Child-Adult Relationship Enhancement in Primary Care (PriCARE): A Randomized Trial of a Parent Training for Child Behavior Problems

Acad Pediatr. 2017 Jan-Feb;17(1):53-60. doi: 10.1016/j.acap.2016.06.009. Epub 2016 Jun 25.

Abstract

Objective: Child-Adult Relationship Enhancement in Primary Care (PriCARE) is a 6-session group parent training designed to teach positive parenting skills. Our objective was to measure PriCARE's impact on child behavior and parenting attitudes.

Methods: Parents of children 2 to 6 years old with behavior concerns were randomized to PriCARE (n = 80) or control (n = 40). Child behavior and parenting attitudes were measured at baseline (0 weeks), program completion (9 weeks), and 7 weeks after program completion (16 weeks) using the Eyberg Child Behavior Inventory (ECBI) and the Adult Adolescent Parenting Inventory 2 (AAPI2). Linear regression models compared mean ECBI and AAPI2 change scores from 0 to 16 weeks in the PriCARE and control groups, adjusted for baseline scores.

Results: Of those randomized to PriCARE, 43% attended 3 or more sessions. Decreases in mean ECBI intensity and problem scores between 0 and 16 weeks were greater in the PriCARE group, reflecting a larger improvement in behavior problems [intensity: -22 (-29, -16) vs -7 (-17, 2), P = .012; problem: -5 (-7, -4) vs -2 (-4, 0), P = .014]. Scores on 3 of the 5 AAPI2 subscales reflected greater improvements in parenting attitudes in the PriCARE group compared to control in the following areas: empathy toward children's needs [0.82 (0.51, 1.14) vs 0.25 (-0.19, 0.70), P = .04], corporal punishment [0.22 (0.00, 0.45) vs -0.30 (-0.61, 0.02), P = .009], and power and independence [0.37 (-0.02, 0.76) vs -0.64 (-1.19, -0.09), P = .003].

Conclusions: PriCARE shows promise in improving parent-reported child-behavior problems in preschool-aged children and increasing positive parenting attitudes.

Keywords: behavioral problems; corporal punishment; parent training; primary care.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Attitude*
  • Child
  • Child Behavior*
  • Child, Preschool
  • Education, Nonprofessional
  • Empathy
  • Female
  • Humans
  • Linear Models
  • Male
  • Parent-Child Relations*
  • Parents / education*
  • Power, Psychological
  • Primary Health Care*
  • Problem Behavior*
  • Punishment
  • Young Adult