Skip to main content
Erschienen in: Prevention Science 4/2018

15.09.2017

After Deployment, Adaptive Parenting Tools: 1-Year Outcomes of an Evidence-Based Parenting Program for Military Families Following Deployment

verfasst von: Abigail H. Gewirtz, David S. DeGarmo, Osnat Zamir

Erschienen in: Prevention Science | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Abstract

Despite significant stressors facing military families over the past 15 years of wars in Iraq and Afghanistan, no parenting programs adapted or developed for military families with school-aged children have been rigorously tested. We present outcome data from the first randomized controlled trial of a behavioral parent training program for families with a parent deployed to Iraq or Afghanistan. In the present study, 336 primarily National Guard and Reserve families with 4–12-year-old children were recruited from a Midwestern state. At least one parent in each family had deployed to the recent conflicts: Operations Iraqi or Enduring Freedom, or New Dawn (OIF/OEF/OND). Families were randomized to a group-based parenting program (After Deployment, Adaptive Parenting Tools (ADAPT)) or web and print resources-as-usual. Using a social interaction learning framework, we hypothesized an indirect effects model: that the intervention would improve parenting, which, in turn, would be associated with improvements in child outcomes. Applying intent-to-treat analyses, we examined the program’s effect on observed parenting, and children’s adjustment at 12-months post baseline. Controlling for demographic (marital status, length, child gender), deployment variables (number of deployments), and baseline values, families randomized to the ADAPT intervention showed significantly improved observed parenting compared to those in the comparison group. Observed parenting, in turn, was associated with significant improvements in child adjustment. These findings present the first evidence for the effectiveness of a parenting program for deployed military families with school-aged children.
Fußnoten
1
We hypothesize indirect effects of change in parenting to improvements in child adjustment, rather than mediating effects because mediation is more robustly tested with the mediator as a temporal antecedent to a distal outcome. We also expected and tested replication of PMTO findings from Forgatch and DeGarmo (1999) who found that parenting, as target of the intervention, showed preliminary sensitivity to change with indirect associations to child outcomes at 12-month post baseline, demonstrating full mediation at later follow-ups.
 
2
It was for that reason—as well as consideration of participant burden—that we opted not to gather observational parenting data at posttest (T2). That is why the current report focuses on change from T1 to T3.
 
