Long-Term Effects of Parenting Preventive Interventions to Promote Resilience of Children and Adolescents

The goal of prevention is to change developmental trajectories. Prevention approaches propose that by changing risk and protective factors early in development reductions in problem outcomes can be achieved many years later. Parent training programs have been one of the most effective approaches to prevention, and have demonstrated efficacy both when applied to high risk populations and when delivered universally. The current presentation will present a review of evidence from long-term outcomes (over three years or more) of  thirteen prevention programs with a parenting component concerning whether these programs are achieving the promise of prevention. The thirteen programs are targeted both universally to all parents of children experiencing normative developmental transitions (i.e., transitions to begin elementary school or high school), to parents dealing with stressful adversities (e.g., divorce, bereavement, poverty,  racism), and to parents dealing with children who exhibit elevated levels of externalizing problems.  The presentation reviews evidence from these trials concerning the long-term effects of programs to change parenting, to reduce problem outcomes and mediating pathways that account for long-term program effects. Finding indicate that all programs reported significant effects to improve some aspect of parenting in the short term, and five programs reported improved parenting three years or more following program completion. All the programs reported significant direct effects on problem outcomes three or more years after the program, with significant effects lasting up to 15 years following the program. Consistent with prior evidence of the multiple benefits of parenting interventions (Hale, Fitzgerald-Yau & Viner, 2014), seven programs reported significant long-term direct effects on three or more problem outcomes including internalizing problems, externalizing problems and substance use problems. Parenting was found to mediate long-term program effects on multiple domains of outcomes. For six of the programs multiple linkage cascading models were reported in which early effects on parenting led to later effects on children’s competence or problem behaviors which in turn led to long-term effects to reduce problem outcomes. Illustratively, a multi-linkage model for the Family Bereavement Program indicated that post-test effects to strengthen positive parenting, led to reductions in internalizing and externalizing problems at 11-month follow-up, which in turn led to decreased substance use and abuse six years later. Scientific opportunities for future research on parenting interventions and public health implications of implementing these evidence based programs are discussed.