TRANSLATING PARENTS ANONYMOUS® RESEARCH FINDINGS INTO PROGRAMMING AND PRACTICE

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TRANSLATING PARENTS ANONYMOUS RESEARCH FINDINGS
INTO PROGRAMMING AND PRACTICE

• Margaret L. Polinsky, MSW, PhDLisa Pion-Berlin,
  PhD
• Tanya Long, Parent Leader
• 17th National Conference on Child Abuse and
  Neglect
• April 1, 2009
• Atlanta, Georgia

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Overview for Today

• Background
• Research Questions Heuristic
• Methodology
• Sample
• Research Findings
• Implications
• Dissemination to the Network
• Development and Use of the Group Fidelity Tool
• Use by the Network

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BACKGROUND OJJDP/NCCD

• 2000-2007 - Office of Juvenile Justice and
  Delinquency Prevention (OJJDP) awarded grants to
• The National Council on Crime and Delinquency
  (NCCD) in Oakland, CA
• To conduct an evaluation study of Parents
  Anonymous

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BACKGROUNDPARENTS ANONYMOUS

• Parents Anonymous Precept
• Parents Anonymous Group Elements
• Parents Anonymous Group Goals
• 4 Therapeutic Principles of Parents Anonymous
  Groups
• Mutual Support
• Shared Leadership
• Parent Leadership
• Personal Growth

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OJJDP OBJECTIVES GOALS

• Explore efficacy of Parents Anonymous
• Update previous studies
• Increase methodological rigor

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PARTICIPATORY EVALUATION APPROACH

• Project Advisory Board, with Parent Leader
• NCCD Madeline Wordes, PhD Raelene Freitag, PhD
  Angie Wolf, PhD
• Consultants Keith Humphreys, PhD Julian
  Rappaport, PhD
• Parents Anonymous Inc. Peggy Polinsky, PhD
  Tanya Long, Parent Leader

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OVERARCHING RESEARCH QUESTION

• Does Parents Anonymous work to reduce the
  risk of child maltreatment and, if so, for all
  parents or for some more than others?

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RESEARCH QUESTIONS

• Do Parents Anonymous group participants improve
  their parenting behaviors and/or reduce their
  child maltreatment behaviors?
• Does Parents Anonymous group participation
  reduce the potential risk factors for child
  maltreatment?
• Does Parents Anonymous group participation
  increase the potential protective factors for
  child maltreatment?
• Are there differences in outcomes related to
  child maltreatment, risk factors, and protective
  factors among different types of group
  participants?
• What characteristics distinguish parents who
  continue group participation from those who do
  not?

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EVALUATION HEURISTIC
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STUDY PHASES DESIGN

• Process Evaluation (2001-2002)
• Outcome Evaluation (2003-2007)
• Quasi-experimental time-series design
• 3 telephone interviews over 6 months
• Outcome Evaluation (2005-2007)
• One-time face-to-face interviews with
  Spanish-speaking Parents Anonymous parents
• Uniqueness

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16 MEASURES

• MEASURES OF CHILD MALTREATMENT OUTCOMES
• Parenting Distress CAPI
• Parenting Rigidity CAPI
• Psychological and Physical Aggression Towards
  Children CTSPC

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MEASURES (cont)

• MEASURES OF RISK FACTORS
• Life Stress Scale - Kanner, et al.
• Parenting Stress Index-Short Form (PSI-SF)
• Emotional and Physical Violence between Partners
  Conflict Tactics Scale (CTS)
• Alcohol Use-Short Michigan Alcoholism Screening
  Test (SMAST)
• Drug Use-Drug Abuse Screening Test (DAST)

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MEASURES (cont)

• MEASURES OF PROTECTIVE FACTORS
• Quality of Life Scale - Andrews Withey
• Social Support NSSQ
• Emotional/Instrumental
• General
• Parenting Sense of Competence (PSOC)
• Nonviolent Discipline Tactics (CTSPC)
• Family Functioning - McMaster Family Assessment
  Device (FAD)

