Abstract: Comparing the Cost-Effectiveness of Two Evidence-Based Parenting Programs for Families of Color Raising Young Children in Urban Poverty (Society for Prevention Research 25th Annual Meeting)

Schedule:

Friday, June 2, 2017

Congressional D (Hyatt Regency Washington, Washington DC)

* noted as presenting author

Deborah Ann Gross, DNSc, Professor, Johns Hopkins University, Baltimore, MD

Harolyn Belcher, MD, Director of Research, Kennedy Krieger Institute, Baltimore, MD

Mirian Ofonedu, PhD, Research Manager, Kennedy Krieger Institute, Baltimore, MI

Chakra Budhathoki, PhD, Assistant Professor, The Johns Hopkins University, Baltimore, MD

Daryl Dutrow, MSW, Clinician, Kennedy Krieger Institute, Baltimore, MD

Eric Slade, PhD, Associate Professor, University of Maryland School of Medicine, Baltimore, MD

Melissa Kurtz, MSN, Doctoral Candidate, The Johns Hopkins University, Baltimore, MD

Introduction: Although parent training (PT) is a well-established approach for reducing behavior problems in young children, there is mounting evidence that PT is not as effective for low-income families and families of color. It is unclear whether this racial/ethnic and economic disparity is due to differences in PT effectiveness, accessibility, acceptability, or other factors. As PT programs become more widely disseminated in community and primary care settings, it is essential that we understand which evidence-based programs and PT modalities are most acceptable and cost-effective for families of color raising young children in urban poverty. Using a randomized design, we compare the cost-effectiveness and acceptability of two evidence-based PT programs presenting similar content but using different delivery models: the group-based Chicago Parent Program (CPP) versus the “gold standard” dyadic coaching model of Parent-Child Interaction Therapy (PCIT).

Methods: The study was conducted in an urban mental health clinic serving predominantly African American families receiving Medicaid. From 2012-2016, 161 young children (2-5 years old) and their parents were randomized to CPP (n=81) or PCIT (n=80). Primary outcomes are child behavior problems, discipline strategies, parenting qualities, parent and clinician satisfaction, and mental health clinic cost. Participants were assessed at baseline, post-intervention, and 4-month follow-up.

Results: The majority of participants are African American (73%), unmarried (81%), and low-income (72% reporting annual household income <$20K); no demographic differences by condition were found. Over one third of families never attended CPP (35.8%) or PCIT (36.2%). To date, 16.3% of PCIT cases have been able to complete PT (M number of sessions to reach “mastery” = 28.2 sessions; M length of PCIT = 13.1 months). CPP is restricted to a maximum of 12 sessions over 3 months, 41% of parents attended at least half of CPP sessions; 19.8% completed at least 80% of CPP. Parent and clinician satisfaction rates were high across conditions. Preliminary cost data show that from baseline to post-intervention, provider costs for CPP are lower than for PCIT by $602 per child. “No-show” rates for CPP were lower (23%) than for PCIT (42%). Cost-effectiveness data comparing CPP and PCIT on child behavior and parent outcomes are currently being analyzed. Subgroup analyses will be conducted to examine which PT program is most effective for which children.

Conclusions: This study will help to inform policies on how best to invest healthcare dollars for improving behavioral outcomes for young children of color living in urban poverty.

Deborah Ann Gross
Chicago Parent Program: Royalties/Profit-sharing

Abstract: Comparing the Cost-Effectiveness of Two Evidence-Based Parenting Programs for Families of Color Raising Young Children in Urban Poverty (Society for Prevention Research 25th Annual Meeting)

473 Comparing the Cost-Effectiveness of Two Evidence-Based Parenting Programs for Families of Color Raising Young Children in Urban Poverty