at post, which was maintained at follow-up. Conclusion This study demonstrates the feasibility of delivering Indigenous Triple P to Aboriginal families in remote settings, and the importance of partnership with communities. Program tailoring, flexible delivery, use of Aboriginal parent coaches and provision of practical support to families resulted in a culturally acceptable parent support program. With local Aboriginal co-design, this initiative should be generalisable to similar remote communities elsewhere.

The role of social identity and self-efficacy in predicting service providers’ use of Stepping Stones Triple P following training

BackgroundIdentifying factors that may contribute to the use of programs following the completion of training by practitioners is of practical and theoretical importance. AimThis study examined the role of social identity and self-efficacy in contributing to the delivery of an evidence-based parenting program. Methods and ProceduresA sample of 63 multi-disciplinary professionals trained in the Stepping Stones Triple P-Positive Parenting Program, for parents of children with developmental disability, as part of a statewide roll-out were interviewed two years after training. Data on the number of hours of delivery during the 2-year period was analysed along with quantitative data obtained during interviews that assessed professionals’ self-efficacy and social identity as a Stepping Stones professional. Outcomes and ResultsSocial identity was associated with the use of SSTP in an independent analysis, but the association was no longer significant when other factors were included in a regression model. Self-efficacy predicted the use of SSTP and was found to be a mediator in the relationship between social identity and use of SSTP. Conclusions and ImplicationsThis first investigation into the role of social identity in the implementation of evidence-based parenting programs showed that social identity could play an important role. The role of self-efficacy in predicting program use was further supported in this study and the mediator function of self-efficacy is explored. The practical and theoretical implications of the role of self-efficacy and social identity in the training of professionals are discussed.

Group-based parent training programme for children with neurological conditions: a feasibility study

Objective and designThis study aimed to determine the feasibility and effectiveness of a parent training programme for parents of children with neurological conditions and behaviours that challenge.SettingChild and adolescent mental...

Short-term outcomes from a pilot randomized controlled trial evaluating a virtual culturally adapted parenting intervention among Filipino parents of school-age children.

Filipino youth in the United States have significant behavioral health problems, including high rates of depression and suicidal behavior. Evidence-based parenting groups promote positive parenting practices and improve child behavior, yet few have been implemented online. This study tested the short-term effects of a culturally adapted hybrid version of the Incredible Years School Age Basic and Advance Programs when delivered online among groups of parents of Filipino children and estimated intervention effect sizes. Forty-nine parents of children aged 8-12 years recruited from schools, clinics, community organizations, and social media were randomly assigned to intervention or a wait-list control group that received literature from the American Academy of Pediatrics' Bright Futures program. The intervention consisted of 12 weekly 2-hr sessions. Parent perceptions of child behavior, parenting practices, and parenting stress as well as child surveys of anxiety and depression symptoms using validated assessments were obtained at baseline and 3-month postintervention follow-up. Forty parents completed both baseline and follow-up surveys with a mean attendance of 9.35 out of 12 sessions (n = 18). Analysis of covariance comparing 3-month (pre-/postintervention) changes revealed that the program had a statistically significant positive impact on parenting practices (positive verbal discipline, praise and incentives, and clear expectations); parent perceptions of their child's internalizing symptoms; and child-reported anxiety and depression symptoms. Results support the feasibility and potential effectiveness of offering an online evidence-based parenting program to promote positive parenting and decrease child anxiety and depression. This multigenerational approach to mental health prevention could potentially help address the growing mental health epidemic among youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Changes in Psychiatric Symptoms in Swedish Mothers Who Took Part in Project Support: An Intervention for Mothers Exposed to Intimate Partner Violence With Children Who Have Developed Conduct Problems.

Project Support (PS) is an evidence-based individual support and parenting program developed for mothers exposed to intimate partner violence (IPV) whose children have developed conduct disorders. This Swedish feasibility study focuses on changes in the mothers' psychiatric symptoms, in relation to social and emotional support received as part of PS. In a within-subject design in a naturalistic setting (i.e., 10 social service units), mothers (n = 35) reported a significant decrease in symptoms, but from an individual perspective, most mothers still suffered from clinical levels of psychiatric symptoms. The need for additional interventions for mothers exposed to IPV is discussed.