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STUDY PROCEDURES

• 100 groups randomly selected from 230
• Group Facilitators contacted, consented and
  trained to recruit parents
• Study goals and benefits explained to parents new
  to group
• Interested parents contacted Study 800 or mailed
  in information
• Researchers called parents, conducted informed
  consent, assigned ID , conducted first interview
  within week

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STUDY BENEFITS TO PARENT PARTICIPANTS

• Talk to an interested person
• Confidentiality
• 50 for first interview
• 75 for second interview
• 100 for third interview

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PARTICIPANT ELIGIBILITY REQUIREMENTS

• At least 18 years old
• Living with at least 1 child between birth and 17
• New to Parents Anonymous
• (had not attended more than 5 Parents
  Anonymous group meetings during the month or
  year prior to recruitment date)

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INTERVIEW DESIGN

• Computer Assisted Telephone Interview (CATI)
  data entered directly into database
• One-hour structured interview
• 5 domains
• Demographics background
• Child maltreatment outcomes
• Child maltreatment risk factors
• Child maltreatment protective factors
• Experience with Parents Anonymous

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PARTICIPANTS

• 232 parents completed 3 interviews
• 206 included in analysis (due to retroactive
  determination that 26 had attended group more
  than 5 times)
• From 54 groups in 19 states
• Sample was representative of the general
  population of Parents Anonymous parents

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DATA ANALYSIS

• SPSS data files each double-checked for accuracy,
  then merged into single file
• Descriptive statistics, histograms, frequency
  distributions, examination of outliers
• Regression analysis assessing scale score change
  over time and differential influence on
  variability in scale score change by parent and
  group characteristics
• Few significant findings led to scrapping plans
  for higher order analyses
• Only t-test results

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ANALYSIS GROUPINGS

• Demographic and Background variables coded as
  binary
• Parents who continued through the study period (6
  months) n188
• Parents who dropped out after first interview
  n18

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BINARY CODING (N206)

• Gender Female (91) /Male (9)
• Ethnicity African American (48)/White
  (42)/Other(10)
• Education ltHS (21)/HS or more (79)
• Income Low (lt13,000 annually) (48)/High (52)
• Child with special needs Yes (50)
• Prior help-seeking for parenting Yes (72)
• Physical or mental illness history Yes (49)
• Alcohol or drug abuse history Yes (18)
• History of CPS Contact Yes (27)
• Mandated attendance Yes (15)

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LOW RISK OF CHILD MALTREATMENT

• Baseline
• Parents reported little abusive behavior
• CTSPC average scores (scale 1-5)
• 0.71 for psychological aggression
• 0.21 for physical aggression
• Average Risk Factors scores low
• Average Protective Factors scores high

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STATISTICALLY SIGNIFICANT RESULTS
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REDUCED CHILD MALTREATMENT OUTCOMES
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REDUCED RISK FACTORS
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INCREASED PROTECTIVE FACTORS
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GENERAL FINDINGS

• All parents benefited, but benefit was especially
  consistent for those parents most in need on each
  measure at baseline.
• The parents most in need at baseline showed
  statistically significant improvement on all
  child maltreatment, risk, and protective factors.

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ONE PARENTS EXPERIENCE WITH PARENTS ANONYMOUS

• Tanya Long
• Parent
• Parent Leader
• Parent Group Leader
• National Parent Leadership Team
• NCCD Project Advisory Board
• Parents Anonymous Inc. Board of Directors

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FINDINGS FOR SPANISH-LANGUAGE PARENTS

• In a separate segment of the study, 36 parents
  from Spanish-language Parents Anonymous groups
  in 2 states were assessed with semi-structured,
  in-person, qualitative interviews.
• At the beginning of Parents Anonymous group
  attendance
• The parents reported isolation, mental health
  issues, stress, and dysfunctional family life

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Spanish-Language Parents (cont)

• After attending Parents Anonymous groups
• Parents reported more social support, better
  parenting practices, greater satisfaction with
  parenting, higher family functioning, and a
  higher sense of their own worth and capabilities.
• The interviewees also reported that the Parents
  Anonymous group provided confidentiality and
  respect and a willingness to share, explore and
  resolve personal problems.

