Effectiveness of an Online Parenting Training

NCT05111886 | Completed Results

• 2 other identifiers: Mehus, CR34MH124690
• Study Type: interventional
• Target: 94
• Locations: 1 country
• Sites: 1

Brief Summary

Child and adolescent behavioral health problems are related to the leading causes of youth morbidity and mortality. Parent-focused preventive interventions, such as GenerationPMTO (GenPMTO), effectively prevent behavioral health problems such as depression and conduct disorders. Unfortunately, parenting programs are not widely available nor well-attended. Pediatric primary care (PC) is a non-stigmatizing setting with nearly universal reach and, therefore, an ideal access point to increase availability. However, PC personnel are not trained to address behavioral health topics. Also, typical referral practices are inadequate. There is a need to develop effective referral practices in conjunction with increasing availability. There are also logistical barriers to attending in-person parenting programs, like the need for childcare and a large time-commitment. There is a need to overcome these logistical barriers with more accessible programs. The long-term goal is to prevent significant behavioral health problems by increasing access to GenPMTO.

Conditions

Behavior Problem; Behavior, Child; Parents; Parent-Child Relations

Keywords

Parent program, GenerationPMTO; Primary care referral, pediatric referral; Primary care communication skills training; Online delivery; Brief interventions; Parents of 3-5 year old children; Behavior concerns; Parent behavior; Child externalizing, child internalizing; Acceptability, appropriateness, feasibility

Outcome Measures

Primary Outcomes (6)

• Aim 3: Change in Behavioral Assessment System Child Score

  Outcome is reported as the difference in pre- and post-intervention Externalizing Risk Scores, a subscale from the Behavior Assessment System for Children (3rd Edition, Parent Report Form - Preschool), which measures externalizing, internalizing, and adaptive behaviors. The Externalizing Risk Scores subscale measures externalizing behaviors the sum of using 9 items with a four-choice response format, for a raw Externalizing Risk Score range of 0-27. Higher scores indicate worse levels of externalizing behavior functioning. Scores of 0-10 are in the normal risk range, scores of 11-19 are elevated, and scores of 20 or above are extremely elevated. This is administered to parents before and after the intervention window (8 week separation). The change score was calculated as the value at 8 weeks minus value at baseline.

  8 weeks

• Aim 3: Change in Alabama Parenting Questionnaire

  Outcome is reported as the difference in total scale score on the Alabama Parenting Questionnaire (preschool version) (Clerkin et al., 2007). This questionnaire contains 32 items rated on a 5-point scale ranging from "Never" to "Always." Total scores range from 32 to 160 with higher score indicating more involvement and positive parenting. This is administered to parents before and after the intervention window (8 week separation).

  8 weeks

• Aim 3: Change in Parent Locus of Control

  Outcome is reported as the difference in total scores on the Parent Locus of Control measure (Lovejoy et al., 1997). This measure contains 24 items rated on a 5-point scale from strongly disagree (1) to strongly agree (5). Scores range from 24 to 120. High scores on the scale indicate an external locus of parenting control and low scores indicate an internal locus. This is administered to parents before and after the intervention window (8 week separation).

  8 weeks

• Aim 2: Percentage of Completed Referrals

  Percentage of eligible appointments leading to successful referral.

  1 year

• Aim 2: Parent Attendance

  For each referred caregiver, the number of sessions attended (0-6) was divided by the total possible number of sessions (6), to calculate the percent of sessions attended. The average was then calculated by referring clinician condition (training or control).

  1 year

• Aim 1: Fidelity of Implementation Rating System

  Communication skills rating will be measured using the Support and Guide Observational Coding Scale of audio-recorded provider responses to clinical vignettes, a measure adapted from the Fidelity of Implementation Rating System. The scale measures the communication skills of supporting, guiding, confronting (reverse-coded), teaching (reverse-coded), and tone. Each of these components is averaged across the three vignettes on a 0-3 scale (support, guide, confront, teach), or a 0-2 scale (tone). A total scale is then summed for a total scale score range of 0-14, with higher scores indicating greater communication skills. These vignette prompts are administered to providers before and after the pilot year (1 year separation).

  1 year

Secondary Outcomes (4)

• Intervention Acceptability Measure

  8 weeks (Parents) 1 year (Therapists)

• Appropriateness Measure

  Immediately following training

• Feasibility Measure

  1 year

• Readiness to Change - Patient Preferences Subscale Score

  8 weeks, 1 year

Study Arms (5)

Primary Care Personnel Training

EXPERIMENTAL

Primary care personnel within two Federally Qualified Health Center (FQHC) primary care clinics will be randomly assigned to receive communication skills training or a control condition.

Behavioral: Communication Skills Training; Diagnostic Test: Survey of Experience

Primary Care Personnel Training Control

ACTIVE COMPARATOR

Primary care personnel within two Federally Qualified Health Center (FQHC) primary care clinics will be randomly assigned to receive communication skills training or a control condition. Control group personnel will receive a written description of the referral process but no training.

Behavioral: Written Referral Process; Diagnostic Test: Survey of Experience

Parents eHealth GenPMTO

EXPERIMENTAL

Parents of 3- to 5-year-olds who receive services from primary care personnel at an Federally Qualified Health Center (FQHC) primary care clinic. Primary care personnel will refer parents of child with externalizing or internalizing behaviors to study therapists. Parents may be assigned to GenPMTO or control after referral.

Behavioral: eHealth GenPMTO; Diagnostic Test: Survey of Experience

Parents Control

ACTIVE COMPARATOR

Parents of 3- to 5-year-olds who receive services from primary care personnel at an Federally Qualified Health Center (FQHC) primary care clinic. Primary care personnel will refer parents of child with externalizing or internalizing behaviors to study therapists. Parents may be assigned to GenPMTO or control after referral.

