The benefits of an enhanced Nobody's Perfect Parenting Program for child welfare clients including non-custodial parents

Children and Youth Services Review 34 (2012) 2081–2087

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The benefits of an enhanced Nobody's Perfect Parenting Program for child welfare clients including non-custodial parents☆ Deborah J. Kennett a,⁎, 1, Gail Chislett b, 1 a b

Department of Psychology, Trent University, Peterborough, Ontario, Canada Health Promotion Division, Peterborough County-City Health Unit, 10 Hospital Drive, Peterborough, Ontario, Canada K9J 8M1

a r t i c l e

i n f o

Article history: Received 27 April 2012 Received in revised form 27 June 2012 Accepted 6 July 2012 Available online 16 July 2012 Keywords: Nobody's Perfect Program Learned resourcefulness Non-custodial Attendance Parenting self-efficacy Parent resourcefulness

a b s t r a c t A mixed-methods pilot project was conducted to study the effect of participation in an enhanced Nobody's Perfect Program (NP) composed of 12 three-hour weekly sessions. The 73 study participants were clients of the child welfare system. Prior to the program, parents completed demographic information, along with self-report measures assessing learned resourcefulness, the types of interactions with their children, parent resourcefulness, knowledge and use of resources, parent competency, and self-efficacy. Measures were completed again after the program and at a two month follow-up testing. Results revealed that 53% of parents completed the program, with non-completers more likely having less education. For program completers, significant improvements were observed in knowledge and use of community resources, positive parenting interactions and parenting resourcefulness, with gains in parenting competence and efficacy approaching significance. Parents completing the program described in rich detail their satisfaction with the enhanced version of NP in an exit focus group interview. Recommendations for parents facing multiple challenges are discussed. © 2012 Elsevier Ltd. All rights reserved.

1. Introduction Most perpetrators of infant and child maltreatment are parents (e.g., Public Health Agency of Canada, 2010), with a reported child maltreatment incidence rate of 10.6 per 1000 children in the U.S. (U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, 2010). The main (and often co-occurring) risk factors for child maltreatment have been found to be parental substance abuse (Street, Whitlingum, Gibson, Cairns, & Ellis, 2008), parental mental illness (Howard, Thornicroft, Salmon, & Appleby, 2004), intimate partner violence (Dixon, Hamilton-Giachritsis, Browne, & Ostapuik, 2007), child conduct problems (Barth, 2009), and poverty (Arditti, Burton, & Neeves-Botelho, 2010). Selective parenting education programs have been developed to address one or more risk factors in an attempt to reduce the incidence of child maltreatment (e.g., Barth, 2009; Mikton & Butchart, 2009; Ronan, Canoy, & Burke, 2009). These interventions are intended to prevent an initial occurrence of maltreatment, prevent a re-offence, increase parenting capacity, promote family reunification, or facilitate contact between the biological ☆ This research was supported by the Ontario Trillium Foundation, grant ID #9972187. ⁎ Corresponding author at: Trent University, 1600 West Bank Drive, Peterborough, Ontario, Canada K9J 7B8. Tel.: +1 705 748 1011x7770; fax: +1 705 748 1580. E-mail addresses: [email protected] (D.J. Kennett), [email protected] (G. Chislett). 1 Ordering of authorship was randomly determined. Level of contribution to the research was equal. 0190-7409/$ – see front matter © 2012 Elsevier Ltd. All rights reserved. doi:10.1016/j.childyouth.2012.07.001

parent and child when reunification is not possible but contact will contribute to the child's psychological and emotional well-being and safeguard their identity needs (Thomson & Thorpe, 2004). Although parent education programs have shown promise in reducing child maltreatment (e.g., Lundahl, Nimer, & Parsons, 2006; Prinz, Sanders, Shapiro, Whitaker, & Lutzker, 2009), most do not specifically deal with multiple parental problems and the major risk factors of child maltreatment (e.g., Asawa, Hansen, & Flood, 2008; Barth, 2009), perhaps accounting for the mixed evidence relating to the prevention of abuse (e.g., Law, Plunkett, Taylor, & Gunning, 2009; Mikton & Butchart, 2009). One parent education program serving parents with risk factors for child maltreatment is Nobody's Perfect (NP). NP was developed by Health Canada in collaboration with its target group of parents who are young, single, socially isolated, geographically isolated, or who have limited formal education or income. The program helps parents of children up to five years of age to increase their parenting knowledge and skills and promote the healthy development of their children. Parent development is a primary goal. NP is usually offered as a series of eight two-hour sessions held once a week in a community location. The program covers topics such as child development, child behavior management, nutrition, health, safety, first aid, budgeting, and stress and anger management, and incorporates the principles and delivery of adult education (Wood Cantano, 2000). Participants select their topics as a group, by consensus, set personal goals and are self-directed. NP emphasizes the importance of experiential learning and respects life-experience.

