Heather J. Risser

A Meta-Analysis of Father Involvement in Parent Training

Objective: Investigate (a) whether including fathers in parent training enhances outcomes and (b) whether mothers and fathers benefit equally from parent training. Method: Using traditional meta-analysis methodology, 26 studies that could answer the research questions were identified and meta-analyzed. Results: Studies that included fathers, compared with those that did not, reported significantly more positive changes in childrens behavior and desirable parenting practices, but not in perceptions toward parenting. Compared with mothers, fathers reported fewer desirable gains from parent training. Conclusions: Fathers should not be excluded from parent training and should be encouraged to attend. Further research should seek to understand how parent-training programs might better meet the needs of fathers.

Does accessibility of positive and negative schema vary by child physical abuse risk

OBJECTIVE To examine differences in accessibility of positive and negative schema in parents with high and low risk for child physical abuse (CPA). METHODS This study combined picture priming and lexical decision making methods to assess the accessibility of positive and negative words following presentation of child and adult faces. The child and adult faces depicted positive, ambiguous, and negative affective valences. The sample included 67 (51 low and 16 high CPA risk) general population parents. RESULTS CPA risk status was associated with accessibility of positive/negative words only following priming with faces of the opposite affective valence. More specifically, high CPA risk parents were slower to respond to positive (negative) words following priming with negative (positive) faces. Exploratory analyses indicated that this pattern of findings was more clearly apparent when picture primes involved adult faces. CONCLUSION The present findings suggest that high and low CPA risk parents differ in how they process affectively incongruent information. Research is needed to further examine schema accessibility, as well as to examine whether processes involved in attention and affect integration play a role in CPA risk.

Revisiting the Issue of the Child Abuse Potential Inventory's Internal Consistency in Adolescent Samples

PURPOSE Although the Child Abuse Potential (CAP) Inventory is generally considered to be a reliable screening tool for assessing child physical abuse risk, there is concern that it may lack internal consistency when completed by adolescents (Blinn-Pike and Mingus, J Adolesc 2000;23:107-11). This concern has been reflected in subsequent reviews summarizing the CAPs psychometric properties (Walker and Davies, J Fam Violence 2010;25:215-27), and calls for data on the reliability of the CAP Inventory as completed by adolescents have been issued (Blinn-Pike, J Adolesc Health 2002;30:148). The purpose of this study was to provide additional data examining the internal consistency of the CAP Inventory as completed by adolescents in a variety of contexts. METHOD This study included five samples comprising 3,281 adolescent and adult respondents who completed the CAP Inventory. Two samples included at-risk mothers who were enrolled in home-visiting services and were participating in program evaluations. Three samples included college students the majority of whom were nonparents participating in the research to explore the risk of physical abuse among children. RESULTS The analyses showed high internal consistency estimates for the CAP Inventory abuse scale as completed by adolescent mothers (Kuder-Richardson reliability coefficient range = .90-.96). Moreover, regardless of the sampling technique, parental status, or demographic characteristics, our analyses revealed overall good to excellent internal consistency estimates for the CAP Inventory abuse scale as completed by adolescent respondents. Indeed, the internal consistency estimates obtained from adolescent respondents were similar to the estimates obtained for adult respondents in each of these same samples. CONCLUSION Our results provide strong support for a claim of good to excellent internal consistency of the CAP Inventory with adolescent samples.

Predictors of Treatment Engagement for Young Children Exposed to Violence

This study examined factors associated with treatment engagement and child outcomes in 1,365 children receiving community-based services for exposure to violence. Data were collected on children and families who completed an intake interview. Children were categorized into groups based on whether they attended any therapy sessions after the intake, terminated prematurely from therapy, or completed treatment. Results demonstrated that child emotional and behavioral problems at intake, general parent stress, and income did not differ by treatment engagement. Type of violence exposure, parent–child stress, and race differed by category of treatment engagement. Strategies from Safe From the Start service providers to increase treatment engagement are included in the discussion.

An innovative health-care delivery model for children with medical complexity

Children with medical complexity (CMC) account for a disproportionate share of pediatric health-care utilization and cost that is largely attributable to long hospitalizations, frequent hospital readmissions, and high use of emergency departments. In response, the Centers for Medicare and Medicaid Services Health Care Innovation Center supports the development and testing of innovative health-care payment and service delivery models. The purpose of this article is to describe the CMS-funded coordinated health care for complex kids (CHECK) program, an innovative system of health-care delivery that provides improved, comprehensive, and well-coordinated services to CMC. The CHECK program uses a combination of high-tech and low-tech interventions to connect patients, stakeholders, and providers. It is anticipated that the investment in additional support services to CMC will result in improved quality of care that leads to a reduction in unnecessary inpatient hospitalizations, readmissions, and emergency department visits and a total cost savings. The CHECK program has the potential to inform future cost-effective health-care models aimed at improving the quality of life and care for CMC and their families.