Behavioral: One Session Education about Resources; Diagnostic Test: Survey of Experience

Therapists

OTHER

Community therapists trained to deliver GenPMTO.

Diagnostic Test: Survey of Experience

Interventions

Communication Skills Training BEHAVIORAL

The training will focus on communication skills based on key constructs in the Health Belief Model and motivation/resistance research (described in section A3), the training will focus on: (1) conveying the benefits of parenting programs, (2) knowledge of and responses to common perceived barriers to attending parenting programs, and (3) skills and strategies to effectively motivate and refer parents in ways that are least likely to elicit resistance. The in-person training will last 60-90 minutes. It will include a theoretical background and experiential learning; each step of the referral process will be demonstrated and role-played. The investigators will work to ensure that personnel receive continuing education credits for the training.

Primary Care Personnel Training

eHealth GenPMTO BEHAVIORAL

The GenPMTO is delivered over the phone (not online). This version is up to 6 sessions in length. This brief eHealth version of GenPMTO will be delivered through community therapists. The program will be delivered one-on-one (i.e., between a therapist and a parent or couple).

Parents eHealth GenPMTO

Written Referral Process BEHAVIORAL

A written summary and process map of the referral process, modeled on the Institute for Healthcare Improvement (IHI) 9-step process for "closing the loop" on referrals.

Primary Care Personnel Training Control

One Session Education about Resources BEHAVIORAL

One online or phone conversation with the therapist in which the therapist guides the parent to the following resources: (a) a book, Raising Cooperative Kids, by GenPMTO co-developer Marion Forgatch; (b) a website, behaviorchecker.org, which includes behavioral "prescriptions" for common behavior issues; and (c) information about Early Childhood and Family Education classes, which are provided for free in Minnesota through public schools.

Parents Control

Survey of Experience DIAGNOSTIC_TEST

Satisfaction with referral process

Parents Control; Parents eHealth GenPMTO; Primary Care Personnel Training; Primary Care Personnel Training Control; Therapists

Eligibility Criteria

• Age: 16 Years - 100 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants are eligible for Aim 1 if they are:
• Able to speak English
• Able to participate in the focus group
• Participants are eligible for Aim 2 if they are:
• Primary care personnel who are currently practicing in a collaborating clinic
• Therapists who are eligible for reimbursement from insurance and Medicaid
• Parents who are:
• Referred to a therapist by their providers
• Have the ability to speak English or Spanish, and
• Are a primary caregiver for a child between the ages of 3 and 5 years old

You may not qualify if:

• None

Sponsors & Collaborators

• University of Minnesota: lead
• National Institute of Mental Health (NIMH): collaborator

Study Sites (1)

University of Minnesota

Minneapolis, Minnesota, 55455, United States

Location

Related Publications (7)

• Clerkin SM, Marks DJ, Policaro KL, Halperin JM. Psychometric properties of the Alabama parenting questionnaire-preschool revision. J Clin Child Adolesc Psychol. 2007 Mar;36(1):19-28. doi: 10.1080/15374410709336565.

  PMID: 17206878 BACKGROUND

• Forgatch MS, Patterson GR, DeGarmo DS. Evaluating fidelity: predictive validity for a measure of competent adherence to the Oregon model of parent management training. Behav Ther. 2005;36(1):3-13. doi: 10.1016/s0005-7894(05)80049-8.

  PMID: 16718302 BACKGROUND

• Helfrich CD, Li YF, Sharp ND, Sales AE. Organizational readiness to change assessment (ORCA): development of an instrument based on the Promoting Action on Research in Health Services (PARIHS) framework. Implement Sci. 2009 Jul 14;4:38. doi: 10.1186/1748-5908-4-38.

  PMID: 19594942 BACKGROUND

• Lovejoy MC, Verda MR, Hays CE. Convergent and discriminant validity of measures of parenting efficacy and control. J Clin Child Psychol. 1997 Dec;26(4):366-76. doi: 10.1207/s15374424jccp2604_5.

  PMID: 9418175 BACKGROUND

• Weiner BJ, Lewis CC, Stanick C, Powell BJ, Dorsey CN, Clary AS, Boynton MH, Halko H. Psychometric assessment of three newly developed implementation outcome measures. Implement Sci. 2017 Aug 29;12(1):108. doi: 10.1186/s13012-017-0635-3.

  PMID: 28851459 BACKGROUND

• Kamphaus, R. W. & Reynolds, C. R. (2015). BASC 3 Behavioral and Emotional Screening System Manual. Pearson PsychCorp.

  BACKGROUND

• Mehus, C., Ballard, J., Driscoll, J., Sargeant, L., & Exsted, M. (2025). Support and Guide: Observational Coding Scale Manual for Primary Care Clinician Conversations with Parents. University of Minnesota Digital Conservancy. Retrieved from https://hdl.handle.net/11299/276913

  BACKGROUND

MeSH Terms

Conditions

Mental Disorders; Child Behavior

Condition Hierarchy (Ancestors)

Behavior

Results Point of Contact

• Title: Christopher Mehus, PhD, LMFT
• Organization: University of Minnesota

CJMehus@umn.edu

651-785-3660

Study Officials

• Chris Mehus, PhD

  University of Minnesota

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 14, 2021
• First Posted: November 8, 2021
• Study Start: February 21, 2022
• Primary Completion: June 1, 2024
• Study Completion: June 1, 2024
• Last Updated: February 4, 2026
• Results First Posted: February 4, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: SAP
• Time Frame: 3 years

Locations

US (1)