Literatur
Zurück zum Zitat Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA School-Age Forms & Profiles. Burlington: University of Vermont, Research Center for Children, Youth, & Families. Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA School-Age Forms & Profiles. Burlington: University of Vermont, Research Center for Children, Youth, & Families.
Zurück zum Zitat Asher, S. R., & Wheeler, V. A. (1985). Children’s loneliness: A comparison of rejected and neglected peer status. Journal of Consulting and Clinical Psychology, 53(4), 500–505.CrossRefPubMed Asher, S. R., & Wheeler, V. A. (1985). Children’s loneliness: A comparison of rejected and neglected peer status. Journal of Consulting and Clinical Psychology, 53(4), 500–505.CrossRefPubMed
Zurück zum Zitat Brown, C. H., Wang, W., Kellam, S. G., Muthen, B. O., Petras, H., Toyinbo, P., et al. (2008). Methods for testing theory and evaluating impact in randomized filed trials: Intent-to-treat analysis for integrating the perspective of person, place and time. Drug and Alcohol Dependence, 95, S74–S104.CrossRefPubMedPubMedCentral Brown, C. H., Wang, W., Kellam, S. G., Muthen, B. O., Petras, H., Toyinbo, P., et al. (2008). Methods for testing theory and evaluating impact in randomized filed trials: Intent-to-treat analysis for integrating the perspective of person, place and time. Drug and Alcohol Dependence, 95, S74–S104.CrossRefPubMedPubMedCentral
Zurück zum Zitat Byrne, B. M. (2013). Structural equation modeling with Mplus: Basic concepts, applications, and programming. Routledge. Byrne, B. M. (2013). Structural equation modeling with Mplus: Basic concepts, applications, and programming. Routledge.
Zurück zum Zitat Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Lawrence Earlbaum Associates. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Lawrence Earlbaum Associates.
Zurück zum Zitat Conger, R. D., Wallace, L. E., Sun, Y., Simons, R. L., McLoyd, V. C., & Brody, G. H. (2002). Economic pressure in African American families: A replication and extension of the family stress model. Developmental Psychology, 38, 179–193.CrossRefPubMed Conger, R. D., Wallace, L. E., Sun, Y., Simons, R. L., McLoyd, V. C., & Brody, G. H. (2002). Economic pressure in African American families: A replication and extension of the family stress model. Developmental Psychology, 38, 179–193.CrossRefPubMed
Zurück zum Zitat Creech, S. K., Hadley, W., & Borsari, B. (2014). The impact of military deployment and reintegration on children and parenting: A systematic review. Professional Psychology, Research and Practice, 45, 452–464.CrossRefPubMedPubMedCentral Creech, S. K., Hadley, W., & Borsari, B. (2014). The impact of military deployment and reintegration on children and parenting: A systematic review. Professional Psychology, Research and Practice, 45, 452–464.CrossRefPubMedPubMedCentral
Zurück zum Zitat Davis, L., Hanson, S. K., Zamir, O., Gewirtz, A. H., & DeGarmo, D. S. (2015). Associations of contextual risk and protective factors with fathers’ parenting practices in the postdeployment environment. Psychological Services, 12, 250–260.CrossRefPubMedPubMedCentral Davis, L., Hanson, S. K., Zamir, O., Gewirtz, A. H., & DeGarmo, D. S. (2015). Associations of contextual risk and protective factors with fathers’ parenting practices in the postdeployment environment. Psychological Services, 12, 250–260.CrossRefPubMedPubMedCentral
Zurück zum Zitat Dishion, T., Peterson, J., Winter, C. E., Jabson, J. M., & Hogansen, J. M. (2007). Family assessment task coder impressions. Unpublished coding manual. Dishion, T., Peterson, J., Winter, C. E., Jabson, J. M., & Hogansen, J. M. (2007). Family assessment task coder impressions. Unpublished coding manual.
Zurück zum Zitat Doty, J. L., Rudi, J., Pinna, K., Hanson, S. K., & Gewirtz, A. H. (2016). If you build it, will they come? Patterns of internet-based and face-to-face participation in a parenting program for military families. Journal of Medical Internet Research, 18, e169.CrossRefPubMedPubMedCentral Doty, J. L., Rudi, J., Pinna, K., Hanson, S. K., & Gewirtz, A. H. (2016). If you build it, will they come? Patterns of internet-based and face-to-face participation in a parenting program for military families. Journal of Medical Internet Research, 18, e169.CrossRefPubMedPubMedCentral
