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Intervention Summary

Metropolitan Family Services Parenting Fundamentals

Parenting Fundamentals (formerly called the Parenting Education Program) is a group-based parent education and skills training program for parents who speak English or Spanish and, often, have low incomes, are part of an immigrant family, and/or are involved with the court or social service system. The program is designed to improve participants' parenting strategies and, by extension, to improve their children's behavior, social capacities, emotional competencies, and cognitive abilities. The program's content is tailored developmentally for use with parents of children in the following age groups: 0-4, 4-8, 8-12, and 12-18.

Parenting Fundamentals is delivered in either English or Spanish by trained parent educators who conduct 2-hour, weekly group training sessions and up to three home visits with each participant over the course of the 8-week program. The group training sessions are curriculum based and cover such topics as appropriate nonviolent disciplinary approaches, issues related to child development, parent-child communication skills, and problem solving. The home visits provide opportunities for individualized assistance; discussion and practice of parenting strategies; an evaluation of the home environment; and parental modeling related to patience, respect, and self-care. Parents also receive access to comprehensive referral services and an ongoing support program.

Parent educators, typically social services professionals and paraprofessionals, as well as parents who previously participated in the program, must complete training before implementing Parenting Fundamentals. After parent educators have implemented the program, they must complete booster training on facilitation skills and cultural competency.

The study reviewed for this summary was conducted with two groups of parents: those with children ages 0-7 and those with children ages 7-12. In addition, almost half of the parents (primarily mothers) in the study were mandated to participate by the court or social service system.

Descriptive Information

Areas of Interest Mental health promotion
Outcomes
1: Understanding of parenting strategies
2: Home environment
3: Child behavior in the home
Outcome Categories Family/relationships
Social functioning
Ages 0-5 (Early childhood)
6-12 (Childhood)
18-25 (Young adult)
26-55 (Adult)
Genders Male
Female
Races/Ethnicities American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
White
Race/ethnicity unspecified
Non-U.S. population
Settings Home
Other community settings
Geographic Locations Urban
Implementation History The Community Counseling Centers of Chicago developed and first implemented Parenting Fundamentals (formerly called the Parenting Education Program). Since then, the program has served over 4,700 parents and caregivers at 41 sites in Illinois and Puerto Rico.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: Yes
Adaptations The program has been adapted for use with Puerto Rican Islanders. Additionally, the program has been translated into Arabic, Chinese, and Vietnamese, and it has been conducted in Assyrian and Urdu through interpreters.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Universal
Selective

Quality of Research

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Sanchez Cesareo, M., Acosta Perez, E., Adams, M., Navarro, E., Bensinger, K., & Colon Jordan, H. From the bottom up: Community-based effectiveness study of the Parenting Education Program. Unpublished manuscript.

Supplementary Materials

Caldwell, B., & Bradley, R. Home Observation for Measurement of the Environment (HOME). University of Arkansas at Little Rock.

Sanchez-Cesareo, M., Garcia, D. I., & Sanabria, J. J. Evaluation of the Parenting Education Program: Long report. Unpublished manuscript.

Outcomes

Outcome 1: Understanding of parenting strategies
Description of Measures Understanding of parenting strategies was assessed using the Parenting Education Program Pre-Post Test, a survey that measures parenting knowledge and behavioral intent through items related to child development knowledge, communication skills, problem-solving skills, and nonviolent discipline strategies. Parents respond to 5 vignettes and 15-17 multiple-choice questions (e.g., "Your 10 year old has just been told he cannot have something. He throws a book on the floor. Question: What strategy could you use with your son? a) Praise him for standing up for what he wants; b) Strap him to a chair until he understands that throwing objects is wrong; c) Order him to pick up the book and apologize; d) Set limits and give him choices").

Two versions of the survey were used in the study: one for parents of children ages 0-7 and one for parents of children ages 7-12. Parents were assessed at baseline, at the end of the 8-week intervention, and at 24 weeks after baseline (4-month follow-up) by trained evaluators or program staff in group settings or in the home.
Key Findings Parents were randomly assigned to the intervention group, which received Parenting Fundamentals, or the comparison group, which received a financial literacy program. Relative to parents in the comparison group, those in the intervention group had a greater understanding of parenting strategies at the end of the 8-week intervention (p < .01) and at the 4-month follow-up (p < .01). These findings were associated with small effect sizes (Cohen's d = 0.21 and 0.49, respectively).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.3 (0.0-4.0 scale)
Outcome 2: Home environment
Description of Measures Home environment was assessed using two versions of the Home Observation for Measurement of the Environment (HOME): the Infant/Toddler (IT) HOME, for children ages 0-3, and the Early Childhood (EC) HOME, for children ages 3-6. The HOME, a combined observational and interview instrument, uses a binary-choice (i.e., yes/no) format to assess the quality and quantity of the stimulation and support available to a child in the home environment and focuses on the child as a recipient of inputs from objects, events, and transactions occurring in connection with the family surroundings. The IT HOME is composed of 45 items clustered into 6 subscales: (1) Parental Responsivity, (2) Acceptance of Child, (3) Organization of the Environment, (4) Learning Materials, (5) Parental Involvement, and (6) Variety in Experience. The EC HOME contains 55 items clustered into 8 subscales: (1) Learning Materials, (2) Language Stimulation, (3) Physical Environment, (4) Parental Responsivity, (5) Learning Stimulation, (6) Modeling of Social Maturity, (7) Variety in Experience, and (8) Acceptance of Child.

