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01-10-2021

Preferences for Parenting Programs in Head Start: Using Conjoint Analysis to Understand Engagement in Parenting Health Promotion Programs

Authors: Frances Wymbs, Greta L. Doctoroff, Anil Chacko, Gillian Sternheim

Published in: Prevention Science | Issue 7/2021

Abstract

The impact of evidence-based parenting health promotion programs is threatened by limited enrollment and attendance. We used a discrete choice experiment (DCE) to examine how Early Head Start and Head Start parents prioritized key attributes of parenting programs when considering potential participation. Utility values and importance scores indicate that parents placed the highest priority on a program that optimized child academic outcomes, and after that, on a program that offered incentives and logistical supports, and maximized potential effects on friendship skills, behavioral skills, and the parent–child relationship. Next, we used simulations or forecasting tools to estimate parents’ preferences for types of programs. Sixty-five percent of parents preferred Outcome-focused Programs that fostered parents’ understanding and practice of skills, whereas 23% prioritized Enhanced Support Programs offering logistic support, such as incentives, followed by child outcomes. The remaining 12% of parents preferred Format-focused Programs that targeted positive outcomes via one 30-min meeting. Parents preferring Outcome-focused Programs reported higher child prosocial behaviors compared to parents preferring Enhanced Support and Format-focused Programs. Parents preferring Outcome-focused Programs were more likely to be those of 3- and 4-year-old children than of 2-year-olds. Findings challenge the one-size-fits-all approach to offering parenting programs and suggest ways to enhance accessibility and program reach.

We use the term “health promotion program” to refer to programs that bolster academic success as well as a variety of health and family outcomes, such as those offered in Head Start Programming. Some health promotion programs include parent training programs. Core components of behavioral parent training programs, such as The Incredible Years (Webster-Stratton & Bywater, 2019), include building strong relationships; being a social, emotional, and academic coach for children; providing praise and incentives; setting limits and establishing household rules; and handling misbehavior.

Process factors or attributes include variations in delivery or format (e.g., meeting individually with a therapist or in groups with other parents, families, and/or children) as well as the inclusion of logistical supports and incentives to facilitate the transfer process of information.

Outcome attributes include areas of improved functioning in children and improvements in parents’ knowledge, skill, and emotional well-being related to parenting and child rearing.

Content attributes include parent skills targeted in the program session or the child’s behavioral goal or target.

For consistency, we use the definitions and categorizations of content, process, and outcome attributes used in Cunningham et al. (2008, 2013), Waschbusch et al. (2011), and Wymbs et al. (2015, 2017).

We use the term “Latine” in our study based on parents’ stated preference for the name used for their cultural/ethnic group.

Role plays and practice with other parents are examples of active learning strategies; parents did not see these examples when answering the conjoint survey.

Armitage, C. J., & Conner, M. (2001). Efficacy of the Theory of Planned Behaviour: A meta-analytic review. British Journal of Social Psychology, 40, 471–499.CrossRef

Baker, C. N., Arnold, D. H., & Meagher, S. (2011). Enrollment and attendance in a parent training prevention program for conduct problems. Prevention Science, 12, 126–138. https://doi.org/10.1007/s11121-010-0187-0CrossRefPubMed

Bourdon, K., Goodman, R., Rae, D., Simpson, G., & Koretz, D. (2005). The Strengths and Difficulties Questionnaire: U.S. normative data and psychometric properties. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 557–564.CrossRef

Caldwell, M., Brotman, L., Coard, S., Wallace, S., Stellabotte, D., & Calzada, E. (2005). Community involvement in adapting and testing a prevention program for presechoolers living in urban communities: Parent Corps. Journal of Child and Family Studies, 14, 373–386.CrossRef

Caruso, E., Rahnev, D., & Banaji, M. (2009). Using conjoint analysis to detect discrimination: Revealing covert preferences from overt choices. Social Cognition, 27, 128–137.CrossRef

Chacko, A., Fabiano, G. A., Doctoroff, G. L., & Fortson, B. (2018). Engaging fathers in effective parenting for preschool children using shared book reading: A randomized controlled trial. Journal of Clinical Child and Adolescent Psychology, 47, 79–93. https://doi.org/10.1080/15374416.2016.1266648CrossRefPubMed

Chacko, A., Jensen, S. A., Lowry, L. S., Cornwell, M., Chimklis, A., Chan, E., Lee, D., & Pulgarin, B. (2016). Engagement in behavioral parent training: Review of the literature and implications for practice. Clinical Child Family Psychology Reviews, 19, 204–215. https://doi.org/10.1007/s10567-016-0205-2CrossRef

