Using Malleable Baseline Target Moderators to Predict Who Benefits from Behavioral Parenting Training: A Latent Profile Analysis

Introduction: Behavioral parenting (BPT) programs are widely used to prevent and decrease child problem behavior (e.g., oppositional and defiant behavior). There is convincing evidence that children in families who participate in BPT programs on average show a larger decrease in these problem behaviors than children of parents who do not participate. However, how much families benefit from BPT varies immensely between families and some of the participating families do not seem to benefit at all. Many possible (mostly static child and family characteristics, such as gender or social economic status) moderators of BPT effectiveness have been explored to explain these differential effects, but results are mixed. To date, we seem unable to predict who might benefit (more), and who does not. One way forward might be to explore theoretically “active or malleable” moderators, specifically baseline levels of the putative mediators that are targeted in the intervention. In case of BPT, effectiveness might thus depend on the presence, type, and severity of parenting problems prior to the intervention (i.e., baseline). It might for example be that specifically families in which parents show high levels of negative parenting behavior and low levels of positive parenting behavior at baseline benefit from BPT. The current study will therefore explore whether families’ baseline “parenting profile” predict the effectiveness of BPT on their parenting and child behavior.

Methods: Individual participant data of 786 families of 4 Dutch trials on the BPT program Incredible Years (2 indicated prevention; 1 selective prevention; 1 selective prevention and treatment) will be used. Children were between 2 and 10 years of age and at risk for−or showing−problem behavior. Both before (pre-test or baseline) and directly after the intervention period, parents reported on their child’s problem behavior and on their parenting behavior. We selected parenting behaviors which are highly predictive of child problem behavior, and which are targeted in BPT: parental warmth, (appropriate) behavioral control, harsh parenting, and neglectful parenting (i.e., lack of monitoring).

Results and Discussion: Latent profile analyses are conducted in Mplus. Evidence of BTM effects will suggest that the use of malleable moderators such as “parenting profiles” can inform our referral and intervention strategies, help us use our evidence-based programs more efficiently, and ultimately increase their cost-effectiveness.