The Promise of Implementing Family-Focused Prevention in Primary Care Settings

This TED-Like Talk will highlight the promise of implementing family-focused prevention programs in primary health care settings. The speakers will highlight their successes, ongoing projects, and lessons learned in their pursuit of this aim, illustrating a wide range of implementation strategies.

Evidence-based family-focused preventive interventions have limited reach due to (1) current social norms and perceptions of parenting programs, (2) concerns about the expertise of sponsoring organizations to offer parenting advice, and (3) a paucity of stable funding mechanisms (Leslie et al, 2016, AJPM). The chair will briefly introduce the aforementioned barriers and summarize the reasons that implementation through primary care may be a promising solution.

The first presenter - drawing on expertise in implementation science and experience implementing the Family Check-Up in primary care - will discuss organizational implementation strategies to increase access to parenting programs in and through primary care. These include an integrated care model and a centralized model with explication of advantages and considerations for each depending on the larger health care context.

The second presenter will highlight the value of equipping pediatric primary care settings with the tools and resources necessary to support parents in handling their children’s challenging behavior problems. Issues associated with the implementation of parenting supports in the primary care setting will be explored drawing on feasibility data collected from pediatricians who were trained to implement the Triple P – Positive Parenting Program.

The third presenter will discuss the development and nation-wide (Norway) implementation of the family-focused prevention program, Early Initiatives for Children at Risk (Norwegian acronym; TIBIR). This program builds on Parent Management Training, the Oregon Model (PMTO) and was developed to scale up the use of evidence-based interventions for the prevention and reduction of child conduct problems in primary care settings.

The fourth presenter will focus on his experiences conducting first a feasibility trial and currently a large effectiveness trial of an eHealth adaptation of an evidence-based preventive intervention for Hispanic youth. Lessons learned from diverse primary care clinics in the feasibility study are informing the implementation of the intervention across four clinics in the existing trial.

The final presenter will summarize the progress of a National Academies of Science collaborative group working to leverage research, advocacy, and public awareness to achieve the goal of widespread implementation of family-focused prevention in primary care.