Chacko, A., Wymbs, B., Rajwan, E., & Wymbs, F. (2017). Characteristics of parents of children with ADHD who never attend, drop out, and complete behavioral parent training. Journal of Child and Family Studies, 26, 950–960.CrossRef

Chaudry, A., & Wimer, C. (2016). Poverty is not just an indicator: The relationship between income, poverty, and child well-being. Academic Pediatrics, 16, S23–S29. https://doi.org/10.1016/j.acap.2015.12.010 PMID: 27044698.CrossRefPubMed

Chronis, A., Lahey, B., Pelham, W., Williams, S., Baumann, B., Kipp, H., Jones, H., & Rathouz, P. (2007). Maternal depression and early positive parenting predict future conduct problems in young children with attention-deficit/hyperactivity disorder. Developmental Psychology, 43, 70–82. https://doi.org/10.1037/0012-1649.43.1.70CrossRefPubMed

Cunningham, C., Chen, Y., Deal, K., Rimas, H., McGrath, P., Reid, G., Lipman, E., & Corkum, P. (2013). The interim service preferences of parents waiting for children’s mental health treatment: A discrete choice conjoint experiment. Journal of Abnormal Child Psychology, 41, 865–877.CrossRef

Cunningham, C. E., Deal, K., Rimas, H., Buchanan, D. H., Gold, M., Sdao-Jarvie, K., & Boyle, M. (2008). Modeling the information preferences of parents of children with mental health problems: A discrete choice conjoint experiment. Journal of Abnormal Child Psychology, 36, 1123–1138. https://doi.org/10.1007/s10802-008-9238-4CrossRefPubMed

Dumas, J. E., Moreland, A., French, B., & Pearl, A. (2010). Effects of monetary incentives on engagement in the PACE parenting program. Journal of Clinical Child & Adolescent Psychology, 39, 302–313. https://doi.org/10.1080/15374411003691792CrossRef

Evans, G. W. (2004). The environment of childhood poverty. American Psychologist, 59, 77–92. https://doi-org.proxy.library.ohio.edu/10.1037/0003-066X.59.2.77

Fabiano, G. A., Schatz, N. K., & Jerome, S. (2016). Parental preferences for early intervention programming examined using best-worst scaling methodology. Child and Youth Care Forum, 45, 655–673. https://doi.org/10.1007/s10566-016-9348-zCrossRef

Garvey, C., Julion, W., Fogg, L., Kratovil, A., & Gross, D. (2006). Measuring participation in a prevention trial with parents of young children. Research in Nursing & Health, 29, 212–222. https://doi.org/10.1002/nur.20127CrossRef

Gleason, M. M., Zeanah, C. H., & Dickstein, S. (2010). Recognizing young children in need of mental health assessment: Development and preliminary validity of the Early Childhood Screening Assessment. Infant Mental Health Journal, 31, 335–357.CrossRef

Gonzalez, C., Morawska, A., & Haslam, D. (2018). Enhancing initial parental engagement in interventions for parents of young children: A systematic review. Clinicial Child and Family Psychology Review, 21, 415–432. https://doi.org/10.1007/s10567-018-0259-4

Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581–586.CrossRef

Gross, D., & Bettencourt, A. F. (2019). Financial incentives for promoting participation in a school-based parenting program in low-income communities. Prevention Science, 20, 585–597. https://doi.org/10.1007/s11121-019-0977-yCrossRefPubMedPubMedCentral

Gross, D., Johnson, T., Ridge, A., Garvey, C., Julion, W., Treysman, A., & Fogg, L. (2011). Cost-effectiveness of childcare discounts on parent participation in preventive parent training in low-income communities. The Journal of Primary Prevention, 32, 283–298. https://doi.org/10.1007/s10935-011-0255-7CrossRefPubMedPubMedCentral

Heinrichs, N., Bertram, H., Kuschel, A., & Hahlweg, K. (2005). Parent recruitment and retention in a universal prevention program for child behavior and emotional problems: Barriers to research and program participation. Prevention Science, 6, 275–286.CrossRef

Huber, J., Orme, B., & Miller, R. (2007). Dealing with product similarity in conjoint simulators. In A. Gustafsson, A. Hermann, & F. Huber (Eds.), Conjoint measurement: Methods and applications (4th ed., pp. 347–352). Springer.

