Participant, Program, and Provider Effects on Parent Retention in a Universal Preventive Intervention Targeting Multiple Youth Outcomes

Introduction: Preventive interventions improve parenting and decrease the prevalence of youth disorders, but dissemination of these interventions has proved challenging. Retaining participation levels that translate to adequate dosage is one significant barrier. Although both parent and program characteristics predict retention, research has disproportionately focused on parent characteristics. Knowing modifiable program factors that influence retention is important and can optimize implementation. This study will examine participant as well as intervention group and provider effects on retention among Mexican American mothers enrolled in a universal group intervention (Bridges to High School) delivered in the context of an efficacy trial. Identifying program factors that influence retention in efficacy trials may be particularly important given implications for replicating effects when programs go to scale (e.g., identify criteria for provider selection).

Method: This study included mothers in the intervention condition of the Bridges efficacy trial who attended at least 1 session (n = 292). We used growth mixture modeling (GMM) in MPLUS to model attendance patterns (i.e., classes) across 11 sessions and to classify mothers into patterns. Health beliefs, participation intentions, cultural factors, and intervention group process, person-level variables shown to influence participation, were included as covariates of class membership. In forthcoming analyses, we will model mothers’ class membership as an observed outcome and use a multilevel framework to examine intervention group and provider effects (n = 23) on class membership (i.e., classify-analyze approach). Group and provider effects include fidelity, group size, provider demographics (e.g., professional training, ethnicity, age), and provider perceptions of program benefits, self-efficacy, and skill proficiency.

Results: GMM results supported three patterns: Early Terminators (ET), Mid-program Terminators (MPT), and Persistent Attenders (PA); health beliefs, participation intentions, cultural factors, and group process were associated with class membership. Preliminary analyses examining group and provider effects show mothers were more likely to be in the ET and MPT classes when providers implemented with higher levels of fidelity, were younger, and not Mexican American.

Conclusion: There are diverse patterns of intervention participation, with which parent and program characteristics are differentially associated. Knowing parent characteristics that predict retention informs subpopulations for which an intervention is effective; knowing program factors associated with retention informs what program features are necessary to replicate effects and thus may be active program ingredients.