Safe from the Start: evaluating interventions for children exposed to violence

This article describes a multisite evaluation designed to identify promising practices for children exposed to multiple violence types, as well as their caregivers. The interventions improved emotional and behavioral symptoms for children and decreased caregiver stress related to parenting. Regression analyses were run to determine which intervention topics and intervention formats for child services were associated with child symptom reduction. Additional regression analyses explored which intervention topics and intervention formats for caregiver services were associated with symptom reduction for caregivers as well as their children. Insights drawn from these analyses might be helpful to agencies seeking to improve their services for young children who have been exposed to violence.

Do Maternal and Paternal Mental Illness and Substance Abuse Predict Treatment Outcomes for Children Exposed to Violence

This study examined whether having a parent with a mental illness or a parent who abuses substances predicts treatment outcomes for children receiving community-based services for exposure to violence. From 2001 to 2011, data were collected from 492 children from one-and-a-half to seven years old and their primary caregivers enrolled in Safe From the Start services. Results indicated significant improvements pre-intervention to post-intervention in child emotional and behavioural problems, as measured by the Child Behavior Checklist (CBCL). One-way bivariate analyses indicated that children of mothers or fathers with a mental illness and children of mothers who abused substances had higher CBCL scores at intake. Repeated-measures analyses of variance revealed a main effect such that maternal and paternal mental illness and maternal substance abuse were associated with poorer CBCL scores. The only parental risk factor to moderate the association between treatment and CBCL scores was paternal mental illness. Treatment was associated with greater improvement in CBCL scores for children of fathers with, relative to those without, mental illness, and the effect was due to higher CBCL scores at intake for children of fathers with mental illness rather than lower outcome scores. Results suggest that Safe From the Start services which provide early intervention can be effective in improving childrens emotional and behavioural functioning. Additionally, the effectiveness of services appears to be robust to parental risk factors such as mental illness and substance abuse.

A study protocol testing the implementation, efficacy, and cost effectiveness of the ezParent program in pediatric primary care

INTRODUCTION Up to 20% of children demonstrate behavior problems that interfere with relationship development and academic achievement. Parent participation in behavioral parent training programs has been shown to decrease child problem behaviors and promote positive parent-child relationships. However, attendance and parent involvement in face-to-face parent training remain low. Testing the implementation, efficacy, and cost of alternative delivery models is needed to (a) increase the reach and sustainability of parent training interventions and (b) address the barriers to parent participation and implementation of such programs, specifically in primary health care settings. The purpose of this paper is to describe the study protocol evaluating the implementation, efficacy, and cost-effectiveness of delivering the tablet-based ezParent program in pediatric primary care sites. METHODS The implementation of the ezParent in four pediatric primary care sites will be evaluated using a descriptive design and cost-effectiveness analysis. The efficacy of the ezParent will be tested using a randomized controlled trial design with 312 parents of 2 to 5year old children from pediatric primary care settings. Data on parenting and child behavior outcomes will be obtained from all participants at baseline, and 3, 6, and 12months post baseline. DISCUSSION Integrating and evaluating the implementation of the ezParent in pediatric primary care is an innovative opportunity to promote positive parenting with potential for universal access to the preschool population and for low cost by building on existing infrastructure in pediatric primary care.

University of Illinois at Chicago's Interdisciplinary Center for Research on Violence: Changing Systems to Prevent Violence in Chicago and Beyond

This article describes an interdisciplinary center at the University of Illinois at Chicago focused on collaborative research on violence. Our center is unique in its emphasis on developing infrastructure and distinctive processes for overcoming obstacles to interdisciplinary research; the involvement of outside policy makers, advocates, and service providers in jointly discussing and developing research proposals; the breadth of commitments from leading violence researchers and administrators across five colleges; and the innovativeness of proposed research projects that support interdisciplinary activity and show promise for funding. The center has developed an infrastructure to address violence-related issues in both research and teaching. This article discusses the challenges of implementation and boundary spanning in a university context and makes recommendations for sustainability.