Lerner, C., & Nightingale, M. O. (2016). Tuning in: Parents of young children speak up about what they think, know, and need. Zero to Three. Retrieved from https://www.zerotothree.org/resources/series/tuning-in-parents-of-young-children-tell-us-what-they-think-know-and-need

Mian, N. D., Eisenhower, A. S., & Carter, A. S. (2015). Targeted prevention of childhood anxiety: Engaging parents in an underserved community. American Journal of Community Psychology, 55, 58–69. https://doi.org/10.1007/s10464-014-9696-5CrossRefPubMed

Miller, X., & Sambell, S. (2003). What do parents feel they need? Implications of parents’ perspectives for the facilitation of parenting programmes. Children and Society, 17(1), 32–44. https://doi.org/10.1002/chi.726

National Academies of Sciences, Engineering, and Medicine. (2016). Parenting matters: Supporting parents of children ages 0–8. Washington, DC: The National Academies Press. https://doi.org/10.17226/21868

Office of Head Start. (2017). Administration of children and family services. US Department of Health and Human Services. Office of Head Start. https://www.acf.hhs.gov/ohs/about

Orme, B. K. (2013). Getting started with conjoint analysis: Strategies for product design and pricing research. Research Publishers.

Pelham, W., Fabiano, G., Waxmonsky, J., Greiner, A., Gnagy, E., & Murphy, S. (2016). Treatment sequencing for childhood ADHD: A multiple-randomization study of adaptive medication and behavioral interventions. Journal of Clinical Child and Adolescent Psychology, 45, 396–415.CrossRef

Phillips, K., Johnson, F., & Maddala, T. (2002). Measuring what people value: A comparison of “attitude” and “preference” surveys. Health Services Research, 37, 1659–1679.CrossRef

Reisberg, D. (2006). Cognition: Exploring the Science of the Mind. Norton.

Ryan, M., & Gerard, K. (2003). Using discrete choice experiments to value health care: Current practice and future prospects. Applied Health Economics and Policy Analysis, 2, 55–64.

Sawtooth Software. (2017). (Lighthouse Studio) [Computer software]. Sawtooth Software Inc. http://www.sawtoothsoftware.com

Spoth, R., & Redmond, C. (2000). Research on family engagement in preventive interventions: Toward improved use of scientific findings in primary prevention practice. The Journal of Primary Prevention, 21, 267–284. https://doi.org/10.1023/A:1007039421026CrossRef

Waschbusch, D. A., Cunningham, C. E., Pelham Jr, W. E., Rimas, H. L., Geriner, A. R., Gnagy, E. M., et al. (2011). A discrete choice conjoint experiment to evaluate parent preferences for treatment of young, medication naïve children with ADHD. Journal of Clinical Child and Adolescent Psychology, 40, 546–561.CrossRef

Webster-Stratton, C., & Bywater, T. (2019). The Incredible Years® series: An internationally evidenced multimodal approach to enhancing child outcomes. In B. H. Fiese, M. Celano, K. Deater-Deckard, E. N. Jouriles, & M. A. Whisman (Eds.), APA handbook of contemporary family psychology: Family therapy and training (pp. 343–359). American Psychological Association. https://doi-org.elibrary.einsteinmed.org/10.1037/0000101-021

Webster-Stratton, C., Rinaldi, J., & Reid, J. M. (2011). Long-term outcomes of Incredible Years Parenting Program: Predictors of adolescent adjustment. Child and Adolescent Mental Health, 16, 38–46. https://doi.org/10.1111/j.1475-3588.2010.00576.xCrossRefPubMedPubMedCentral

Wymbs, F. (2018). Parents’ preferences for school- and community-based services for children at-risk for ADHD. School Mental Health, 10, 386–401.CrossRef

Wymbs, F., Chen, Y., Rimas, H., Deal, K., Waschbusch, D., & Pelham, W. (2017). Examining parents’ preferences for group parent training for ADHD when individual parent training is unavailable. Journal of Child and Family Studies, 26, 888–904.CrossRef

Wymbs, F., Cunningham, C., Chen, Y., Rimas, H., Deal, K., Waschbusch, D., & Pelham, W. (2015). Examining parents’ preferences for group and individual parent training for children with ADHD symptoms. Journal of Clinical Child and Adolescent Psychology, 45, 614–631.CrossRef

Title: Preferences for Parenting Programs in Head Start: Using Conjoint Analysis to Understand Engagement in Parenting Health Promotion Programs
Authors: Frances Wymbs
Greta L. Doctoroff
Anil Chacko
Gillian Sternheim
Publication date: 01-10-2021
Publisher: Springer US
Published in: Prevention Science / Issue 7/2021
Print ISSN: 1389-4986
Electronic ISSN: 1573-6695
DOI: https://doi.org/10.1007/s11121-021-01288-7

At a glance: The STEP trials

Springer Medicine

Preferences for Parenting Programs in Head Start: Using Conjoint Analysis to Understand Engagement in Parenting Health Promotion Programs

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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