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A participant-crafted “group agreement” guides group functioning. Pairs of trained co-facilitators lead the group using a manualized process, and an interactive, congenial, non-judgmental and empathetic approach. Delivery is respectful, actively involves participants in their learning, involves cooperative learning (e.g., group discussions, shared thoughts and experiences), provides opportunities to practice skills and reflect on one's personal situation and experience and uses small group activities to promote problem-solving, learning and building on knowledge. The program is offered free of charge, and parenting books, transportation assistance, childcare and snacks are provided. Parents earn a certificate for completing the program. Evaluations of NP indicate that participants improve their parent– child interactions and increase their problem-solving abilities, stress coping skills, perceptions of social support and use of effective behavior management techniques (Skrypnek & Charchun, 2009). Chislett and Kennett (2007) found parents earning NP certificates demonstrated and maintained a significant increase in parenting resourcefulness, warm/positive parent–child interactions, parenting competency and satisfaction, and knowledge of and use of community resources. The authors linked gains to number of sessions attended and recommended holding series of 10–12 sessions. Kennett, Chislett, and Olver (2012) reappraised the program, introducing a measure of general learned resourcefulness and emphasizing the importance of this construct in program outcomes, as they found positive gains in both general and parenting resourcefulness skills at the end of NP. Highly resourceful people cope with everyday life demands by using positive self-instructions, applying problem solving methods and delaying immediate gratification (Rosenbaum, 1990, 2000). Learned resourcefulness is unrelated to IQ, education level and socioeconomic status in adults (Derry, Chovaz, McLachlan, & Cummings, 1993). Research on the development of learned resourcefulness skills points to a strong relationship between the degree of resourcefulness exhibited by a child and the characteristics of the child's family, especially those of the mother (Preechawong et al., 2007; Türkel & Tezer, 2008; Zauszniewski, Chung, Chang, & Krafcik, 2002). Thus, one would expect, given NP's experiential and problem-solving focused approach, this program to promote general learned resourcefulness, as was the case in Kennett et al.'s (2012) study. Traditionally, about half of the parents attending NP in Peterborough, Ontario and surrounding areas disclose child welfare involvement. Children's Aid Society (CAS), a child welfare agency, and the court system refer parents to attend NP to improve their ability to care for their children. An uneasy truce has been noted at times between NP participants who are non-custodial clients of CAS and participants in the same NP group having no dealings whatsoever with child welfare. In addition, high rates of attrition are often seen in non-custodial parents disclosing multiple hardships and challenges (Kemp, Marcenko, Hoagwood, & Vesneski, 2009; Salveron, Lewig, & Arney, 2009). In an effort to better meet the needs of child welfare clients, for this investigation, enhanced NP series were piloted as a selective intervention for CAS referrals, both custodial and non-custodial. Although other interventions with a stronger evidence base are offered in Peterborough and focus on the positive management of child conduct problems, NP was the intervention of choice based on its broad scope in addressing multiple parental problems; and wide topic range (all aspects of child rearing, and safe and healthy lifestyles). NP helps parents to address their circumstances and refers them to other community interventions, including other evidence-based parenting programs. In keeping with the previously noted recommendations for selective parenting programs and in acknowledgment of the good track record of the program, the enhanced model uses the same course material and learning approach as the regular NP program. Rather, the program is expanded into a series of 12 three-hour weekly sessions, so facilitators can provide a slower pace, if necessary, and more information, repetition, practice and review. Unlike the regular group, each session ends with

home-learning guidelines. And, instead of using a paper consumer evaluation, a focus group is held to discuss participant satisfaction, learning and delivery recommendations. Each subsequent session begins with a discussion about the application of the previous week's lesson in the home. Refreshments are provided twice during each session, in contrast to once in a regular session. Thus, this study was designed as an open-trial pilot project to provide preliminary data on the usefulness of the enhanced model of NP for child welfare clients facing multiple challenges, some of whom do not have their children in their care. At program completion, we expected to see improvements in general learned resourcefulness, parenting resourcefulness, parent–child interactions, confidence in the parenting role, and knowledge and use of community resources, with maintenance of gains at follow-up. Sustaining engagement is often a challenge with child welfare participants. Thus, it is important that studies of selective programs capture qualitative as well as quantitative data (Law et al., 2009). Analysis of exit focus discussion's transcripts provided additional qualitative evidence regarding participants' satisfaction with the program, perceptions of their gains, and views about program delivery will be discussed. 2. Method 2.1. Participants The average age for the 73 participants was 26.11 years (SD = 8.12), ranging from 16 to 55 years. Given the local demographics, it was not surprising that most parents identified themselves as belonging to no ethnic group; however, 3 identified themselves as native, 3 as half-native and 1 as black. Of the sample, 59% were females, 90% reported household incomes of $20,000 or less per year, 43% reported being single parents, 56% were custodial parents of up to 4 children, 34% had completed at least secondary school education, 67% reported no difficulty reading, 25% had attended a non-enhanced version of NP previously, and 90% had never attended a parenting program of another type before this one. Although 58% had at least one child between the ages 1 to 3 years, 42% had only one child less than one year of age. 2.2. Measures Unless otherwise indicated, participants rated the items of each scale from 1 (strongly disagree) to 4 (strongly agree). For all of the scales, a higher score or sub-score reflects a more positive parenting practice or personal attribute. Construct validity and reliability of all the scales/subscales are discussed by Chislett and Kennett (2007) and Kennett et al. (2012), along with reported means and standard deviations. The Parent–Child Interaction Scale is a 13-item parenting behavior scale (Oldershaw, 2002) and, according to factor analysis, has 3 dimensions: 4 items assess positive/warm interactions, 5 items assess angry and punitive parenting, and 4 items assess ineffective child management. Each item is rated on a 6-point scale from 1 (never) to 5 (always), and 0 (not applicable to me). Further information on this scale can be retrieved from http://www.ucalgary.ca/~landru/ adc/kids/k96-9a.htm#9.9. The 33-item Parent Resourcefulness Scale assesses the extent to which parents use positive self-statements, problem-solving strategies, delay of immediate gratification, among other self-control strategies to cope with the demands of parenting (Walker, 1990). Using a 5-point scale, parents indicate the extent to which they agree with each statement (0 = not applicable to me, 1 = strongly disagree to 4 = strongly agree). Total scores can range from 0 to 132. The 11-item Knowledge and Use of Resources Scale was developed by Chislett and Kennett (2007) to assess parents' knowledge

