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Pilot of Enhanced Child Adult Relationship Enhancement in Pediatric Primary Care

2019-10-07 08:56:58 | BioPortfolio

Summary

The purpose of this study is to evaluate the efficacy of the enhanced PriCARE intervention in improving parenting capacity, decreasing child behavior problems, and reducing risk of child maltreatment at 4 primary care clinics in Philadelphia and 2 primary care clinics in North Carolina.

Description

Child behavioral concerns are common among families served by Children's Hospital of Philadelphia (CHOP) and University of North Carolina (UNC) pediatric primary care centers. To address this, we developed Child Adult Relationship Enhancement in Pediatric Primary Care (PriCARE). PriCARE has been evaluated at in primary care centers at CHOP and UNC with promising findings with regards to reductions in child behavioral problems. The PriCARE curriculum has now been enhanced with strategies to increase participant engagement, retention of skills, and attendance. Efficacy of this enhanced PriCARE curriculum has not yet been evaluated. Nor has the impact of the PriCARE intervention on child maltreatment risk been explored.

The objectives of this study are to 1) evaluate the efficacy of the enhanced PriCARE to decrease improve parenting capacity and skills, 2) measure the impact on caregiver-reported child behavior problems, 3) measure the impact on the quality of the caregiver-child relationship, 4) measure the impact on the risk of child maltreatment, 5) understand caregivers' perceptions of the efficacy of the intervention, 6) develop, pilot, and implement ongoing improvements to a new PriCARE Timeout Module and its added benefit to caregivers, and 7) identify predictors of attendance and strategies to further improve the intervention's effectiveness, implementation and dissemination.

We will perform a randomized controlled trial (RCT) of the effectiveness of the enhanced PriCARE on objectives listed above among 2- to 6-year-old children and their parents at CHOP's urban Primary Care Centers and two University of North Carolina primary care sites. We intend to randomize up to 110 child-caregiver pairs (220 subjects) to receive PriCARE immediately plus usual treatment (intervention group) and up to 110 child-parent pairs (220 subjects) to receive PriCARE at a later time plus usual treatment (control group) for a total of up to 220 child-caregiver pairs (440 subjects). All child-caregivers pairs randomized to the control group will be placed on a waitlist and offered PriCARE after completion of data collection. Child maltreatment risk, parenting attitudes and skills, child behavior, and quality of the child-caregiver relationship will be measured at baseline (time 1) and 8-17 weeks after randomization (time 2) for both the intervention and control groups. The follow up interview will also include a brief satisfaction questionnaire for participants randomized to the intervention group. For the subgroup of participants who complete the Timeout Module, these measurements will be repeated after 2-4 weeks after completion of the Timeout intervention (time 3).

Study Design

Conditions

Child Behavior Problem

Intervention

PriCARE

Location

University of North Carolina
Chapel Hill
North Carolina
United States
27514

Status

Not yet recruiting

Source

Children's Hospital of Philadelphia

Results (where available)

View Results

Links

Published on BioPortfolio: 2019-10-07T08:56:58-0400

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Medical and Biotech [MESH] Definitions

Performing the role of a parent by care-giving, nurturance, and protection of the child by a natural or substitute parent. The parent supports the child by exercising authority and through consistent, empathic, appropriate behavior in response to the child's needs. PARENTING differs from CHILD REARING in that in child rearing the emphasis is on the act of training or bringing up the children and the interaction between the parent and child, while parenting emphasizes the responsibility and qualities of exemplary behavior of the parent.

Any observable response or action of a child from 24 months through 12 years of age. For neonates or children younger than 24 months, INFANT BEHAVIOR is available.

Repeated physical injuries inflicted on the child by the parent, parents, or surrogate parent; often triggered by the child's minor and normal irritating behavior.

The training or bringing-up of children by parents or parent-substitutes. It is used also for child rearing practices in different societies, at different economic levels, in different ethnic groups, etc. It differs from PARENTING in that in child rearing the emphasis is on the act of training or bringing up the child and the interaction between the parent and child, while parenting emphasizes the responsibility and qualities of exemplary behavior of the parent.

Repeated problem behavior.

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Pediatrics is the general medicine of childhood. Because of the developmental processes (psychological and physical) of childhood, the involvement of parents, and the social management of conditions at home and at school, pediatrics is a specialty. With ...


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