Brief Parenting Seminars for Preventing Child Behavioral and Emotional Difficulties: a Pilot Randomized Controlled Trial

Early parenting programs can prevent the development of child behavioral and emotional difficulties. Despite the high prevalence of these difficulties in Greek children aged 2 to 12, no evidence-based parenting programs have been tested in randomized trials in Greece. We pilot-tested the efficacy of a brief parenting intervention for universal prevention of child behavioral and emotional difficulties. Parents from the general population (N = 124) were randomly assigned to receive the Triple P (Positive Parenting Program) Seminar Series (n = 83), or leaflet information on child health (n = 41). Most participants were highly educated mothers with boys and girls aged 2–12, from middle-income, inner-city households. Participants reported on child behavior, parenting style and parenting adjustment, before and after the intervention and six months later. At post-intervention, parent-reported behavioral problems were reduced in the intervention group, but increased in the control group (p = 0.001); these differences remained at 6-month follow-up. Of those in the clinical range (28%) at baseline, significantly more intervention children than control children moved to normal range six months later. Disrupted parenting practices were reduced more in intervention parents at post-intervention but were not maintained at follow-up. No significant differences were found in secondary child behavioral difficulties, child emotional difficulties, parenting confidence and distress over time. This Seminar Series is a brief, easily replicable and likely cost-effective early intervention leading to significant medium-sized reductions over six months in behavioral difficulties, and improvements in disrupted parenting. These findings broadly support other evidence about effective transportability of parenting interventions across countries.

Use of technology in evidence-based programs for child maltreatment and its impact on parent and child outcomes.

Technology has been used in evidence-based child maltreatment (CM) programs for over a decade. Although advancements have been made, the extent of the application of technology in these programs, and its influence on parental and child outcomes, remains unclear within the context of changes that emerged because of the COVID-19 pandemic. This scoping review provides a contextualized overview and summary of the use of technology in evidence-based parenting and child programs serving families impacted by child maltreatment and the effects of technology-enhanced programs on target outcomes. Using Arksey and O'Malley's methodological framework, we searched seven databases to identify peer-reviewed and grey literature published in English from 2000 to 2023 on evidence-based programs, according to the California Evidence-Based Clearinghouse (CEBC), that included technological supports for two populations: at-risk parents for child maltreatment prevention, and children and youth 0-18 years exposed to child maltreatment. All study designs were included. Eight evidence-based parenting programs and one evidence-based child trauma program were identified as using technology across a total of 25 peer-reviewed articles and 2 peer-reviewed abstracts meeting inclusion criteria (n = 19 on parent-level programs; n = 8 on child-level programs). Four studies were published in the context of COVID-19. Two main uses of technology emerged: (1) remote programmatic delivery (i.e., delivering all or part of the program virtually using technology) and (2) programmatic enhancement (i.e., augmenting program content with technology). Improvements across parenting and child mental health and behavioral outcomes were generally observed. Technology use in evidence-based child maltreatment programs is not new; however, the small sample since the start of the COVID-19 pandemic in this review that met inclusion criteria highlight the dearth of research published on the topic. Findings also suggest the need for the inclusion of implementation outcomes related to adoption and engagement, which could inform equitable dissemination and implementation of these programs. Additional considerations for research and practice are discussed.

Adapting a video-feedback intervention to support teacher–child interaction and behavior regulation of young children at school: A qualitative pilot study

The evidence-based parenting program Video-Feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) may have potential to also support teachers in primary schools in their interaction with children with behavior problems. We therefore adapted the intervention for use with primary school teachers (VIPP-School). Here we examined the feasibility of VIPP-School, using qualitative analyses of the perceptions of teachers and VIPP-interveners on their experiences with VIPP-School. Three teacher-child dyads from kindergarten and 2nd grade participated in six sessions of VIPP-School. Perceptions of the participants were collected using semi-structured interviews, logbooks, observations and a questionnaire. The data were qualitatively analysed. Thematic analysis showed five main themes: 1) scheduling of appointments, 2) experiences with intervention elements, 3) working alliance, 4) changes in the teacher-child interaction, 5) defining the target group. Teachers mentioned notable time investment, but appreciated the video feedback as a great way to become more aware of subtle signals of the child and their own behaviors. This study shows that with some adaptations VIPP-School is an acceptable and deliverable intervention for teachers in primary education. It has potential for supporting teachers in the interaction with children with behavioral problems. Further research on the effectiveness of VIPP-School is recommended.

A budget impact analysis of cost to implement a whole child health focused, family-based intervention in primary care for children with elevated BMI

