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Involving Parents

Involving Parents. Presented by: Barri Burrus, Ph.D. RTI International NC TTUPC Annual Conference Greensboro, NC October 23, 2009. What do we mean by “parents?” What does the evidence tell us about involving parents? What are some ways we can include parents?

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Involving Parents

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  1. Involving Parents Presented by: Barri Burrus, Ph.D. RTI International NC TTUPC Annual Conference Greensboro, NC October 23, 2009

  2. What do we mean by “parents?” What does the evidence tell us about involving parents? What are some ways we can include parents? What are anticipated barriers for involving parents and how can we overcome them? Overview

  3. Who do we consider “parents?” • Caregivers responsible for the day-to-day care of the child or adolescent. • May be biological parent or parents • Often includes extended kin such as grandparents, aunts, uncles or step-parents

  4. What does the evidence tell us about the effects of interventions for parents • Recent systematic review conducted for U.S. Preventive Services Task Force • Generates recommendations for some interventions, based on whether or not sufficient evidence exists and results are included in Community Guide (www.TheCommunityGuide.org) • Parenting/caregiver review was designed to look at effectiveness of these interventions for a range of cross-cutting risk and protective behaviors.

  5. Interrelated Conceptual Domains of Risk Factors and Protective Factors Behavior Risk Factors Problem Drinking Poor School Work Protective Factors Church Attendance Involvement in School and Voluntary Clubs Personality Risk Factors Low Perceived Life Chances Low Self-Esteem Risk-Taking Propensity Protective Factors Value on Achievement Value of Health Intolerance of Deviance Perceived Environment Risk Factors Models for Deviant Behaviors Parent-Friends Normative Conflict Protective Factors Models for conventional Behavior High controls against Deviant Behavior Social Environment Risk Factors Poverty Normative Anomie Racial Inequity Illegitimate Opportunity Protective Factors Quality Schools Cohesive Family Neighborhood Resources Interested Adults Biology/ Genetics Risk Factors Family history of alcoholism Protective Factors High intelligence Risk & Protective Behaviors Adolescent Risk Behaviors/Lifestyles Problem Behaviors Health-Related Behaviors School Behavior Risk Behaviors Unhealthy Eating Tobacco Use Illicit drug use Delinquency Truancy Dropout Health/Life-Compromising Outcomes Health Social Roles Personal Development Preparation for Adulthood Risk Outcomes School failure Social Isolation Legal Trouble Disease/Illness Lowered fitness Limited work skills Unemployability Amotivation Inadequate Self-Concept Depression/ Suicide Reference: Jessor, 1991

  6. Key Intervention Population Proximal outcomes Recommendation outcomes Analytic Framework Parenting/Caregiver Interventions Adolescent’s knowledge, attitudes, or perceptions about risk/protective behaviors Adolescent risk behaviors Caregiver behaviors (e.g., monitoring, communication) Caregivers of Adolescents (Parents, guardians, others) Caregiver & adolescent relationship dynamic Adolescent health outcomes Adolescent protective behaviors Caregiver’s knowledge, attitudes, or perceptions about adolescent’s risk/protective behaviors Adolescent opportunity/motivation to engage in risk/protective behaviors

  7. Relative Change Among Risk Behaviors (8 studies, 8 study arms, 32 data points) Toumbourou 2002 (suicidal) Toumbourou 2002 (self-harm) Toumbourou 2002 (delinquent) Toumbourou 2002 (mult subst use) Toumbourou 2002 (substance use) Rotheram-Borus 2001 (hard drugs) Rotheram-Borus 2001 (marijuana) Rotheram-Borus 2001 (drinking) Bauman 2000 (drinking) Rotheram-Borus 2001 (non-cessation) Rotheram-Borus 2001 (smoking) Bauman 2000 (smoking) Rotheram-Borus 2002 (sex partners) Postrado 1992 (sexual onset) Wu 2003 (fighting) Li 2002 (fighting) Wu 2003 (bat/stick) Wu 2003 (knife/razor) Li 2002 (carried a weapon) Wu 2003 (illicit drugs) Wu 2003 (marijuana) Li 2002 (marijuana) Wu 2003 (drinking) Li 2002 (drinking) Wu 2003 (smoking) Li 2002 (smoking) Wu 2003 (non condom use) Wu 2003 (anal sex) Dancy 2006 (sex) Wu 2003 (sex) Li 2002 (sex) DiIorio 2006 (non condom use) No treatment comparison group Alternate treatment comparison group Treated comparison group Relative Percent Change Favors Intervention

  8. US Preventive Services Task Force Recommendation The Task Force recommends person-to-person interventions intended to modify adolescents’ risk and protective behaviors by improving their caregivers’ parenting skills on the basis of sufficient evidence of effectiveness in reducing adolescent risk behaviors. These interventions are conducted either face-to-face or by telephone and occur outside of clinical settings.   

  9. What this recommendation means for your project • The available evidence suggests working with parents or other caregivers through direct, interpersonal contact can affect adolescents’ risk and protective behaviors • Use of tobacco was not uniquely investigated but was one of the cross-cutting behaviors • Risk and protective behaviors that are in addition to tobacco may also be affected by parenting interventions. This could increase the appeal for parents.

  10. What are ways caregivers can be involved • Communication between parent and adolescent • Monitoring and supervision • Role modeling

  11. Guideline for Parents: Communication • Talk directly to children about the dangers of tobacco use • Educate and dispel the myths (e.g., spit tobacco and cigars are not safe alternatives) • Personalize tobacco’s impacts • Loss of friends or family • Challenges of quitting • Start early (around 5 or 6) and keep it up through teen years and possibly beyond • Deglamorize tobacco depicted in media • Denormalize tobacco use for teens • Teach refusal skills

  12. Guidelines for Parents: Monitoring and Supervision • Know where the child/adolescent is and what he or she is doing • Know if the child’s friends use tobacco • Limit access for purchasing tobacco • Limit access to tobacco products in the home and friends’ homes

  13. Guidelines for Parents: Role Modeling • If parents use tobacco, encourage them to quit • Consider not using around the children • Take it outside and communicate why you are doing this • Don’t offer tobacco products to youth and make sure tobacco products aren’t where children can have access

  14. Incorporating Parenting Interventions into Grant Activities • What are examples of past successes? • What are other ideas?

  15. Brainstorming Key Barrier and Potential Facilitators Key Barrier: Parents and other caregivers lack the time and motivation to participate What are some ways that you can: • Make it easier to participate than not to participate? • Make it fun? • Make it worth their time?

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