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and use of the general array of family resources and supports located within the community. Total scores can range from 11 to 44. Factor analysis of the 12-item Parenting Sense of Competence Scale (Ohan, Johnston, & Leung, 2000), reveals two dimensions: parental efficacy, and parental satisfaction. Scores on each of these two dimensions can range from 6 to 24. In contrast to the self-efficacy dimension of the Parenting Sense of Competence Scale, the 11-item Parent Efficacy Scale (Chislett & Kennett, 2007) assesses the extent to which parents believe that they have the general ability to overcome the stressors of being parents. Total scores can range from 11 to 44. Rosenbaum's (1980) Self-Control Schedule (SCS) is widely used in the literature to assess the learned resourcefulness skills people use to cope with everyday life upsets and demands. It consists of 36 items, which are rated on a six-point Likert scale ranging from − 3, very uncharacteristic of me, to + 3, very characteristic of me. In the management of their everyday life, individuals are asked to what extent they rely on problem-solving strategies, use positive self statements to cope with stressful situations, and are able to delay gratification. Scores can range from − 108 to 108.

At least ten topics were to be covered in each series. Topics were chosen by participants from a menu of options, by consensus. All groups discussed positive communications, healthy relationships and community resources, and chose the topics of child behavior, child discipline, safety, first aid and CPR, anger management, stress management and budgeting. Seven of the nine groups also chose child development, nutrition and child routines. A few groups covered child illness, baby care, attachment and/or children's healthy sexual development as well. Two groups discussed addictions. Facilitators completed two questionnaires during each series. The first questionnaire was e-mailed after the third session, and was intended to monitor delivery (e.g. “Do you end each session with guidelines for home-learning and a review of the topic?”) and elicit practitioner feedback (e.g. “Do you think the recorded focus groups give parents more feelings of ownership than the written evaluations do?”). The final questionnaire, completed after the series ended, included questions like, “How well does this model fit the target group?”, “How did parents benefit from attending an “enhanced” series?”, “Did you see more changes in parents who attended the “enhanced” series, compared to parents attending a “regular” series? If so, what did you see?” and “What changes would you make to this model?”

2.3. Procedure

3. Results

Local CAS case workers recruited clients, with some being mandated to attend a parenting program. Interested parents were informed about the study and demographic information was obtained. At their first session of the enhanced program, participants agreeing to take part in the study (N = 73) completed ethical consent forms followed by the pre-test inventories conducted by independent assessors. Study participants comprised 63% of enhanced series parents (N = 116). Of the 43 parents who did not participate in the survey but attended the enhanced series, 65% (N = 28) were absent during the first session and missed the pre-test due to late registration, illness, or an appointment; 19% (N = 8) had previously attended an enhanced series and did not qualify for the study again; 14% (N = 6) refused to take the survey for undisclosed reasons; and 2% (N = 1) decided not to take the NP program. Respondents completed the same inventories at the end of the series (post-test, N = 42) and two months afterwards (follow-up test; N = 34). During testing conditions, surveys were read out loud, but some respondents having no difficulty reading preferred to work ahead. For completing all test conditions, respondents received a $30 Walmart gift card. Parents completing at least 8 of the 12 sessions earned a certificate, in accordance with local practice of requiring participants to attend at least two-thirds of the sessions. At the end of each session, a focus group was conducted and digitally recorded by facilitators, then transcribed with no identifiers. Participants were asked, for example, how they liked the session, if it was helpful, and how it could be improved. Facilitators reviewed the responses later, responded to concerns and followed suggestions as much as possible. The transcript was read back to participants at the subsequent session to confirm accuracy. The first eleven focus group interviews were intended to open communication channels, develop trust and exhaust demand responses. Only the final exit focus group transcript was used for the study. This interview was longer, and questions included: “What did you like about the program”, “What worked well and what didn't work well?”, “How has attending the program made a difference in your life?”, “What new things did you learn?”, “Describe the new skills that you are currently using at home.” and “What would you like to see done differently when the program is offered again?” Over the course of this 29-month study, nine enhanced NP series were held in community locations. Participants with phones received weekly reminder calls from the coordinator also confirming their taxi order.

