Promoting positive parenting for families in pediatric primary care : program development and a pilot randomized controlled trial

Positive parenting practices protect children and families from a host of adverse outcomes, but evidence-based interventions that support these practices are often unavailable to families in need. The current study sought to target barriers to access and reach of evidence-based parenting interventions using innovative approaches. This study utilized an embedded experimental mixed methods design to support the development of an intervention informed by the preferences and feedback of end-users to enhance its cultural and ecological fit. The resulting preventive e-health intervention on positive parenting, titled Parenting A to Z (PAZ) was tested in a pilot randomized controlled trial (N = 60) during well-child visits in pediatric primary care. Results indicated the feasibility and acceptability of the intervention, its delivery format, and electronic follow up procedures. There were no significant differences between the PAZ condition and the control condition related to the growth of child disruptive behavior, parental stress, parental self-efficacy, knowledge of effective parenting practices, and parenting practices over time. However, the effect size of the intervention on parental stress (d = .11) was commensurate with other evidence-based preventive interventions. These findings suggest the potential to attenuate parenting stress with a very brief, self-directed, electronic parenting intervention within the scope of a well-child visit. The current study outlines the feasibility, acceptability, and impact of a brief-single-session, self-administered preventive intervention and its potential to reduce risk in a population unlikely to access traditional mental health services.