Session: System Capacity and Operational Considerations When Scaling up Evidence Based Parenting Programs (Society for Prevention Research 26th Annual Meeting)

Evidence-based parenting programs have decades of evidence supporting their effects on a wide range of health outcomes. Public health impact of these programs has been limited by a failure to implement programs in systems that families access on a regular basis. Primary care is one system that is growing popularity among the prevention science community. Organizations such as the American Board of Pediatrics, the American Psychological Association, and the American Academy of Pediatrics support the integration of evidence based parenting programs in primary care due to social norms around parenting programs, parent perceptions about the expertise of primary care providers, and sustainable funding mechanisms. With increasing divorce rates across sectors of society, family courts are another potential home for evidence-based parenting programs. The proposed symposium will present the results of efforts to partner with these two systems to promote the scale up of three evidence based parenting programs.

The first paper will describe efforts to test an adaptation of the Family Check Up in three primary care clinics to address pediatric obesity. Because substantial variability exists across clinics, an understanding of this variability will be critical for large-scale efforts to scale up programs in primary care. This paper will discuss barriers related to recruitment and enrollment and strategies for overcoming those barriers.

The second paper presents will describe a study to test the delivery of the online Triple P system in primary care clinics. Physicians often report feeling unprepared to help parents with child behavior problems. This study found that Triple P training improved physician self-efficacy, however, again substantial variability was found.

The third paper will describe a study to test the New Beginnings Program embedded within the family court system. There has been concern about a drop off in program outcomes due to declines in fidelity when programs are implemented in community settings. This study compares fidelity, attendance, and satisfaction data to ratings from the efficacy trial to test this assumption. Results showed no declines in fidelity, however, there were substantial reductions in attendance, which may be due to demographic and pretest differences in the study sample and have implications for program effects.

Finally, a discussant with expertise in health services research will provide comments on each of these papers and address implications for the dissemination and implementation of evidence-based parenting programs.