BackgroundAlthough the cost of implementing evidence-based interventions (EBIs) is a key determinant of adoption, lack of cost information is widespread. We previously evaluated the cost of preparing to implement Family Check-Up 4 Health (FCU4Health), an individually tailored, evidence-based parenting program that takes a whole child approach, with effects on both behavioral health and health behavior outcomes, in primary care settings. This study estimates the cost of implementation, including preparation.MethodsWe assessed the cost of FCU4Health across the preparation and implementation phases spanning 32 months and 1 week (October 1, 2016–June 13, 2019) in a type 2 hybrid effectiveness-implementation study. This family-level randomized controlled trial took place in Arizona with n = 113 predominantly low-income, Latino families with children ages > 5.5 to < 13 years. Using electronic cost capture and time-based activity-driven methods, budget impact analysis from the perspective of a future FCU4Health adopting entity—namely, ambulatory pediatric care clinicians—was used to estimate the cost of implementation. Labor costs were based on 2021 Bureau of Labor Statistics Occupational Employment Statistics, NIH-directed salary cap levels or known salaries, plus fringe benefits at a standard rate of 30%. Non-labor costs were based on actual amounts spent from receipts and invoices.ResultsThe cost of FCU4Health implementation to 113 families was $268,886 ($2380 per family). Actual per family cost varied widely, as individual tailoring resulted in families receiving a range of 1–15 sessions. The estimated cost of replicating implementation for future sites ranged from $37,636-$72,372 ($333–$641 per family). Using our previously reported preparation costs (i.e., $174,489; $1544 per family), with estimated replication costs of $18,524–$21,836 ($164–$193 per family), the total cost of delivering FCU4Health was $443,375 ($3924 per family), with total estimated replication costs of $56,160–$94,208 ($497-$834 per family).ConclusionsThis study provides a baseline for costs associated with implementation of an individually tailored parenting program. Results provide critical information for decision makers and a model for future economic analysis and can be used to inform optimization thresholds for implementation and, when necessary, benchmarks for program adaptation to promote scale-up.Trial registrationThis trial was prospectively registered on January 6, 2017, at ClinicalTrials.gov (NCT03013309).

Five-year fidelity assessment of an evidence-based parenting program (GenerationPMTO): inter-rater reliability following international implementation

BackgroundImplementing evidence-based programs in community service settings introduces the challenge of ensuring sustained fidelity to the original program. We employ a fidelity measure based on direct observation of practitioners’ competence and adherence to the evidence-based parenting program (EBPP) GenerationPMTO following installation in national and international sites. Fidelity monitoring is crucial, especially when the program purveyor transfers administration of the program to the community as was done in this case. In previous studies, the Fidelity of Implementation rating system (FIMP) was used to evaluate practitioners’ fidelity to the GenerationPMTO intervention in six countries following implementation showing high levels of adherence up to 17 years post certification. Other studies showed FIMP to have predictive validity. The present study provides inter-rater reliability data for this fidelity tool across teams of the purveyor, Implementation Sciences International, Inc./ISII, and national and international sites over a five-year period.MethodsData assess inter-rater reliability in terms of percent agreement and intraclass correlation (ICC) for the purveyor’s two fidelity teams and the fidelity teams in seven implementation sites.ResultsResults report stable good to excellent levels of inter-rater reliability and ICCs as well as good attendance at fidelity meetings for all fidelity teams.ConclusionsThis observational method of assessing fidelity post implementation is a promising approach to enable EBPPs to be transferred safely from purveyors to communities while maintaining reliable fidelity to the intervention.

Pearls of wisdom: Updated skill-specific parenting strategies in the first 6 years.

This article provides knowledge translation on up-to-date parenting strategies (pearls of wisdom). These pearls support the development of specific skills in children from birth through 5 years of age. Paediatricians have indicated that they feel inadequately trained in providing parenting guidance. This article could be used by family physicians, community health nurses, nurse practitioners, and paediatricians as an office reference when providing anticipatory parenting guidance and when there are parent or clinician concerns that relate to various developmental stages. Included are general tips for guiding parents and pearls that support self-regulation, attachment, perspective taking, and developing the child's sense of self. The present review links pearls to specific reference sources in the literature which cite developmental standards and advice. Evidence-based parenting programs are cited for children with more complex presentations due to developmental, regulatory, or behavioural disorders, temperament individual differences, or limited parenting support. Website links for parents are recommended, and Parenting Pearls handouts provided, to solidify understanding and follow through.

The Change of Practitioner’s Self-Efficacy in Triple P Professional Training: Moderating Role of Practitioner Characteristics, Country, and Delivery Mode

Two studies examined the change in self-efficacy of practitioners after attending Triple P training and the moderators that affect training outcomes. Study 1 used a large multidisciplinary sample of health, education, and welfare practitioners (N = 37,235) came from 30 countries around the world, which all participate in a Triple P professional training course during 2012–2019. This study assessed practitioners’ overall self-efficacy and their consultation skills efficacy prior to training, immediately following training, and at six- to eight-weeks follow-up. Participants reported significant improvements of their overall self-efficacy and their consultation skills self-efficacy. There were significantly small differences based on practitioners’ gender, disciplines, education levels, and country location. Study 2 examined the training outcomes of videoconference-based training (following the COVID-19 pandemic) compared to in-person training (N = 6867). No significant differences were found between videoconference and in-person training on any outcome measure. Implications for the global dissemination of evidence-based parenting programs as part of a comprehensive public health response to COVID-19 was discussed.