An evaluation of the online universal COPING parent programme:

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Presentation transcript:

An evaluation of the online universal COPING parent programme: A pilot randomised controlled trial Dawn Owen, Margiad Williams & Professor Judy Hutchings Centre for Evidence Based Early Intervention Bangor University COPING: The Confident Parent Internet Guide Objective The main objective was to determine whether the programme led to increases in positive parenting strategies as determined by a behavioural observation of parent-child interaction using the Dyadic Parent-Child Interaction Coding System (DPICS; Eyberg & Robinson, 1981). Secondary objectives were to explore whether there were any changes in child behaviour, self-reported parenting skills, parental mental health and sense of competence. The online universal programme is based on the content of ‘The Little Parent Handbook’ (Hutchings, 2013) and introduces evidence-based behavioural principles that have been shown to be effective in contributing to positive parent and child outcomes (Gardner et al., 2006; Hutchings et al., 2007; Furlong et al., 2013). The programme introduces positive strategies to strengthen parent-child relationships and encourage positive child behaviour, primarily through encouraging parents to be positive role models and to praise and reward desirable child behaviour (Hutchings, 2013). 10 weekly chapters include play, praising and rewarding positive behaviour, how to get better at giving instructions, language development and teaching new behaviours. The intervention components involve reading through the content, watching video examples of positive parenting, answering questions based on the videos, completing multiple-choice quizzes and practicing the skills at home. Parents of children aged 3-8 years with an interest in positive parenting were invited to participate. Despite recruiting a fairly affluent sample (see table 1), almost half of the parents were reporting high levels of child problem behaviour, maladaptive parenting style and symptoms of mental health at baseline. Over 40% of children scored above the cut-off on the ECBI intensity scale and over 45% scored above the cut-off on the ECBI problem scale. Over 40% of parents scored above the clinical cut off on the GHQ and comparison of the scores for the Parenting Scale sub-scales with the mean clinical group scores from parents of children with behavioural problems (Arnold et al.,1993), showed mean scores were more problematic than Arnold et al.’s (1993) clinical group.   Complete Case Analyses For the primary outcome, there was a significant difference between intervention and waitlist control conditions with parents in the intervention condition demonstrating a significant reduction in observed indirect commands (F (1, 33) = 6.36, p = .017) with a medium effect size (d = 0.59). There were no other significant differences on the primary measure, however the praise category showed a large effect size for intervention over control participants (d = 0.82). There was no significant difference on any of the secondary outcomes.   Per-Protocol Analyses (for parents who completed at least 1 chapter of the programme) For the primary outcome, there was a significant difference between intervention and waitlist control conditions with intervention parents demonstrating a significant reduction in observed indirect commands (F (1, 25) = 5.56, p = .026, d = 0.56) and a significant increase in observed praise (F (1, 25) = 4.71, p = .040, d = 1.38). All five observed behavioural categories showed benefits for intervention over control parents, three showed medium effect size changes (reduction in indirect commands, questions and negative parenting), praise demonstrated a large change and direct commands a small change. There was no significant difference for any of the secondary outcomes, however the ECBI problem sub-scale (d = 0.67) showed medium intervention effect size changes. Main Findings Recruitment Fifty-six parents (N=56) were recruited by health visitors & school nurses and by posters distributed to local primary schools and nurseries. Families were randomised to either the intervention (n=38) or 3-month wait-list control condition (n=18) on a 2:1 ratio stratified by child age and gender. Data were collected at baseline and three-months post-intervention for all families, and six-months later for intervention parents only. Table 1. Family demographic characteristics Demographics Intervention (n=38) Control (n=18) Child age, months: M (SD) 58.79 (19.33) 54.39 (18.84) Child gender, male: n (%) 27 (71.05) 13 (72.22) Parent age, years: M (SD) 34.13 (7.07) 32.44 (5.75) Parent age at birth of first child M (SD) 26.30 (6.53) 25.89 (4.76) Married or in a relationship: n (%) 30 (78.95) 16 (88.89) Employment: 35 (92.11) 15 (83.33) Post 16 education: n (%) Figure 1. Mean scores for observed praise using the per-protocol analyses Figure 2. Mean scores for observed indirect command using the per-protocol analyses Conclusion This universal programme was successful in encouraging positive parental practices; significantly increasing observed praise and decreasing indirect commands for those parents who accessed the programme. The improvements in the positive parenting behaviours that promote healthy child development (Bayer et al., 2007) warrant further investigation. For further information regarding this project, please contact Dawn Owen; dawn.a.owen@bangor.ac.uk