3.1. Attendance and certificate earners Parents attended an average of 65% (SD= 32.73) of the sessions, ranging from 8.33 to 100%. Although only 53% of the study participants (N = 39) completed the program (i.e., at least 8 out of 12 sessions) and earned a certificate, 30% (N= 22) of them attended 12 out of 12 sessions. Data was not collected on the reasons for non-completion (N= 34), mainly due to loss of contact. However, some anecdotal information is available (N = 19). Three couples had their infants apprehended with no possibility of custody, and stopped coming to the series; four parents missed sessions due to personal or family member illness; four parents stopped coming due to relationship and/or housing issues; two parents missed sessions due to work; one parent was admitted to a treatment facility; one parent left the area; and one parent was incarcerated. Table 1 illustrates the number and percentage of parents not earning versus earning a certificate based on demographic information. Although certificate earners in comparison to non-certificate earners were more likely to be female and custodial parents, Chi-squared tests for independence failed to reach significance. Also, no significant differences were observed between the groups for reading level, number of children, being a single parent and number of previous parenting programs attended before this one. As well, most non-certificate and certificate earners lived in poverty having yearly incomes under $21,000Cd. Significant differences in educational level, nonetheless, differentiated the two groups, χ2 (1, N= 73) = 5.25, p b 0.05. Certificate earners were more likely to have attained at least a high school degree than non-certificate earners. For the certificate and non-certificate earners, Table 2 provides the mean (SD) scores attained for the inventories. In comparison to Chislett and Kennett's (2007) and Kennett et al.'s (2012) studies not necessarily involving CAS clients and comprising mainly of custodial parents, parents of this study at pre-test were observed to have substantially lower scores on the parenting resourcefulness and parenting practices inventories, but had similar scores for the general resourcefulness, feelings of parenting competence and parenting efficacy measures. For parents of this study, independent t-tests showed no significant differences between these measures for certificate earners and non-earners at pre-test; however, there was a tendency for non-certificate earners to have slightly more confidence in their parenting efficacy than certificate earners, t (69) = 1.92, p = 0.06.

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Did not earn certificate

Earned certificate

resources, positive parent–child interactions and parenting resourcefulness, with increases in competence efficacy and parenting efficacy approaching significance (see Table 3 for F values and post hoc outcomes). Newman–Keuls post hoc analyses revealed that most of these significant increases were between pre and follow-up testing.

N

%

N

%

3.3. Relative pre/post gains

15 19

44.12 55.88

15 24

38.46 61.54

17 17

50.00 50.00

15 24

38.46 61.54

22 12

64.71 35.29

20 19

51.28 48.72

21 13

61.76 38.24

21 18

53.85 46.15

0 14 15 2 3

0.00 41.18 44.12 5.88 8.82

1 14 22 2 0

2.56 35.90 56.41 5.13 0.00

1 26 4 3 0

2.94 76.47 11.77 8.82 0.00

1 20 10 6 2

2.56 51.28 25.64 15.38 5.13

2 7 25

5.88 20.59 73.53

3 12 24

7.69 30.77 61.54

23 11

67.65 32.35

32 7

82.05 17.94

23 11

67.65 32.35

30 9

76.92 23.08

Hake's (1998) gain factor was used to determine the relative improvements parents made by the end of the program. Simply looking at differences between post–pre scores (i.e., absolute improvement) fails to take into account parents' skill or belief level at the start of the program. Thus, to determine relative improvement for each participant and inventory, the following equation was post−pretestscores used: maximumpossiblescore : pretestscore Pre/post relative gains in one parenting attribute were moderately to strongly in strength associated with pre/post relative gains in other parenting attributes. For example, participants showing greater relative gains in general learned resourcefulness also had greater relative gains in competence efficacy (r = 0.66, p b 0.001), competence satisfaction (r = 0.38, p = 0.03) and parenting efficacy (r = 0.61, p b 0.001). Moreover, greater relative gains in competence efficacy and parenting efficacy were related to greater relative gains in parenting resourcefulness (r = 0.39, p = 0.02 and 0.51, p = 0.002, respectively). Finally, gains in competence satisfaction were associated with greater relative gains in parenting efficacy (r = 0.36, p = 0.03) and greater knowledge about community resources (r = 0.87, p b 0.001). Attending a higher percentage of sessions was positively related to higher relative gains in effective child management (r = 0.37, p =0.03). Females showed considerably greater relative gains in effective child management over males (r = 0.36, p =0.03). Although there was a tendency for custodial parents to show higher relative gains in effective child management over non-custodial parents (r = 0.31, p = 0.08), there was a tendency for non-custodial parents to have greater relative gains in warm/positive parenting practices (r = -0.29, p = 0.09) and general resourcefulness (r = -0.32, p = 0.07). No other demographic features of the sample were related to relative gain scores.