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WHY PARENTS DECIDED TO ATTEND PARENTS ANONYMOUS

• Want to be a better parent (40)
• Want to meet other parents (34)
• Mandated (15)
• To get help coping with stress (14)
• Help others (7)
• Help with childcare (7)
• Be in a place where others listen (5)
• Help to stop hurting their children (1)

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IMPACT OF PARENTS ANONYMOUS ATTENDANCE PARENT
REPORTING

• Received the services needed to raise healthy
  children (96)
• Formed relationships with other Parents
  Anonymous group members (77)
• Parenting became easier (77)

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IMPACT OF ATTENDANCE (cont)

• Changed the way they parent (71)
• Improved problem solving skills (43)
• Learned new parenting and discipline ideas and
  methods (43)
• Became more patient (11)
• Learned more about child development (11)
• Improved communication skills (9)

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STUDY LIMITATIONS

• Not a randomized controlled trial
• Effects may have been due to other factors
  besides Parents Anonymous
• Participants were volunteers, who may have been
  different from non-volunteers.
• Few parents were at-risk for child maltreatment
  at baseline, limiting the statistical analyses.

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STUDY STRENGTHS

• Longitudinal, time-series design
• Inclusion of child maltreatment risk factors not
  studied before in relation of effects of parent
  support groups
• alcohol/drugs
• mental health
• family functioning
• domestic violence

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SUMMARY IMPLICATIONS

• The broad-based approach to family strengthening
  offered by Parents Anonymous appears to allow
  parents to address their most pressing needs
  while at the same time providing a safety net,
  buffering the impact of the process of change
  across other factors.
• Parents Anonymous seems to allow parents with
  differing backgrounds and differing needs to
  address and solve their particular issues,
  especially parents with the most acute needs upon
  entry.

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Dissemination to the Network

• Presentations at Parents Anonymous Inc. Annual
  Conferences, 2003 on
• One-pager
• NCCD Special Report
• Emphasis on the importance of being
  evidence-based
• Provision of the Group Fidelity Tool to assure
  adherence to the proven-successful Parents
  Anonymous model

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Development and Use of the Group Fidelity Tool

• A Group Fidelity Tool was developed and
  validated, based on the NCCD Group Assessment
  Tool
• The GFT measures the degree to which groups
  follow the Parents Anonymous model
• All groups now collect GFTs once a year as part
  of their accreditation requirements

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Use by the Network

• Parents Anonymous Inc. is the only national
  organization in the child abuse and neglect field
  that has participated in a national evaluation of
  a parent support group model that showed its
  effectiveness in family strengthening and child
  maltreatment prevention.
• The Network uses this information
• In grant proposals
• In reports to Boards of Directors
• In establishing new Parents Anonymous groups

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In the Works

• A paper describing the findings is now under
  review by Child Abuse Neglect
• GFT reports will be automatically provided to
  groups submitting GFT data to Parents Anonymous
  Inc.
• A grant proposal is being written with a
  randomized controlled design

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ACKNOWLEDGEMENTS AND GRATITUDE

• Thank you to the many parents and staff of
  Parents Anonymous groups who participated in
  this evaluation. Your contribution was essential
  to the findings that Parents Anonymous works!

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CONTACT INFORMATION

• Peggy Polinsky, MSW, PhD
• Director of Research Evaluation
• Parents Anonymous Inc.
• 675 West Foothill Blvd., Suite 220
• Claremont, CA 91101
• Tel [phone], Ext. 213
• E-mail ppolinsky_at_parentsanonymous.org