Parental and Family Factors Influencing Retention in a Parenting Randomized Control Trial (RTC)

PRESENTATION TYPE: Individual Poster

THEME: Research, Policy, and Practice

 

TITLE: Parental and Family Factors Influencing Retention in a Parenting Randomized Control Trial (RCT).

 

ABSTRACT BODY:

Background: Evidence suggests that those in greatest need of intervention are the least likely to sustain their involvement, receiving the lowest treatment dosages. Selective attrition during research evaluating interventions compounds this issue. Our study aimed to explore potential factors underlying low retention rates in a high-risk, diverse sample with the goal of providing recommendations for a parenting intervention RCT.

Methods: Data was collected at 8 separate time-points over 12 months in an ongoing study exploring toxic stress and parenting in a sample of predominantly Latino (68%) Early Head Start (EHS) children and their families (n=148). Retention was measured by the number of sessions and data collection points that parents successfully completed. Data collection involved interviews, cognitive testing, child assessments, and physiologic measures. Hierarchical linear regression models examined whether economic hardship, parental trauma history, maternal anxiety, or maternal appraisal of stress predicted study retention.

Results: Demographic variables predicted retention, R²=.24,Adjusted R²=.16,R² Change=.24,F(3, 32)=3.27,p< .05. Specifically, parents with lower economic hardship and who were not working had greater retention. The second block added maternal psychological variables which accounted for significant additional variance in retention, R²=.48,Adjusted R² =.39, R² Change=.24,F(5, 30)=5.45,p< .01. Specifically, mothers with fewer negative appraisals of stress and less anxiety were more likely to be retained in the program. The third block added parental Adverse Childhood Experiences (ACE) which accounted for additional variance, R²=.56, Adjusted R²=.46,R² Change=.08,F(6, 29)=6.05,p< .000. Increased parental trauma history significantly impacts retention, even when controlling for all aforementioned risk factors.

Conclusions: Findings indicate that while economic hardship, unemployment, maternal anxiety, and higher levels of reported stress all predict lower participant retention, parental trauma history remains a significant predictor after controlling for these variables. Failure to address parental needs through a trauma-informed lens may account for diminished returns on prevention and intervention program investments. These results add merit to the usefulness of two-generation approaches, which target relevant parental needs alongside child-oriented services.