A Pilot Study to Identify Best Practices for Implementation of a Positive Parenting Training Program in the Foster Care Population

Brief Summary

Detailed Description

Children in foster care have disproportionately high rates of mental and behavioral health concerns. Foster caregivers have reported challenges managing such difficult behaviors. Such behaviors are associated with placement instability. Child Adult Relationship Enhancement (CARE), an evidence-based positive parenting intervention, has shown promising findings in the primary care setting and its curriculum has been enhanced (PriCARE). This positive parenting intervention offers a promising strategy to provide foster caregivers with the skills needed to address these behavioral problems. The objectives of this study are 1) to evaluate the acceptability and feasibility of PriCARE, a positive parenting intervention, in the foster care setting 2) to assess the efficacy of PriCARE to promote positive parenting, increase empathy among foster caregivers, and improve parenting efficacy and satisfaction and 3) to identify best practices for implementation and dissemination of PriCARE in the foster care setting. Foster caregivers of foster children 18 months-6 years of age in the Philadelphia child welfare system will be enrolled in this study. Foster caregivers must be English-speaking and age 18 years or older. Foster caregivers will be recruited from the Children's Hospital of Philadelphia (CHOP) Fostering Health Program, CHOP primary care sites, CHOP Safe Place Care Clinics, direct referrals from social workers and medical providers, and from referrals from Philadelphia foster care agencies and organizations. Sixty foster caregivers will be enrolled in the study and will be assigned to the enhanced PriCARE program. Each approximately 9 hour CARE training group will be attended by approximately 4-12 caregivers without their children. An initial interview will be conducted prior to initiation of the PriCARE program and will include measures to obtain baseline data regarding demographic information, parenting attitudes and parenting strategies. A second interview will be conducted 4-10 weeks after PriCARE program completion and will include a semi-structured qualitative interview as well as measures of parenting attitudes and parenting strategies.

Primary Outcomes

Secondary Outcomes

• The change in Parenting Sense of Competence score between baseline and follow-up visit(baseline (pre-intervention) and follow-up (4-10 wks post-intervention))
• Understanding foster caregiver perspectives on parenting and the impact of the PriCARE intervention on their parenting through qualitative interviews(baseline (pre-intervention) and follow-up (4-10 wks post-intervention))
• Therapeutic Attitude Inventory (TAI) score(follow-up (4-10 wks post-intervention))
• Change in Adult-Adolescent Parenting Inventory-2 (AAPI-2) score between baseline and follow-up visit(baseline (pre-intervention) and follow-up (4-10 wks post-intervention))
• Change in Parenting Scale score between baseline and follow-up visit(baseline (pre-intervention) and follow-up (4-10 wks post-intervention))