Fostering Parent Participation in a Longitudinal Study: The Los Angeles Legacy for Children™ Experience APHA 135th Annual Meeting and Exposition November 5, 2007 Washington D.C. Judy Howard, Leila Beckwith & Dane Fitzmorris University of California, Los Angeles (UCLA)

Intervention Strategy in Legacy for Children™ at UCLA Foster a sense of community Mothers’-only groups Child development information Support development of parenting style Mothers’/children’s groups Knowledge about child development Peer group interactions among the children Modeling developmentally appropriate interactions Opportunity to practice strategies Foster a sense of community and friendship among the mothers, among the children, and among mothers with other mothers’ children Mothers’-only groups provided the mothers with child development information and supported the mothers in developing their own parenting style Mothers’/children’s groups fostered mothers’ knowledge about child development and peer group interactions among the children Mothers’/children’s groups provided the opportunity for the mothers to observe the group leader modeling developmentally appropriate interactions with the children and to practice strategies taken from the mothers’ only groups

Retention Strategies for Study Participants Group intervention design Selection of staff Perks for study participants

Retention Strategies for the Mothers’/Children’s Group Design Build parental social ties by creating a neighborhood: Mothers Get to know each other’s children Observe parenting behaviors Children Peer interactions Friendships Interactions with all Legacy mothers Build parental social ties among the mothers by creating a neighborhood: Allow each mother to know another mother’s infant/ toddler by way of a supervised child development setting Expose each mother to the opportunity to observe the parenting behaviors of others in the group Expose each child to another child over a 3 year period so that peer interaction and beginning of friendship could occur among the children and could be seen by their mothers Expose each child to interactions with other mothers

Retention Strategies for the Mothers’-Only Group Design Build parental social ties through shared reflections on parenting issues and parental identity: Shared rules of group conduct Consistent session format One-on-One time with Group Leader Shared rules of group conduct in order to establish trust and confidentiality Each mothers’-only session had the same format---welcome, questions and comments, and a topic discussion that always included open-ended questions and individual choice about amount of participation Each mother could have private time with the group leader, if she felt the need.

Retention Strategy Through Socialization After Each Group Session Hot meals Served after each group session Fun Club Held after each mothers’-only session Fun Club: Included time for crafts, walks in Westwood Village to Starbucks and to the cookie store, and party planning

Challenges to Hiring a Group Intervention Leader Skills and comfort level to work well with both adults and children Knowledgeable about group dynamics—adults and young children Knowledgeable about parenting issues, stresses, family belief systems Knowledgeable about child development issues Challenges to Hiring a Group Intervention Leader for Joint Task of Facilitating

Retention Strategy for Staff Stability Leading to Participant Satisfaction Stable group leaders with a high level of professional skill and commitment Qualifications: Master’s degree Experience in both parenting groups and child development Personal qualifications Non-judgmental, flexible, emotional stability, professional boundaries, sense of humor Respect research data gathering efforts In order to maintain stable group leaders with a high level of professional skill and commitment, we sought the following qualifications: Master’s degree in a related field Experience in both parenting groups and child development Personal qualifications—non-judgmental, flexible, emotional stability, professional boundaries, sense of humor Respect research data gathering efforts Before hiring, job candidate was asked to role play a curriculum session with 2 senior staff playing the role of the mothers

Staff Stability During the 3 Years of the Main Study 3 out of 5 group leaders remained during the entire main study 1 group leader remained with her intervention groups, except for the final 2 months. Able to attend the mothers’/children’s graduation celebrations 1 group leader was terminated after a few months 3 out of 5 group leaders remained during the entire main study 1 group leader remained with her intervention groups, except for the final 2 months. Able to attend the mothers’/children’s graduation celebrations 1 group leader was terminated after a few months for failing to complete data forms

Perks as Part of the Retention Strategy Transportation Child Care funds Health ombudsman (Public Health Nurse) Birthday cards Transportation Provided to and from each session $25.00 Provided to each mother for child care on days of mothers’-only sessions and every session for those with more than one child Health ombudsman (Public Health Nurse) Available to intervention study participants to provide assistance with health care issues Birthday cards For mothers and children

Retention Strategies That Proved Difficult to Provide Hot meals Transportation FUN Club Hot meals Difficult to obtain and were expensive Mothers complained about the lack of variety Transportation Instability among drivers, drivers inappropriate behavior with the mothers and vice versa, arranging for routes that did not exceed 45 minutes one way, arranging for pick ups in adjacent zip codes so that there was an adequate number of infant seats and adult seats, break down of vans, and changing state regulations for passenger vans. FUN Club Difficult to implement and mothers preferred the structured parenting sessions.

Thank You More information is available at www.cdc.gov/ncbddd/child