Clinical Trial Details
— Status: Not yet recruiting
Administrative data
| NCT number |
NCT06329336 |
| Other study ID # |
STUDY00019653 |
| Secondary ID |
UL1TR002319 |
| Status |
Not yet recruiting |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
June 1, 2024 |
| Est. completion date |
April 2025 |
Study information
| Verified date |
April 2024 |
| Source |
University of Washington |
| Contact |
Liliana J Lengua, PhD |
| Phone |
206-543-5655 |
| Email |
liliana[@]uw.edu |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
Together with the Community Care Team of King County Community Partnership for Transition
Solutions (KCCPTS), the investigators propose to collaborate in adapting parenting
intervention(s) to support the well-being and effective parenting of parents re-entering the
community, as well as that of their children's primary caregiver. The aim is promoting the
well-being of the parents/caregivers and their children, fostering positive child
development, and ultimately, preventing the intergenerational transmission of adversity. The
KCCPTS Community Care Team includes re-entry navigators who have lived experience of
adversity and incarceration, bringing their unique insights regarding the re-entry
experience, from both personal and professional experiences. This study will evaluate a
task-sharing approach to offering formerly incarcerated parents and their families a
parenting support intervention. That is, re-entry navigators will be trained to deliver
evidence-based parenting interventions. This increases the feasibility and accessibility of
the program, particularly because facilitators have shared experiences and trusted
connections with their clients. This project proposes four main activities: 1) conduct focus
groups with parents re-entering the community to better understand their parenting needs, 2)
work with KCCPTS re-entry navigators to incorporate information from their experience and the
focus group to adapt a parenting intervention, 3) train re-entry navigators to deliver the
program, and 4) conduct a preliminary evaluation of the impact of the program on parents'
well-being and parenting when the program is delivered by KCCPTS re-entry navigators. If this
preliminary evaluation shows promise in supporting parent well-being and parenting
effectiveness, the investigators will seek funding to conduct a larger, more rigorous
evaluation.
Description:
Research Plan: The incarceration of a parent is associated with a higher likelihood of
children living in poverty, increased likelihood of needing mental health services and
involvement in child protective service, increases in teen crime, and significant decreases
in educational attainment and adult employment. Incarceration disproportionately affects
families of color and those living in poverty, and impacts children's long-term ability to
emerge from poverty in adulthood, increasing the rate of intergenerational transmission of
adversity and incarceration. Thus, it is critical to support families experiencing the
incarceration of a parent. It is equally important to provide parents returning home from
prison with programs that equip them with parenting strategies and techniques to buffer the
potentially adverse outcomes of parental incarceration on their children's socioemotional
development. It may be the case that parenting programs post release may in fact serve to
reduce recidivism.
The proposed project arises out of a request from KCCPTS, stemming from their recognition of
the parenting needs of their clients and the desire to break the cycle of intergenerational
transmission of adversity and incarceration. Parents returning to their families after
incarceration have unique experiences and needs as they work to strengthen their
relationships with their children. In addition to potential challenges connecting with and
parenting their children, they often experience mental health issues related to their adverse
childhood experiences (ACEs) and incarceration. This may contribute to the intergenerational
transmission of adversity and incarceration. While parenting interventions exist, they do not
specifically address the unique needs of formerly incarcerated parents. Additionally, they
are expensive or hard to access, and do not explicitly address the mental and emotional
well-being of the parent to support more effective parenting. Caregivers for the children
while the parent was incarcerated, usually the other parent or a grandparent, also experience
adversity and challenges with parenting, and may benefit from support as they surrender the
parenting role or co-parent with the formerly incarcerated parent. The proposed project would
equip staff with tools to more effectively support the well-being of parents, children and
caregivers through a task-sharing approach.
A task-sharing model for prevention is a promising approach to addressing the need for
interventions in low-resource settings with a limited workforce to meet the need. In
task-sharing, staff currently working with community organizations serving children and
families are trained to deliver prevention programs. These staff often have developed
trusting relationships with the families they serve, and thus interventions can be
incorporated into regular services at little additional cost to the organization. Finally,
after staff are trained, the tools and resources remain with the community. Such an approach
holds tremendous promise for making preventive parenting interventions more accessible in
communities that often do not have access to evidence-based interventions due to resource,
language, or time barriers. Research evaluating such approaches provides knowledge about
innovative ways to improve mental health in low-resource communities, and a task-sharing
approach, if shown to be effective, offers a generalizable and scalable approach to improving
community mental health over time.