Table 1 Demographic features of parents not earning NP certificates (N = 34) compared to those earning certificates (N = 39). Variables

Gender Males Females Parent Non-custodial Custodial Only one child less than 1 year old No Yes Single parent No Yes Income None b$10,000 $11,000–$20,000 $21,000–$30,000 $31,000–$40,000 Education Primary Some secondary Secondary Some post secondary Post secondary Difficulty reading A lot Some None Attended NP before No Yes Number of prior parenting programs, including NP None 1 or more

3.2. Pre-, post- and follow-up scores for program completers 3.4. Focus group results Table 3 provides the means (SDs) of the measures at pre, post and follow-up testing times for parents completing the program and earning a certificate. A series of one-way within-subjects ANOVAs revealed significant improvements in knowledge and use of community Table 2 Means (M) and standard deviations (SD) of selected variables comparing parents not earning NP certificates (N = 34) to those earning certificates (N = 39). Variables

% attendance Sense of competence — pre Efficacy — pre Satisfaction — pre Parent efficacy — pre Parenting resourcefulness — pre Parent–child interactions — pre Warm/positive — pre Non-angry/punitive — pre Effective management — pre Knowledge of resources — pre General learned resourcefulness — pre Notes. ⁎ p b 0.001. a N = 33. b N = 36. c N = 37. d N = 38.

Did not earn certificate

Earned certificate

M

SD

M

SD

33.33

17.16

92.31⁎

10.54

19.76 17.44 36.56 77.63

2.50 3.38 5.02a 26.36a

18.64 17.04 35.09 72.95

2.42c 2.61c 4.10d 31.31b

15.00 14.50 9.87 34.44 31.42

5.07a 8.34a 6.73a 4.07 31.86a

14.38 13.55 8.00 34.13 25.77

5.90c 8.64c 7.04c 4.35d 23.52b

For the most part, there was nothing parents disliked about the content of the program, with some wishing the series was longer or wanting to take the program again. In series with higher no-shows, parents wished they could have gotten to know the perspectives of these parents better. Topics that were often mentioned as the most beneficial and highly integrated into their own lives were budgeting, first aid/CPR, disciplining, and problem solving, and, for parents with toddlers, potty training was another valued topic. Some parents said the program empowered them, with the following quote as an example: “…the other things we do as parents like with CAS and stuff, sometimes the parents don't feel empowered, and this is a group that makes you feel empowered as a parent”. Many expressed valuing the facilitators' skill level and their ability to relate to and understand their personal needs. The most common general complaint of the program, especially for parents with school aged children, was that NP ran too late into the evening, making it difficult for them to get their child bathed and in bed by a reasonable time. Parents not having custody of their children reported it was difficult for them to do homework and practice newly learned skills. From a qualitative perspective, the enhanced program was most effective when groups were not too small (n = 3) or too large (n = 15), and for groups having a better mixture of gender, custodial and non-custodial roles, education and income level, and general and parenting skill level. Depending on the series clients were assigned, non-program completers were observed to be strikingly challenged on either one or more of the demographic (e.g., education, income)

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Table 3 Means (M) and standard deviations (SD) of pre, post and follow up results for the inventories for participants earning certificates and completing all test conditions (N = 30 to 32). Inventory

Pre M

Parenting sense of competence Sense of efficacy F(2,62) = 2.79, p = 0.07, η2 = 0.08 Sense of satisfaction F(2,62) = 1.08, p = 0.35, η2 = 0.03 Parent efficacy F(2,58) = 2.41 p= 0.10, η2 = 0.08 Parenting resourcefulness F(2,58) = 4.50, p = 0.02, η2 = 0.13 Parent–child interactions Warm/positive parenting F(2,60) = 4.01, p = 0.02, η2 = 0.12 Non-angry/punitive parenting F(2,60) = 0.53, p = 0.59, η2 = 0.02 Effective child management F(2,60) = 0.03, p = 0.97, η2 = 0.001 Knowledge and use of resources F(2,64) = 4.79, p = 0.01, η2 = 0.13 General learned resourcefulness F(2,62) = 0.32, p = 0.73, η2 = 0.01

Post SD

M

Follow-up SD

M

SD

19.20 2.23 Pre vs. follow-up, p= 0.06⁎ 17.70 2.95

19.56

2.37

20.26

2.32

18.30

2.44

18.49

2.85

35.69 4.71 Pre vs. follow-up, pb 0.10⁎ 80.10 28.27 Post vs. follow-up, p = 0.01⁎

37.30

4.63

37.00

4.39

74.90

31.39

85.00

23.93

15.16 4.78 16.42 Pre vs. post, p = 0.08 and pre vs. follow-up, p = 0.02⁎ 14.52 7.42 14.16

4.83

17.10

2.40

9.19

15.58

7.98

7.14

8.85

6.25

3.90

36.61

4.96

24.48

31.60

19.02

8.61

6.92

8.80

34.09 4.89 35.14 Pre vs. follow-up, p= 0.01 and post vs. follow-up, p = 0.08⁎ 29.39 22.55 29.52

Note. ⁎ Significance based on Newman–Keuls post hoc test.

