Adapting and Pilot Testing an Evidence-Based Parenting Intervention for Homeless Families

Introduction: Homelessness among families with children is an increasingly relevant public health concern, especially given the increased risks to psychosocial health and wellbeing faced by this population. When compared to normative families, those who have experienced homelessness experience higher levels of parental distress and increased risk for child emotional, behavioral, and developmental outcomes. However, this population lacks access to effective parenting programs.

Purpose: The purpose of this study was to: 1) systematically adapt an evidence-based parenting intervention for homeless families in transitional housing, and 2) pilot test the adapted intervention.  

Phase 1: The first phase of this study was conducted according to the Planned Adaption approach following four systematic steps: a) examine intervention theory of change, b) identify population differences, c) adapt program content, and d) adapt evaluation strategy. Informed by extant research and our prior work in this area, several adaptations resulted from this process, including changes to non-essential program content, revisions to make visual materials relevant to the transitional housing context, and decreasing intervention length.

Phase 2: In the second phase of this project, a small pilot study was conducted to examine implementation feasibility of the adapted intervention in the transitional housing context. Participant engagement/retention data indicated 25% of participants attended 1 session, 25% attended 2-4 sessions, and 50% attended the majority of sessions. A positive life event (e.g., getting a job, moving into permanent housing) often precluded participants from completing the group, a factor important for informing future intervention efforts. Participant satisfaction scores were high, with a mean satisfaction level across all sessions of M=4.61 (SD=0.20) on a 5-point scale. Individual session satisfaction ranged from 4.28 (SD=0.42; Session 2) to 4.88 (SD=0.17; Session 6), and there were significant differences in satisfaction between sessions (F(2.78, 36.15) = 14.53, p < .001). Qualitative finding confirmed areas of satisfaction and suggested further refinements to the intervention, such as increased targeting of fathers, more opportunities for group discussion, and activities that promote parent-child interaction.

Conclusion: This study illustrates the process through which an existing evidence-based intervention can be adapted for a new target population. The findings are important for informing continued parenting intervention efforts with homeless families in transitional housing and helping to prevent the negative outcomes frequently encountered by homeless parents and children.