Using Video Data to Determine Effective Components of an Evidence-Based Parenting Intervention

Significance: Mental, emotional, and behavioral disorders affect between 13%-20% of U.S. children. A barrier constraining the public health impact of existing interventions is a lack of research regarding core components (i.e., intervention elements hypothesized to produce positive effects). A critical next step is to empirically test hypothesized core components. The objective of this study is to measure intervention components delivered in an evidence-based parenting intervention and determine the core components most functional in achieving positive change.

Innovation: This project shifts research beyond the current practice of relying on theoretically-derived core components to a data-driven understanding of the most effective components operating within an evidence-based parenting intervention. This includes developing an observation-based fidelity system to measure core components. Despite the importance of understanding core components in prevention science, there is a surprising lack of core component-specific fidelity measures. Furthermore, this project is leveraging existing video data from a prevention trial to empirically test the role of each core component. Identifying effective intervention components using existing video data could provide a more efficient alternative than traditional approaches for investigating core components (e.g., dismantling studies).

Approach: The focal intervention for this study is Parent Management Training – the Oregon model (PMTO), now referred to as GenerationPMTO. We are using existing video data from the landmark, NIH-funded Parenting Through Change prevention trial, which demonstrated long-term positive outcomes. The first aim of this study was to develop an observational coding system measuring fidelity to specific core components of the intervention. Then, this coding system will be applied to examine: a) the extent to which each core component is associated with changes in parenting, and b) associations between core components and child outcomes over time, mediated by changes in parenting.

Results/Implications for Optimizing Prevention Science: A core-component fidelity rating system is under development capable of measuring the extent to which hypothesized core components were delivered in each treatment group cohort. This can serve as a model for more efficiently examining core components across evidence-based interventions. Once the relative value of each component is determined, this can enhance development of briefer, more efficient, and cost-effective prevention approaches that can be implemented realistically in community settings to better improve public health.