Zurück zum Zitat Durlak, J. A., & Wells, A. M. (1997). Primary prevention mental health programs for children and adolescents: A meta-analytic review. American Journal of Community Psychology, 25, 115–152.CrossRefPubMed Durlak, J. A., & Wells, A. M. (1997). Primary prevention mental health programs for children and adolescents: A meta-analytic review. American Journal of Community Psychology, 25, 115–152.CrossRefPubMed
Zurück zum Zitat Flay, B. R., Biglan, A., Boruch, R. F., Castro, F. G., Gottfredson, D., Kellam, S., et al. (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6, 151–175.CrossRefPubMed Flay, B. R., Biglan, A., Boruch, R. F., Castro, F. G., Gottfredson, D., Kellam, S., et al. (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6, 151–175.CrossRefPubMed
Zurück zum Zitat Forehand, R., Lafko, N., Parent, J., & Burt, K. B. (2014). Is parenting the mediator of change in behavioral parent training for externalizing problems of youth? Clinical Psychology Review, 34, 608–619.CrossRefPubMedPubMedCentral Forehand, R., Lafko, N., Parent, J., & Burt, K. B. (2014). Is parenting the mediator of change in behavioral parent training for externalizing problems of youth? Clinical Psychology Review, 34, 608–619.CrossRefPubMedPubMedCentral
Zurück zum Zitat Forgatch, M. S., & DeGarmo, D. S. (1999). Parenting through change: An effective prevention program for single mothers. Journal of Consulting and Clinical Psychology, 67, 711–724.CrossRefPubMed Forgatch, M. S., & DeGarmo, D. S. (1999). Parenting through change: An effective prevention program for single mothers. Journal of Consulting and Clinical Psychology, 67, 711–724.CrossRefPubMed
Zurück zum Zitat Forgatch, M. S., & DeGarmo, D. S. (2011). Sustaining fidelity following the nationwide PMTO™ implementation in Norway. Prevention Science, 12, 235–246.CrossRefPubMedPubMedCentral Forgatch, M. S., & DeGarmo, D. S. (2011). Sustaining fidelity following the nationwide PMTO™ implementation in Norway. Prevention Science, 12, 235–246.CrossRefPubMedPubMedCentral
Zurück zum Zitat Forgatch, M. S., & Patterson, G. R. (2010). Parent management training—Oregon model: An intervention for antisocial behavior in children. In J. R. Weisz & A. E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents. New York: Guilford. Forgatch, M. S., & Patterson, G. R. (2010). Parent management training—Oregon model: An intervention for antisocial behavior in children. In J. R. Weisz & A. E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents. New York: Guilford.
Zurück zum Zitat Forgatch, M. S., Knutson, N. M., & Mayne, T. (1992). Coder impressions of ODS lab tasks. Eugene: Oregon Social Learning Center. Forgatch, M. S., Knutson, N. M., & Mayne, T. (1992). Coder impressions of ODS lab tasks. Eugene: Oregon Social Learning Center.
Zurück zum Zitat Forgatch, M. S., Patterson, G. R., & Gewirtz, A. H. (2013). Looking forward: The promise of widespread implementation of parent training programs. Perspectives on Psychological Science, 8, 682–694.CrossRefPubMedPubMedCentral Forgatch, M. S., Patterson, G. R., & Gewirtz, A. H. (2013). Looking forward: The promise of widespread implementation of parent training programs. Perspectives on Psychological Science, 8, 682–694.CrossRefPubMedPubMedCentral
Zurück zum Zitat Gewirtz, A. H., & Youssef, A. M. (2016). Parenting and children’s resilience in military families. New York: Springer. Gewirtz, A. H., & Youssef, A. M. (2016). Parenting and children’s resilience in military families. New York: Springer.
Zurück zum Zitat Gewirtz, A. H., Forgatch, M., & Wieling, E. (2008). Parenting practices as potential mechanisms for child adjustment following mass trauma. Journal of Marital and Family Therapy, 34, 177–192.CrossRefPubMed Gewirtz, A. H., Forgatch, M., & Wieling, E. (2008). Parenting practices as potential mechanisms for child adjustment following mass trauma. Journal of Marital and Family Therapy, 34, 177–192.CrossRefPubMed
Zurück zum Zitat Gewirtz, A. H., Pinna, K. L. M., Hanson, S. K., & Brockberg, D. (2014). Promoting parenting to support reintegrating military families: After deployment, adaptive parenting tools. Psychological Services, 11, 31–40.CrossRefPubMedPubMedCentral Gewirtz, A. H., Pinna, K. L. M., Hanson, S. K., & Brockberg, D. (2014). Promoting parenting to support reintegrating military families: After deployment, adaptive parenting tools. Psychological Services, 11, 31–40.CrossRefPubMedPubMedCentral