or psychological (e.g., general coping skill level, satisfaction with parenting and/or child–parent interactions) variables or both. For instance, in one series, where only two of the six parents earned a certificate, all of the four non-completers were males, not in a parenting role, and had either low parenting satisfaction or efficacy scores and three of them earned less than $10,000 per year. Nonetheless, even for most severely skill deficit and demographically stressed parents completing the enhanced program, inventory scores and focus group data revealed that almost all of them reaped gains in their parenting skills and confidence. 3.5. Facilitator feedback There was an overwhelming and unanimous support for the enhanced over the original version of the program. All facilitators indicated that the increased number of sessions and the longer session duration allowed for more repetition of the material, a sense of trust to develop, client involvement/input, more time to talk about “routine”, and bonding among parents. Facilitators stated that “groups formed friendships and were more receptive as time went on”, and that “sharing with one another and high attendance rates excited them”. The most common concerns among facilitators included the inconsistent attendance, reluctance of parents to do homework (especially non-custodial parents) and late evening sessions. Facilitators concurred that parents completing the homework came back to the group with a more positive outlook and ideas. One facilitator who had better success with homework compliance distributed prizes for its completion. All in all, the facilitators found the enhanced series to be an excellent experience both for them and the clients. 3.6. Coordinator feedback At the beginning of the project, most mandated parents, when given the choice to attend a regular or enhanced series, selected regular to “get it over with quickly”. But, near the end of the project, most chose the enhanced series, having heard from other parents that it was more engaging. Some phoned back after completing the enhanced series and asked to sign up again, with others mentioning that they wouldn't know what to do when they no longer met with the group.

Moreover, after the enhanced series had been underway for a few weeks, during weekly telephone calls to confirm taxis, participants began to chat more about their enjoyment of the program with the coordinator than did those CAS clients attending the regular series. It was also common for them to say of course they were going, they wouldn't miss it. They expressed concern if they couldn't attend a session, and wanted an explanation conveyed with their regrets to the facilitators and the group. One facilitator consulted that she was pleased with how well her group had come together given the members' diversity in age, experiences and attitudes, initially thinking that “some people were going to tear the heads off others in the group”. But the co-facilitators kept intervening when disputes arose and directing attention to the Group Agreement and its principles of respect, taking turns and equality. The group learned to agree to disagree. They began to share personal experiences and opinions safely, and grew to respect each other despite their differences. 4. Discussion Historically, in the location studied, for regular NP programs having a total of 16 contact hours, approximately 75% of participants attend at least 5 out of 8 sessions, and 16% of them attend all 8 sessions. In this study, where the enhanced NP series generated 36 contact hours, nearly 80% of the participants attended at least 5 sessions, 53% attended at least 8 sessions and 30% attended all 12 sessions. Compared to regular NP attendees, participants in enhanced series faced more challenges. All were CAS clients and were, on average, more severely multistressed in terms of their income, educational, reading and parenting skill levels. Many were non-custodial parents and/or parents of one child under one year of age. Given that these parents lived in circumstances with multiple risks, the attendance is quite remarkable. Twelve weeks is a long time for those in extreme situations to maintain stability and consistency in their lives. Our study, nonetheless, found similar attrition challenges to those experienced by other researchers offering selective parent education interventions for parents living in circumstances with multiple risks. For example, Seed, Juarez, and Alnatour (2009), in their longitudinal study of adolescent mothers and pregnant teens living in poverty, attributed attrition mainly to lack of current contact information (changes to address and phone number). We too found lack of a permanent address to be an

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issue with those clients facing the most challenges, and contact through cell phones to be difficult, due to frequent loss of service or disconnection, change of carriers, full mailboxes, and reluctance of participants to answer unrecognized numbers. Other cited reasons for dropping out, some of which we can concur with, include family tragedies, moving away, returning to school, getting a job, greater socio-economic disadvantage, higher levels of stress, illness, lack of time and bad timing (e.g., Letourneau, 2001; Moran, Ghate, & van der Merwe, 2004). Interestingly, however, at a quantitative level, the only factor differentiating parents not earning from those earning a certificate was that the former group was significantly more likely to have attained a lower education. Our focus group analysis, however, clearly revealed that medium-sized groups having a blend of males and females, custodial and non-custodial parents, skill levels and life experiences fared much better than extremely large groups of more than 15 people or small groups comprising predominantly severely challenged, noncustodial parents. Thus, when the group was mixed, even the most multi-stressed parent reaped great benefits from the program. Even though this study's clientele were observed at pre-test to have substantially lower parenting resourcefulness and practices scores than clients of the regular NP series, significant increases were observed for knowledge and use of community resources, positive parent–child interactions and parenting resourcefulness, with increases in competence efficacy and parenting efficacy approaching significance. Some of the positive improvements over time, though, were not observed until follow-up, rather than immediately at the end of the program, as expected. It is possible that some child welfare clients, wishing to cast themselves in the best possible light, overestimated their capacity and scored higher on pre-tests than merited, reducing the significance levels of outcomes. This is supported by focus group reports expressing how much parents had learned. One woman, for instance, said, “I wasn't expecting that I'd learn a lot being that I grew up in a house of five and I'm the oldest. I learned a lot more than I figured I would have, and the books are going to be a good help.” Nonetheless, taking into account the parents' skill and belief level at the start of the program and examining the relative gains they made over the 12 weeks of the program using Hake's (1998) gain factor, relative gains in one parenting attribute were moderately to strongly associated with relative gains in other parenting attributes. Moreover, there was a tendency for non-custodial parents, in comparison to custodial parents, to have greater relative gains in positive parenting practices and general resourcefulness, thus, increasing their chances of being reinstated with their children. Novel to this investigation was the inclusion of the facilitators' and coordinator's feedback. Facilitators' views of the enhanced NP independently coincided with each other and with the clients of other groups. Analysis of both the facilitators' comments and focus group commentaries revealed that the more sessions and the longer session duration allowed for more repetition of the material, a sense of trust to develop between facilitators and the clients, participant involvement/input, more time to talk about “routine”, and bonding among parents. More importantly, groups formed friendships and were more receptive as time went on, and sharing with one another and high attendance rates excited them. Such information could never be easily captured quantitatively, and affirms the value of this type of investigative probing. We questioned why the enhanced NP program was so successful, given the literature's emphases on the high attrition rates for child welfare clients and the difficulty maintaining their continued attendance and engagement even with specialized programming (e.g., Kemp et al., 2009). First and foremost, the weekly focus group sessions asking parents what they liked about the session, how it was helpful and how it could be improved likely instilled a sense of care, trust and personal agency, especially when their responses were reviewed and suggestions were followed in subsequent weeks. Many of these parents had low literacy levels and would be unable to express concerns by simply completing a paper consumer evaluation as in the regular NP

