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Enhancing parental capabilities - Helping Families h ... Parenting influences every phase of a child’s development • School attainment • Peer relationships • Obesity/health

Aug 12, 2020

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  • Enhancing parental capabilities

    Matthew R Sanders, Ph.D.

    Parenting and Family Support Centre

    The University of Queensland

    HFCC, Sydney, February 2014

  • At a glance

    Why parenting is so important

    Challenges facing the

    field

    Enhancing impact

    What’s next

  • Parenting influences every phase of a

    child’s development

    • School attainment

    • Peer relationships

    • Obesity/health

    • Antisocial behavior/drug use

    • Sexuality/HIV

    • Preparedness

    • Social skills

    • Early literacy

    • School readiness

    • Secure attachment

    • Emergent language

    • Emotion regulation

    Early years

    Preschool

    transition to school

    Middle childhood

    Adolescence

  • Improving parenting is a common pathway

    to achieving diverse child outcomes

    Child benefits

    of positive parenting

    Improved child well being

    Reduced child maltreatment

    Reduced child social, emotional

    behavioral problems Reduced risk for

    later problems (academic failure, substance abuse,

    delinquency)

    Greater success at school, work,

    and in relationships

  • Many different children benefit

    Child

    problems

    Conduct

    problems (ODD, CD, ADHD)

    Chronic health

    problems (Obesity, feeding

    problems, asthma,

    eczema, diabetes)

    Internalizing

    problems (Anxiety,

    depression,

    trauma)

    School

    problems (Peer relations,

    classroom

    behaviour)

    Children with

    developmental

    disabilities (ASD,II, traumatic

    brain injury, CP)

  • …and many important adult outcomes

    Adult benefits

    of positive parenting

    Improved self efficacy

    Improved relationships

    and social support

    Reduced family conflict

    Reduced personal distress

    Greater success at work

  • Three more P’s

    Benefits to children,

    parents and communities

    Powerful

    Pervasive

    Persistent

  • Increasing policy level recognition of

    the importance of parenting programs

  • Child

    benefits

    Parent/s

    benefits

    “Child and

    Family”

    friendly

    environment

    Positive

    support for

    children’s

    development

    Community

    benefits

  • Self regulation is important to enhancing

    parental capability

    Parental

    Self regulation

    Self- management

    Self-efficacy Personal agency

    Self- sufficiency

    Minimally

    Sufficient

    Intervention

    R e

    d u

    c e d n

    e e d f

    o r

    s u p p o rt

  • Parental self regulation

    in action

    • Has a clear sense of purpose

    • Knows what behaviours, skills

    and values to promote as a

    parent

    • Has realistic expectations

    • Self-monitors automatically,

    rather than consciously or

    deliberately

    • When personal standards/values

    are violated she brings her

    current behaviour under personal

    control

    • Tunes into her own actions and

    searches for explanations

    • Uses her knowledge to develop

    options and plans

    • Carries out plan and revises plan

    as needed

    • Expects that she can bring about

    good outcomes

    • Is reflective, capable of identifying

    strengths and weaknesses, without

    being unhelpfully self critical

    • Reflections increase her self

    efficacy

    • Mostly enjoys the process

  • Self regulatory capability is

    influenced by context and be learned

    Parental

    capacity

    • Substance abuse

    • Serious mental health problems

    • Family violence

    • Lack of social support

    • Poverty (unemployment)

    • Lack of parental knowledge

    • Lack of preparation

    • Adverse life events (disasters)

    • Teamwork partner support

    • Extended family support

    • Social support

    • Access to parenting programs

    • High quality child care and

    schools

    • Primary heath care services

    Weaken

    Strengthen

  • Why parenting is so important

    Challenges facing the

    field

    Enhancing impact

    What’s next

  • Are we there yet?

  • Tension between the relative merits of

    universal and targeted interventions

    Targeted

    interventions

    for vulnerable

    families

    Universal

    interventions

    for all

    families

  • A blended approach needed

    Level 5

    Level 4

    Level 3

    Level 2

    Level 1

    Intensive family Intervention………................

    Broad focused parenting skills training………...

    Narrow focus parenting skills training………….

    Brief parenting advice……………………………

    Media and communication strategy…………….

    Breadth of reach

    In te

    n s ity

    o f in

    te rv

    e n tio

    n

  • Addressing

    ongoing

    challenges

    Achieving wider

    reach

    Improving our

    interventions

    Improving

    implementation quality

    Better

    outcomes

    for children

    and parents

  • Achieving

    wider reach

    Wider adoption

    of a population

    approach

    Normalise

    parenthood

    preparation

    Winning “hearts

    and minds”

    More

    families

    participate

    at lower

    cost

  • Why do we need a population approach? Children in the clinically elevated range on the SDQ

    (N=1500)

    M = 8.2

    N

    Scores

    Clinical range

    N = 119

  • What if we moved the population mean down

    .5SD

    M = 8.2

    N

    Scores

    Clinical range M = 5.5

    N = 99

  • Percentage Reduction

    M = 8.2

    M = 5.45

    N

    Scores

    Clinical range

    N = 99

    17% reduction

    20 Fewer Cases

    A potential saving of

    $5,255,980

  • What if we moved the population mean down

    1SD

    M = 8.2 Clinical range

    M = 5.5

    M = 2.7

    Scores

    N

    N = 79

  • Percentage Reduction

    M = 8.2 Clinical range

    M = 5.45

    M = 2.7

    Scores

    N

    N = 79

    34% reduction

    40 Fewer Cases

    A potential saving of

    $10,511,960

  • Evidence supporting population level effects is increasing

    Journal of Clinical Epidemiology (in

    press)

  • Population-based approaches can

    work and are very cost effective

    • Lower rates of child out-

    of-home (foster care)

    placements (d=1.22)

    • Lower rates of hospital-

    emergency room

    maltreatment injuries

    (d=1.14)

    • Substantiate cases of

    child maltreatment

    (d=1.09)

    • Benefit to Cost Ratio

    (return on one dollar

    investment) $8.74

  • Costs and benefits of prevention programs Source: WSIPP (January 2014, Inventory of Evidence-Based, Research-Based, and Promising Practices

    For Prevention and Intervention Services for Children and Juveniles

    in the Child Welfare, Juvenile Justice and mental Health Systems

    Prevention Program Manualized Classification Cost beneficial

    Circle of Security Yes Promising N/A

    Healthy Families America Yes Research based No (18%)

    Kaleidoscope Play and

    Learn

    Yes Promising N/A

    Nurse-Family Partnership Yes Evidence-Based Yes (76%)

    Other Home visiting

    programs

    Varies Research Based No (26%)

    Parent-Child Home Program Yes Promising No (26%)

    Parent Mentoring Program Yes Promising N/A

    Parents and Children

    Together

    Yes Promising N/A

    Parents as Teachers Yes Research Based No (36%)

    Promoting first relationships Yes Promising N/A

    Safe Babies, Safe Moms Yes Promising -

    Triple P System Yes Evidence based YES (100%)

  • Achieving

    wider reach

    Wider adoption of

    population

    approach

    Enhance

    individual

    capacity

    Winning “Hearts

    and Minds”

    More

    families

    participate

    at lower

    cost

  • How individuals deliver Triple P matters

    0

    200

    400

    600

    800

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