title: Child-Adult Relationship Enhancement in Primary Care (PriCARE): A Randomized Trial of a Parent Training for Child Behavior Problems.
abstract: Child-Adult Relationship Enhancement in Primary Care (PriCARE) is a 6-session group parent training designed to teach positive parenting skills. Our objective was to measure PriCARE's impact on child behavior and parenting attitudes.
  
  
  
  Parents of children 2 to 6 years old with behavior concerns were randomized to PriCARE (n = 80) or control (n = 40). Child behavior and parenting attitudes were measured at baseline (0 weeks), program completion (9 weeks), and 7 weeks after program completion (16 weeks) using the Eyberg Child Behavior Inventory (ECBI) and the Adult Adolescent Parenting Inventory 2 (AAPI2). Linear regression models compared mean ECBI and AAPI2 change scores from 0 to 16 weeks in the PriCARE and control groups, adjusted for baseline scores.
  
  
  
  Of those randomized to PriCARE, 43% attended 3 or more sessions. Decreases in mean ECBI intensity and problem scores between 0 and 16 weeks were greater in the PriCARE group, reflecting a larger improvement in behavior problems [intensity: -22 (-29, -16) vs -7 (-17, 2), P = .012; problem: -5 (-7, -4) vs -2 (-4, 0), P = .014]. Scores on 3 of the 5 AAPI2 subscales reflected greater improvements in parenting attitudes in the PriCARE group compared to control in the following areas: empathy toward children's needs [0.82 (0.51, 1.14) vs 0.25 (-0.19, 0.70), P = .04], corporal punishment [0.22 (0.00, 0.45) vs -0.30 (-0.61, 0.02), P = .009], and power and independence [0.37 (-0.02, 0.76) vs -0.64 (-1.19, -0.09), P = .003].
  
  
  
  PriCARE shows promise in improving parent-reported child-behavior problems in preschool-aged children and increasing positive parenting attitudes.
authors.affiliation: Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pa; Leonard Davis Institute of Health Economics, University of Pennsylvania School of Medicine, Philadelphia, Pa. Electronic address: Samantha_Schilling@med.unc.edu.
authors.forename: Samantha
authors.initials: S
authors.lastname: Schilling
authors.affiliation: Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pa.
authors.forename: Benjamin
authors.initials: B
authors.lastname: French
authors.affiliation: Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pa.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Berkowitz
authors.affiliation: PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, Pa.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Dougherty
authors.affiliation: Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pa.
authors.forename: Philip V
authors.initials: PV
authors.lastname: Scribano
authors.affiliation: Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pa; PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pa; Leonard Davis Institute of Health Economics, University of Pennsylvania School of Medicine, Philadelphia, Pa.
authors.forename: Joanne N
authors.initials: JN
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D000328:Adult; D001290:Attitude; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D004505:Education, Nonprofessional; D004645:Empathy; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000193:education*; D011209:Power, Psychological; D011320:Primary Health Care; D000066553:Problem Behavior; D011678:Punishment; D055815:Young Adult
keywords: behavioral problems; corporal punishment; parent training; primary care