program. In addition, although many of the parents disliked these focus group sessions initially, as time went on they were eager to voice and share opinions. The three-hour sessions were never rushed, and allowed parents to have more productive and interactive sessions and to review the “group agreement”, if necessary. More food was provided than in regular NP programs, which was likely appreciated by exceptionally low income parents. Increasing the number of sessions from 8 to 12 provided more time to emphasize the importance of communication. Attesting to the enhanced NP's value, many clients were at a loss to see the program end. Despite the program's merits, it comes with a price. Facilitators require further training in how to conduct focus groups, provide feedback and handle suggestions. They must be comfortable working with vulnerable populations and may require support in dealing with individuals who have poor social and group skills, are resentful about being mandated to attend and angry at losing custody of their children, and/ or are in crisis because of mental health, addiction, incarceration, poverty and other issues. Moreover, food, child care, facilitator and transportation costs are heightened when conducting a 36 versus a 16 hour program. Almost every participant needed a taxi in comparison to regular NP parents who are, on average, not as financially disadvantaged. Our findings that attrition is reduced and cohesiveness is enhanced when group members' skill levels, beliefs and demographic characteristics are mixed, makes it challenging for coordinators to orchestrate series composition. A limiting factor of the current investigation is that it did not involve a wait list or randomly assigned control group. But, all of the participants were child welfare clients, many either at high risk of losing their custodial rights or trying to regain their custodial rights. To deny non-custodial clients immediate interventions would further exacerbate their situation, compromise attachment and place them at an even higher risk of not being able to gain access to their children. Custodial clients of CAS would also be adversely affected by a delay in services, given that parent–child interactions may deteriorate in the absence of an intervention and young children can be expected to pass through different developmental stages and exhibit challenging new patterns of behavior during the waiting period. As such, a regular NP intervention was conducted in parallel using the same research methods, but participant demographics revealed this to be a non-matching sample and unsuitable to use for comparison purposes. Subsequent studies also need to directly observe parents' interactions with their children, follow-up with case workers, and track changes in parental hardship. In summary, many parents living in circumstances with multiple risks increased their parenting skill level and became more confident with the parenting role following an enhanced NP program. Had they attended a regular NP program, where parents are not CAS clients and are predominantly more advantaged than them, most would have dropped out, relinquishing any possible beneficial gains. Despite the increased costs of enhanced NP, CAS clients are very receptive and worth the investment. References Arditti, J., Burton, N. L., & Neeves-Botelho, S. (2010). Maternal distress and parenting in the context of cumulative disadvantage. Family Process, 49, 142–164. Asawa, L. E., Hansen, D. J., & Flood, M. F. (2008). Early childhood intervention programs: Opportunities and challenges for preventing child maltreatment. Education and Treatment of Children, 31, 101–126. Barth, R. P. (2009). Preventing child abuse and neglect with parent training: Evidence and opportunities. The Future of Children, 19, 95–118. Chislett, G., & Kennett, D. J. (2007). The effects of the Nobody's Perfect program on parenting resourcefulness and competency. Journal of Child and Family Studies, 16, 473–482. Derry, P. A., Chovaz, C. J., McLachlan, R. S., & Cummings, A. (1993). Learned resourcefulness and psychosocial adjustment following temporal lobectomy in epilepsy. Journal of Social and Clinical Psychology, 12, 454–470. Dixon, L., Hamilton-Giachritsis, C., Browne, K., & Ostapuik, E. (2007). The co-occurrence of child and intimate partner maltreatment in the family: Characteristics of the violent perpetrators. Journal of Family Violence, 22, 675–689.