Trained evaluators conducted in-home assessments with parents and their children ages 0-7 at baseline, at the end of the 8-week intervention, and at 24 weeks after baseline (4-month follow-up).
Key Findings Parents were randomly assigned to the intervention group, which received Parenting Fundamentals, or the comparison group, which received a financial literacy program. Relative to parents in the comparison group, those in the intervention group had a better home environment for children at the end of the 8-week intervention (p = .01) and at the 4-month follow-up (p = .01). These findings were associated with small effect sizes (Cohen's d = 0.43 and 0.12, respectively).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.0 (0.0-4.0 scale)
Outcome 3: Child behavior in the home
Description of Measures Child behavior in the home was assessed using the Behavior Assessment System for Children, Second Edition (BASC–2), which is available for use with parents of children in the following age levels: preschool (ages 2-5), child (ages 6-11), and adolescent (ages 12-21). Parents of children under age 2 were not evaluated with this measure. The BASC-2 uses Parent Rating Scales to measure both adaptive and problem behaviors in four broad domains:

  • Externalizing Problems, which measures disruptive behavior problems, such as aggression, hyperactivity, and delinquency
  • Internalizing Problems, which measures anxiety, depression, and somatization
  • Adaptive Skills, which measures adaptability, activities of daily living, functional communication, and social skills
  • Behavioral Symptoms Index, which measures hyperactivity, aggression, depression, attention problems, atypicality, and withdrawal
Parents were assessed at 24 weeks after baseline (4-month follow-up) by trained evaluators in the home.
Key Findings Parents were randomly assigned to the intervention group, which received Parenting Fundamentals, or the comparison group, which received a financial literacy program. At the 4-month follow-up, the child behavior in the home reported by parents in the intervention group was better than that reported by parents in the comparison group, as indicated by the Internalizing Problems (p = .02), Adaptive Skills (p < .01), and Behavioral Symptoms Index (p = .01) domains. No significant between-group difference was found for the Externalizing Problems domain.
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.3 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 0-5 (Early childhood)
6-12 (Childhood)
18-25 (Young adult)
26-55 (Adult)
88.4% Female
11.6% Male
63.3% Hispanic or Latino
15% Black or African American
8.7% Race/ethnicity unspecified
8.2% White
2.9% Non-U.S. population
1% American Indian or Alaska Native
1% Asian

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Understanding of parenting strategies 3.5 4.0 3.3 3.0 2.0 4.0 3.3
2: Home environment 4.0 2.0 3.3 3.0 2.0 4.0 3.0
3: Child behavior in the home 4.0 3.8 3.3 3.0 2.0 4.0 3.3

Study Strengths

All study measures had good to excellent reliability. Construct validity of the measures was acceptable to excellent. Intervention fidelity was monitored through multiple methods, including the use of two trained bilingual observers who tracked and reported fidelity of the program implementation. Although there was differential loss to follow-up for certain assessments, no statistically significant differences were found between groups after removing those lost to follow-up. Data analysis was appropriate and comprehensive.

Study Weaknesses

Several potential confounding variables were not addressed. In particular, parents who were mandated to participate in the program may have had a different motivation to attend classes than those parents who participated voluntarily.

Readiness for Dissemination

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Center for Evaluation and Sociomedical Research. Individual technical assistance log. San Juan: University of Puerto Rico.

Center for Evaluation and Sociomedical Research. Notebook for evaluation of curriculum implementation fidelity. PARENTS Fundamental Program 7-12 years age group. Puerto Rico Abstinence Education Project. San Juan: University of Puerto Rico.

Community Counseling Centers of Chicago. Implementation manual: Parenting Fundamentals Program for 7 to 12 years old. Chicago, IL: Author.

Community Counseling Centers of Chicago. Parent Education Program: Informed consent for program evaluation participation. Chicago, IL: Author.

Community Counseling Centers of Chicago. Parenting Education Program: Ages 7-12 supervisor training [PowerPoint slides]. Chicago, IL: Author.