Zurück zum Zitat Gewirtz, A. H., DeGarmo, D. S., Lee, S., Morrell, N., & August, G. (2015). Two-year outcomes of the early risers prevention trial with formerly homeless families residing in supportive housing. Journal of Family Psychology, 29, 242–252.CrossRefPubMed Gewirtz, A. H., DeGarmo, D. S., Lee, S., Morrell, N., & August, G. (2015). Two-year outcomes of the early risers prevention trial with formerly homeless families residing in supportive housing. Journal of Family Psychology, 29, 242–252.CrossRefPubMed
Zurück zum Zitat Gewirtz, A.H., DeGarmo, D.S., Plowman, E., August, G.J., & Realmuto, G. (2009). Parenting, parental mental health, and child functioning in families residing in supportive housing. American Journal of Orthopsychiatry, 79, 336-347. Gewirtz, A.H., DeGarmo, D.S., Plowman, E., August, G.J., & Realmuto, G. (2009). Parenting, parental mental health, and child functioning in families residing in supportive housing. American Journal of Orthopsychiatry, 79, 336-347.
Zurück zum Zitat Gewirtz, A. H., DeGarmo, D. S., & Zamir, O. (2016). Effects of a military parenting program on parental distress and suicide ideation: After deployment adaptive parenting tools. Suicide and Life Threatening Behavior (Special Issue), 46, S23–S31.CrossRef Gewirtz, A. H., DeGarmo, D. S., & Zamir, O. (2016). Effects of a military parenting program on parental distress and suicide ideation: After deployment adaptive parenting tools. Suicide and Life Threatening Behavior (Special Issue), 46, S23–S31.CrossRef
Zurück zum Zitat Jo, B. (2002). Estimation of intervention effects with noncompliance: Alternative model specifications. Journal of Educational & Behavioral Statistics, 27(4), 385–409.CrossRef Jo, B. (2002). Estimation of intervention effects with noncompliance: Alternative model specifications. Journal of Educational & Behavioral Statistics, 27(4), 385–409.CrossRef
Zurück zum Zitat Kelley, M. L., & Jouriles, E. N. (2011). An introduction to the special section on U.S. military operations: Effects on military members’ partners and children. Journal of Family Psychology, 25, 459–460.CrossRefPubMed Kelley, M. L., & Jouriles, E. N. (2011). An introduction to the special section on U.S. military operations: Effects on military members’ partners and children. Journal of Family Psychology, 25, 459–460.CrossRefPubMed
Zurück zum Zitat Kraemer, H. C., Wilson, G. T., Fairburn, C. G., & Agras, W. S. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry, 59, 877–883.CrossRefPubMed Kraemer, H. C., Wilson, G. T., Fairburn, C. G., & Agras, W. S. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry, 59, 877–883.CrossRefPubMed
Zurück zum Zitat Lester, P., Peterson, K., Reeves, J., Knauss, L., Glover, D., Mogil, C., et al. (2010). The long war and parental deployment: Effects on military children and at-home spouses. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 310.PubMedPubMedCentral Lester, P., Peterson, K., Reeves, J., Knauss, L., Glover, D., Mogil, C., et al. (2010). The long war and parental deployment: Effects on military children and at-home spouses. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 310.PubMedPubMedCentral
Zurück zum Zitat Little, R. J., & Yau, L. H. Y. (1998). Statistical techniques for analyzing data from prevention trials: Treatment of no-shows using Rubin’s causal model. Psychological Methods, 3, 147–159.CrossRef Little, R. J., & Yau, L. H. Y. (1998). Statistical techniques for analyzing data from prevention trials: Treatment of no-shows using Rubin’s causal model. Psychological Methods, 3, 147–159.CrossRef
Zurück zum Zitat MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. NY: Lawrence Earlbaum Associates. MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. NY: Lawrence Earlbaum Associates.
Zurück zum Zitat McDonald, R. P., & Ho, M.-H. R. (2002). Principles and practice in reporting structural equation analyses. Psychological Methods, 7, 64–82.CrossRefPubMed McDonald, R. P., & Ho, M.-H. R. (2002). Principles and practice in reporting structural equation analyses. Psychological Methods, 7, 64–82.CrossRefPubMed
Zurück zum Zitat Muthén, L. K., & Muthén, B. O. (1998–2015). Mplus: Statistical analysis with latent variables: user’s guide (7th ed.). Los Angeles: StatModel. Muthén, L. K., & Muthén, B. O. (1998–2015). Mplus: Statistical analysis with latent variables: user’s guide (7th ed.). Los Angeles: StatModel.
Zurück zum Zitat Patterson, G. R. (1982). Coercive family process. Eugene: Castalia. Patterson, G. R. (1982). Coercive family process. Eugene: Castalia.
Zurück zum Zitat Patterson, G. R. (2005). Next generation of PMTO models. Behavior Therapist, 28, 25–32. Patterson, G. R. (2005). Next generation of PMTO models. Behavior Therapist, 28, 25–32.
