Innovations in Positive Parenting Education

What if all parents were offered access to brief evidence-based parenting education programs focused on positive parenting strategies?

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Founding Story: Share a story about a key experience or spark that helps the network understand why this project got started or a story about how you became inspired about the potential for this project to succeed.

There are countless examples in which widespread educational efforts combined with greater public access have resulted in vast improvements in public health in the U.S. Over the past few decades, for example, we’ve seen reductions in rates of smoking, drunk driving, and deaths by motor vehicle accidents, just to name a few. “Curve-shifting” approaches (Cohen, Scribner, Farley, 2000), which are designed to target risk factors of high prevalence in a broad or universal population, have been quite effective in such large-scale public health efforts. They aim to shift the mean-level of risk down for an entire population. Although not new to public health, applying these approaches to parenting education and child maltreatment prevention in the U.S. is both a novel and an understudied concept.

Which categories describe you? (the answer will not be public)

  • White (for example: German, Irish, English, Italian, Polish, French, Caucasian)

If you chose to self-identify your race, ethnicity, or origin, please share here: (the answer will not be public)

White

Location: Where is your organization headquartered? [State]

  • Louisiana

Location: Where is your organization headquartered? [City]

New Orleans

Location: Where is your project primarily creating impact? [State]

  • Louisiana

Location: Where is your project primarily creating impact? [City]

New Orleans

Problem: What problem is this project trying to address?

Most parents in the U.S. have used corporal punishment (CP) with their children and believe it is a necessary tool for child discipline. This is despite the fact that there is overwhelming scientific evidence that CP does more harm than good for children’s health, well-being, and development. CP substantially raises children’s risk for being physically abused and also leads to increased risk for aggressive behavior as well as mental and behavioral health issues. So why do parents use CP? For many parents, the simple answer is that that is how they were raised. Many never had the opportunity to learn about positive parenting techniques that do not involve hitting or violence. Because CP is so common in our society, it will take a public health approach to change this norm.

The evidence-base is weak for parenting education interventions that can be delivered at a broad or universal scale.  My colleagues and I identified two such interventions that have promising evidence behind them. We are now in the midst of conducting a community-based randomized controlled trial (RCT) to investigate their efficacy in improving parent and child behavior and other outcomes relevant to children’s well-being.  The two interventions are Play Nicely and Triple P-L2 (Level 2 only). 

Play Nicely is a 30 minute, computer-based education module that can be made available universally in any clinic or primary care setting that serves parents. The intervention was created by pediatrician Dr. Seth Scholer at Vanderbilt University. The program uses narrated modules to enhance parenting skills and promote effective parenting responses to aggressive behavior in young children. The module presents a hypothetical situation of one child harming another, then detailed recommendations for how to prevent this behavior. The viewer is presented with 20 different ways to respond to the situation and can select and review as many as they like. After selecting one, the parent receives feedback about whether that discipline option is considered “Great,” “Good option after others have been tried,” or “There are better options.” Pilot studies have shown Play Nicely to be promising for improving attitudes and intentions linked with positive parenting, increasing self-efficacy in responding to aggressive child behavior, and reducing support for use of CP.

Triple P-L2, as implemented in this study, consists of a brief, 30 minute, one-on-one consultation with a licensed professional (M.S.W. or equivalent) who has undergone “Primary Care Triple P” training with Triple P America (Turner, Sanders, & Markie-Dadds, 1999). After the consult, the parent receives a positive parenting booklet and tip sheets (all produced by Triple P America at the sixth grade reading level) that provide information on the management of common emotional and behavioral problems in children. Prior RCTs of Triple P-L2, with group versus one-on-one administration, showed promising effects on parent and child behavior outcomes.

The evidence to date for both of these interventions is promising but not strong enough to justify full-scale implementation and dissemination to broad or universal populations of parents.  Our study was designed to fill this gap by providing a rigorous test of both of these interventions in order to contribute to a much needed evidence-base for scalable positive parenting education.

Is your model focused on any of the following traditionally underserved communities?

  • Communities of color
  • Low-income communities
  • No, not explicitly

Does your model work within any of the following sectors?

  • Child and Family Services
  • Other

If you chose "other," please share the sector you work within here:

City Health Department, WIC services

Year Founded

2014

Project Stage

  • Start-Up (a pilot that has just started operating)

Example: Walk the network through a specific example of what happens when a person or group engages with your solution.

Here are some stories directly from some participants in our study: 1) "At first, before I came [to this study] I used to spank my four year old. Since I came here …I learned that you can't whoop your child every time they do bad. You take things from them like a TV or iPad or toy to show them that they have to do right in school or anywhere else to listen and be respectful." [What did you learn that was most helpful?] "Not whooping your child for everything." 2) "I learned to better discipline my son with taking away things he cared about more than to hit on him and holler at him to get my discipline in." ; 3) "Time out more, not whipping my child and rewarding her when she does well in school and at home. She does much better at home."

Impact: What was the impact of your work last year? Please also describe the projected future impact for the coming years.

Our preliminary findings show that, compared to the control group, the education intervention groups are reporting increases in using positive discipline practices and decreases in parenting stress, hostile attributions toward the child, child emotional and behavioral problems, and use of and support for CP. Also, parents directly report examples such as the following: 1) "I have learned not to spank my child, but talk with him and find other ways to help him understand that he cannot misbehave. Things like taking away a toy that he likes, and not allowing him to watch the TV. … Really has helped so far. Every now and then they backslide but taking away toys and making them go sit alone in a separate room for a few minutes is working well."; 2) "I've learned how to discipline my kids without fussing or whooping them."

Organization Type

  • hybrid

Annual Budget

  • $250k - $500k

Financial Sustainability Plan: What is your solution’s plan to ensure financial sustainability?

Our study is currently funded by the CDC. We have applied for additional funding.

Unique Value Proposition: How else is this problem being addressed? Are there other organizations working in the same field, and how does your project differ from these other approaches?

If found to be effective, one or both of the programs we are testing could be scaled in family services and health care centers (such as during pediatric wellness visits) for all parents to access. While other parenting education programs exist, there are currently none that we know of that are brief, relatively low-cost interventions with a strong evidence base that can feasibly be scaled to universal or broad dissemination.

Reflect on the Field and its Future: Stepping outside of your project, what do you see as the most important or promising shifts that can advance children’s wellbeing?

There is growing attention to mindfulness and health. Mindfulness practice can help promote mental and emotional well-being and reduce risks for factors that can raise risk for child maltreatment. I think this is an important trend with great promise.

Source: How did you hear about the Children’s Wellbeing Challenge? (the answer will not be public)

  • Email

Referral: If you discovered the Challenge thanks to an organization or person other than Ashoka, who was it? (the answer will not be public)

RWJ listserve

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Team

Catherine, I am excited to learn about your work and look forward to seeing your outcomes. I am a pediatrician (trained in Triple P) starting a nonprofit wellness center. Working to give parents the tools they need to raise healthy kids. Parenting is a huge piece of this. I look forward to learning more about the Play Nicely program and to following your work. Please let me know if you are looking for pediatricians to implement! Thanks for this important work!

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