title: Randomized trial of a cellular phone-enhanced home visitation parenting intervention.
abstract: OBJECTIVE
  Although home visiting programs have been documented to improve parenting in high-risk families, their effectiveness is diminished when parents disengage from programs. Cellular phones offer an approach to promoting parent engagement and enhancing parenting outcomes. Our objective was to examine whether mothers in a parenting intervention, Planned Activities Training (PAT), or cellular phone-enhanced version (CPAT) of the intervention would demonstrate greater use of parenting strategies after treatment and at 6 months post-treatment compared with a wait-list control (WLC).
  
  
  METHODS
  A sample of 371 low-income mothers and their 3.5- to 5.5-year-old children were randomly assigned to condition and assessed at pre-test, post-intervention, and 6 months post-intervention. Treatment efficacy was evaluated through observations of mother-child interactions as well as maternal interviews about depression, parenting stress, and child behaviors.
  
  
  RESULTS
  Mothers receiving PAT and CPAT demonstrated more frequent use of parenting strategies and engaged in more responsive parenting than mothers in the WLC. Mothers receiving CPAT used more PAT parenting strategies than mothers in the other 2 groups and experienced greater reductions in depression and stress. Children of mothers receiving PAT and CPAT demonstrated higher rates of positive engagement, and children of CPAT mothers demonstrated higher levels of adaptive behaviors than children in the WLC. Importantly, changes in parenting, depression, and stress predicted positive child behaviors.
  
  
  CONCLUSIONS
  PAT and CPAT conditions improved parenting strategies and child engagement and reduced children's challenging behaviors. The addition of cellular phones to a home visiting program enhanced maternal responsivity and reduced depression and stress.
authors.affiliation: Juniper Gardens Children's Project, University of Kansas, 444 Minnesota Ave, Suite 300, Kansas City, KS 66101. carta@ku.edu.
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Carta
authors.forename: Jennifer Burke
authors.initials: JB
authors.lastname: Lefever
authors.forename: Kathryn
authors.initials: K
authors.lastname: Bigelow
authors.forename: John
authors.initials: J
authors.lastname: Borkowski
authors.forename: Steven F
authors.initials: SF
authors.lastname: Warren
mesh_terms: D000293:Adolescent; D040421:Cell Phone; D002675:Child, Preschool; D003863:Depression / Q000523:psychology / Q000628:therapy; D004505:Education, Nonprofessional / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006792:House Calls; D006801:Humans; D008297:Male; D009034:Mother-Child Relations / Q000523:psychology*; D016487:Parenting / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy
keywords: externalizing problems; home visitation; internalizing problems; intervention; maternal depression; parenting; parenting stress; randomized controlled trial; technology