Zurück zum Zitat Patterson, G. R., Forgatch, M. S., & Degarmo, D. S. (2010). Cascading effects following intervention. Development and Psychopathology, 22, 949–970.CrossRefPubMedPubMedCentral Patterson, G. R., Forgatch, M. S., & Degarmo, D. S. (2010). Cascading effects following intervention. Development and Psychopathology, 22, 949–970.CrossRefPubMedPubMedCentral
Zurück zum Zitat Prinz, R., Foster, S., Kent, R., & O’Leary, K. (1979). Multivariate assessment of conflict in distressed and nondistressed mother-adolescent dyads. Journal of Applied Behavior Analysis, 12, 691–700.CrossRefPubMedPubMedCentral Prinz, R., Foster, S., Kent, R., & O’Leary, K. (1979). Multivariate assessment of conflict in distressed and nondistressed mother-adolescent dyads. Journal of Applied Behavior Analysis, 12, 691–700.CrossRefPubMedPubMedCentral
Zurück zum Zitat Reynolds, C. R., & Kamphaus, R. W. (2004). Behavior assessment scale for children. Bloomington: Pearson Assessments. Reynolds, C. R., & Kamphaus, R. W. (2004). Behavior assessment scale for children. Bloomington: Pearson Assessments.
Zurück zum Zitat Sandler, I. N., Schoenfelder, E. N., Wolchik, S. A., & MacKinnon, D. P. (2011). Long-term impact of prevention programs to promote effective parenting: Lasting effects but uncertain processes. Annual Review of Psychology, 62, 299–329.CrossRefPubMedPubMedCentral Sandler, I. N., Schoenfelder, E. N., Wolchik, S. A., & MacKinnon, D. P. (2011). Long-term impact of prevention programs to promote effective parenting: Lasting effects but uncertain processes. Annual Review of Psychology, 62, 299–329.CrossRefPubMedPubMedCentral
Zurück zum Zitat Shrout, P. E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7, 422–445.CrossRefPubMed Shrout, P. E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7, 422–445.CrossRefPubMed
Zurück zum Zitat Snyder, J., Reid, J., Stoolmiller, M., Howe, G., Brown, H., Dagne, G., & Cross, W. (2006). The role of behavior observation in measurement systems for randomized prevention trials. Prevention Science, 7, 43–56.CrossRefPubMed Snyder, J., Reid, J., Stoolmiller, M., Howe, G., Brown, H., Dagne, G., & Cross, W. (2006). The role of behavior observation in measurement systems for randomized prevention trials. Prevention Science, 7, 43–56.CrossRefPubMed
Zurück zum Zitat Spoth, R., Redmond, C., Haggerty, K., & Ward, T. (1995). A controlled parenting skills outcome study examining individual difference and attendance effects. Journal of Marriage and Family Counseling, 57, 449–464.CrossRef Spoth, R., Redmond, C., Haggerty, K., & Ward, T. (1995). A controlled parenting skills outcome study examining individual difference and attendance effects. Journal of Marriage and Family Counseling, 57, 449–464.CrossRef
Zurück zum Zitat Sullivan, K., Capp, G., Gilreath, T. D., Benbenishty, R., Roziner, I., & Astor, R. A. (2015). Substance abuse and other adverse outcomes for military-connected youth in California. JAMA Pediatrics, 169, 922–928.CrossRefPubMed Sullivan, K., Capp, G., Gilreath, T. D., Benbenishty, R., Roziner, I., & Astor, R. A. (2015). Substance abuse and other adverse outcomes for military-connected youth in California. JAMA Pediatrics, 169, 922–928.CrossRefPubMed
Zurück zum Zitat Wolchik, S. A., Sandler, I. N., Tein, J.-Y., Mahrer, N. E., Millsap, R. E., Winslow, E., et al. (2013). Fifteen-year follow-up of a randomized trial of a preventive intervention for divorced families: Effects on mental health and substance use outcomes in young adulthood. Journal of Consulting and Clinical Psychology, 81, 660–673.CrossRefPubMedPubMedCentral Wolchik, S. A., Sandler, I. N., Tein, J.-Y., Mahrer, N. E., Millsap, R. E., Winslow, E., et al. (2013). Fifteen-year follow-up of a randomized trial of a preventive intervention for divorced families: Effects on mental health and substance use outcomes in young adulthood. Journal of Consulting and Clinical Psychology, 81, 660–673.CrossRefPubMedPubMedCentral
Metadaten
Titel
After Deployment, Adaptive Parenting Tools: 1-Year Outcomes of an Evidence-Based Parenting Program for Military Families Following Deployment
verfasst von
Abigail H. Gewirtz
David S. DeGarmo
Osnat Zamir
Publikationsdatum
15.09.2017
Verlag
Springer US
Erschienen in
Prevention Science / Ausgabe 4/2018
Print ISSN: 1389-4986
Elektronische ISSN: 1573-6695
DOI
https://doi.org/10.1007/s11121-017-0839-4

Weitere Artikel der Ausgabe 4/2018

Prevention Science 4/2018 Zur Ausgabe