Community Counseling Centers of Chicago. Parenting Fundamentals: Ages 7-12 parent educator training day 1 [PowerPoint slides]. Chicago, IL: Author.

Community Counseling Centers of Chicago. Parenting Fundamentals: Ages 7-12 parent educator training day 2 [PowerPoint slides]. Chicago, IL: Author.

Community Counseling Centers of Chicago. Parenting Fundamentals: Ages 7-12 parent educator training day 3 [PowerPoint slides]. Chicago, IL: Author.

Community Counseling Centers of Chicago. Parenting Fundamentals: Ages 7-12 parent educator training day 4 [PowerPoint slides]. Chicago, IL: Author.

Community Counseling Centers of Chicago. Parenting Fundamentals: Home visit modules 7 to 12. Chicago, IL: Author.

Community Counseling Centers of Chicago. Parenting Fundamentals Program: Children's art group manual. Chicago, IL: Author.

Community Counseling Centers of Chicago. Parenting Fundamentals Program: Comprehensive referrals program. Chicago, IL: Author.

Community Counseling Centers of Chicago. Parenting Fundamentals Program: Home visits. Chicago, IL: Author.

Community Counseling Centers of Chicago. Parenting Fundamentals: 7-12 [Parent manual]. Chicago, IL: Author.

Community Counseling Centers of Chicago. Parenting Fundamentals: Support group manual. Chicago, IL: Author.

Urban Networks Associates. Community Counseling Centers of Chicago: Parenting classes ages 7 to 12 questionnaire.

Urban Networks Associates. Community Counseling Centers of Chicago: Evaluation of parenting skills program [Survey questionnaire].

Urban Networks Associates. Follow up to former participants [Survey questionnaire].

Other dissemination materials:

  • Community Counseling Centers of Chicago: Evaluation of Parenting Skills Program
  • Final Quiz Ages 7-12--Positive Parenting Skills
  • Parent Educator Observation Form for Classes and Home Visit
  • Parenting Fundamentals P.A.R.E.N.T.S. [Laminated card]
  • Parenting Fundamentals Program Educator Training Evaluation Form
  • Perceptions of Evidence-Based Practices Questionnaire
  • Sample attendance log
  • Sample database of participants
  • Sample registration form
  • Sessions 1-8 outlines
  • Training Graduation Scoring Sheet

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
4.0 4.0 4.0 4.0

Dissemination Strengths

Program materials are available for implementers and parents. The materials are comprehensive, organized, and attractive, with helpful tips and prompts for successful implementation integrated throughout. Initial training is required for implementers and is available both on- and off-site. Training involves the use of role-play, mock implementation, continuous feedback, and a competency-based quiz. Former participants can attend parent educator training and become certified implementers, which may increase the relevancy of the program to new participants. The program developers require implementers to attend two booster sessions, which focus on facilitation skills and cultural competency. The developers are available for technical assistance and consultation, as well as on-site coaching. Quality assurance is supported through an array of tools, including a participant attendance log, a fidelity notebook, a parent educator observation checklist (for supervisors to use while observing parent educators during classes and home visits), participant surveys, and a pre- and posttest. In addition, the developers can provide guidance on process and outcome evaluations upon request.

Dissemination Weaknesses

No weaknesses were identified by reviewers.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
Parent Manual (versions available for parents of children ages 0-3, 4-7, 7-12, and 12-16) $30 each Yes
Agency Implementation Package, for 1 supervisor and 4 parent educators (includes Implementation Manual, Home Visit Manual and Modules, Parent Session Outlines, Parent Manual, and Comprehensive Referrals Manual) $750 each Yes
Parent Support Group Manual and Children's Art Group Manual Included in the cost of the Agency Implementation Package No
4-day, on- or off-site Parent Educator and Supervisor Training (includes 10 hours of initial consultation and technical assistance) $2,250 per participant, for up to 23 participants, plus travel expenses for on-site training Yes
1-day, on- or off-site Booster Training--Facilitation Skills (includes 10 hours of initial consultation) $250 per participant, plus travel expenses for on-site training Yes
1-day, on- or off-site Booster Training--Cultural Competency (includes 10 hours of initial consultation) $250 per participant, plus travel expenses for on-site training Yes
Ongoing on-site, phone, or email consultation and technical assistance $100 per hour, plus travel expenses for on-site assistance No
On-site visit, observation, and coaching $100 per hour, plus travel expenses No
Quality assurance protocols Included in the cost of the Agency Implementation Package No
Evaluation materials Some are included in the cost of the Agency Implementation Package; others are available upon request No
Evaluation reporting $100 per hour No

Additional Information

Implementers are only required to purchase parent manuals corresponding to the ages of the participating parents' children. The developer offers tailored trainings for sites that want to implement the program across several age groups. Parent educators can attend booster trainings after they have conducted the intervention two times.