Project Aims: The investigators aim to evaluate a task-sharing approach to offering formerly
incarcerated parents and their families a parenting support intervention. That is, re-entry
navigators will be trained to deliver evidence-based behavioral parenting intervention(s)
that promote children's social-emotional and behavioral well-being. This will include
cognitive-behavioral and mindfulness practices for supporting parent well-being. The
task-sharing approach increases the feasibility and accessibility of the program,
particularly because facilitators have shared experiences and trusted connections with their
clients. This project proposes four main activities: 1) conduct focus groups with parents
re-entering the community to better understand their parenting needs and challenges, 2) work
with KCCPTS re-entry navigators to incorporate information from their experience and the
focus group to adapt an existing parenting intervention, 3) train re-entry navigators to
deliver the program, and 4) conduct a preliminary evaluation of the impact of the program on
parents' well-being and parenting when the program is delivered by KCCPTS re-entry
navigators.
Research Plan: Preliminary studies. The Center for Child and Family Well-being (CCFW) has
convened a multidisciplinary group of collaborators to conduct research on supporting
families experiencing the incarceration of a parent. The goal is to evaluate approaches to
supporting the whole family experiencing a parent's incarceration. Collectively, the
researchers have developed and implemented interventions for parents who are currently or
formerly incarcerated (Charles, Pace) as well as a parenting program for parents living in
poverty or who are experiencing homelessness (Lengua). The proposed study would add to this
body of evidence that a task-sharing approach can address accessibility and feasibility of
prevention programs.
Research design. This project includes 4 research phases related to the study aims:
Aim 1: Conduct 2 focus groups with parents re-entering the community to better understand
their parenting needs. KCCPTS will facilitate the invitation of 5-7 women and 5-7 men who are
parents re-entering the community to participate in 2 separate focus groups led by a UW
research coordinator. The goal of the focus group is to obtain information on parents'
perspectives on their experiences, goals, and preferred approaches to supporting their
relationships with their children. Focus groups will be 1.5 hours and held at KCCPTS
facilities. Structured questions with potential follow-up discussion questions will be
developed together with KCCPTS staff and clients.
Aim 2: Work with KCCPTS re-entry navigators and clients to incorporate their experiences and
focus group information to adapt an existing parenting intervention to be more relevant to
formerly incarcerated individuals. Re-entry navigators' and parents' expertise will be used
to select and adapt a program (e.g., Parenting Inside Out [PIO, Eddy et al., 2008]; Pathways
for Parents [P4P, Charles et al., in press]; Social, Emotional Attunement for Children &
Parents [SEACAP, Lengua et al., 2018]). KCCPTS and research team members will incorporate
changes to the selected program(s) based on focus group findings and staff experiences.
Changes will be incorporated into program manuals to standardize delivery.
Aim 3: Train re-entry navigators to deliver the program. KCCPTS staff who have already
participated in the REAL Pro training will participate in 8-10 hours of training in the
concepts and practices of behavioral parenting and delivering parenting,
cognitive-behavioral, and mindfulness content. Training will be delivered by Dr. Charles (for
PIO/P4P), Dr. Lengua (SEACAP), and CCFW staff.
Aim 4: Conduct a preliminary evaluation of intervention effects on parents' and children's
well-being and parenting behaviors when the program is delivered by KCCPTS re-entry
navigators. Navigators will offer 2 groups, one each to mothers and fathers, with 6-8
participants in each group. The evaluation will include pre-/posttest assessments conducted
by RAs. Assessments will include measures of participant and child mental health, well-being,
parenting behaviors and sense of competence, and satisfaction ratings. Assessments will be
approximately 30 minutes, including obtaining informed consent and administering all
measures.
Measures. Assessments will include CCFW's program evaluation protocol: demographics,
depression (PHQ-9), anxiety (GAD7), Difficulties with Emotion Regulation, Self-Compassion
Scale, Brief Resilience Scale, Flourishing Scale, stress (General Life Events and Perceived
Stress Scales), ACEs, Everyday Discrimination Scale, Positive Relations with Others subscale
of the Psychological Well-being measure, Parenting Behavior Inventory - Very Short Form,
Parent Sense of Confidence Scale, Strengths and Difficulties Questionnaire of child
social-emotional and behavioral adjustment.
Impact: Evidence from the proposed study will be shared with KCCPTS in planning ongoing
collaboration, as well as in international conference presentations. The findings would
support a more rigorous evaluation of the effectiveness of preventive interventions when
delivered by staff working in community organizations serving families experiencing
adversity. With adequate funding, future research can explore the critical downstream impact,
including improved developmental outcomes for children and decreases in the need for more
intensive mental health services for parents. Evaluation of a scalable model for delivering
parenting interventions to promote well-being in parents and children offers a promising
approach to addressing social inequities by ensuring access to evidence-based prevention
programs.