D.J. Kennett, G. Chislett / Children and Youth Services Review 34 (2012) 2081–2087 Hake, R. R. (1998). Interactive-engagement versus traditional methods: A six-thousandstudent survey of mechanics test data for introductory physics courses. American Journal of Physics, 66, 64–74. Howard, L. M., Thornicroft, G., Salmon, M., & Appleby, L. (2004). Predictors of parenting outcome in women with psychotic disorders discharged from mother and baby units. Acta Psychiatrica Scandinavica, 110, 347–355. Kemp, S. P., Marcenko, M. O., Hoagwood, K., & Vesneski, W. (2009). Engaging parents in child welfare services: Bridging family needs and child welfare mandates. Child Welfare, 88, 101–126. Kennett, D. J., Chislett, G., & Olver, A. L. S. (2012). A reappraisal of the Nobody's Perfect program. Journal of Child and Family Studies, 21, 228–236. Law, J., Plunkett, C., Taylor, J., & Gunning, M. (2009). Developing policy in the provision of parenting programmes: Integrating a review of reviews with the perspectives of both parents and professionals. Child: Care, Health and Development, 35, 302–312. Letourneau, N. (2001). Attrition among adolescents and infants involved in a parenting intervention. Child: Care, Health and Development, 27, 183–186. Lundahl, B. W., Nimer, J., & Parsons, B. (2006). Preventing child abuse: A meta-analysis of parent training programs. Research on Social Work Practice, 16, 251–262. Mikton, C., & Butchart, A. (2009). Child maltreatment prevention: A systematic review of reviews. Bulletin of the World Health Organization, 87, 353–361. Moran, P., Ghate, D., & van der Merwe, A. (2004). What works in parenting support? A review of the international evidence. U.K.: Policy Research Bureau, Department for Education and Skills Research Report 574. Retrieved July 8, 2010, from the World Wide Web: http://www.education.gov.uk/research/data/uploadfiles/rr574.pdf Ohan, J. L., Johnston, C., & Leung, D. W. Y. (2000). The parenting sense of competence scale. Evidence of a stable factor structure and validity. Canadian Journal of Behavioural Science, 32, 251–264. Oldershaw, L. (2002). A national survey of parents of young children. Toronto, ON: Invest in Kids. Preechawong, S., Zauszniewski, J. A., Heinzer, M. M. V., Musil, C. M., Kercsmar, C., & Aswinanonh, R. (2007). Relationships of family functioning, self-esteem, and resourceful coping of Thai adolescents with asthma. Issues in Mental Health Nursing, 28, 21–36. Prinz, R. J., Sanders, M. R., Shapiro, C. J., Whitaker, D. J., & Lutzker, J. R. (2009). Population-based prevention of child maltreatment: The U.S. Triple P system population trial. Prevention Science, 10, 1–12. Public Health Agency of Canada (2010). Canadian incidence study of reported child abuse and neglect — 2008: Major findings. Ottawa. Retrieved January 17, 2011, from the World Wide Web: http://www.phac-aspc.gc.ca/cm-vee/csca-ecve/2008/index-eng.php

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Ronan, K. R., Canoy, D. F., & Burke, K. J. (2009). Child maltreatment: Prevalence, risk, solutions, obstacles. Australian Psychologist, 44, 195–213. Rosenbaum, M. (1980). A schedule for assessing self-control behaviors: Preliminary findings. Behavior Therapy, 11, 109–121. Rosenbaum, M. (Ed.). (1990). Learned resourcefulness: On coping skills, self-control, and adaptive behavior. New York, NY: Springer Publishing. Rosenbaum, M. (2000). The self-regulation of experience: Openness and construction. In P. Dewe, A. M. Leiter, & T. Cox (Eds.), Coping and health in organizations (pp. 51–67). London: Taylor and Francis. Salveron, M., Lewig, K., & Arney, F. (2009). Parenting groups for parents whose children are in care. Child Abuse Review, 18, 267–288. Seed, M., Juarez, M., & Alnatour, R. (2009). Improving recruitment and retention rates in preventive longitudinal research with adolescent mothers. Journal of Child and Adolescent Psychiatric Nursing, 22, 150–153. Skrypnek, B. J., & Charchun, J. (2009). An evaluation of the Nobody's Perfect parenting program. Ottawa, ON: Canadian Association of Family Resource Programs (FRP Canada) Retrieved July 28, 2010, from the World Wide Web: http://cbpp-pcpe. phac-aspc.gc.ca/uploads/NP_FRPEvalReport_Final.pdf Street, K., Whitlingum, G., Gibson, P., Cairns, P., & Ellis, M. (2008). Is adequate parenting compatible with maternal drug use? A 5-year follow-up. Child: Care, Health and Development, 34, 204–206. Thomson, J., & Thorpe, R. (2004). Powerful partnerships in social work: Group work with parents of children in care. Australian Social Work, 57, 46–56. Türkel, Y. D., & Tezer, E. (2008). Parenting styles and learned resourcefulness of Turkish adolescents. Adolescence, 43, 143–152. U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (2010). Child Health USA 2010. Rockville, Maryland: U.S. Department of Health and Human Services Retrieved January 17, 2011, from the World Wide Web: http://www.mchb.hrsa.gov/chusa10/ pdfs/c10.pdf Walker, L. (1990). Parenting programs: they serve the needs of which parents? Unpublished thesis, Trent University, Peterborough, Ontario, Canada. Wood Cantano, J. (2000). Working with Nobody's Perfect: A facilitators guide (3rd ed.). Ottawa, ON: Minister of Public Works and Government Services, Canada. Zauszniewski, J. A., Chung, C., Chang, H., & Krafcik, K. (2002). Predictors of resourcefulness in school-aged children. Issues in Mental Health Nursing, 23, 385–401.