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The present randomized controlled trial examined the four months follow-up effectiveness of Parent Management Training Oregon (PMTO) for parents with foster children (aged 4–12) with severe externalizing behavior problems in long-term foster care arrangements. The aim of PMTO, a relative long and intensive (6–9 months, with weekly sessions) parent management training is to reduce children's problem behavior through improvement of parenting practices. We specifically investigated whether PMTO is effective to reduce foster parenting stress. It was expected that PMTO would reduce parenting stress in foster parents, improve the quality of parenting practices, and reduce children's problem behavior. Multi-informant (foster mothers, foster fathers, and teachers) data were used from 86 families. Multilevel analyses based on the intention to treat principle (retention rate 73%) showed that PMTO, compared to care as usual, had no significant direct, nor indirect or sleeper effects at follow-up on parenting stress, parenting behavior and child behavior problems. Earlier reported immediate effects of PMTO on reduced parenting stress at posttest disappeared at follow-up. Additional analyses on the role of non-specific intervention factors in PMTO effects showed that higher therapist fidelity scores resulted in stronger effects of PMTO on parenting responsiveness, parental explaining and autonomy granting. Unexpectedly, higher fidelity scores also predicted less decrease of parenting stress at follow-up. [ABSTRACT FROM AUTHOR]

• Parental supervision and some negative youth behaviors and attitudes improved. • The magnitude of youth behavior improvements was small. • Improved behaviors did not translate into reduced youth delinquency. • The YSET survey showed improvements in both treatment and control. • The YSET survey was found to create survey fatigue and comprehension challenges. This study provides the first randomized controlled trial (RCT) of a family counseling intervention in the Caribbean, and one of the few RCTs on a violence and delinquency prevention program in the region. This trial studies the impact of the Family Matters program for youth aged 10–18 years old and at risk of engaging in delinquent behavior. As a result of the program, parental supervision improved and there was a reduction in some of the youths' negative behaviors and attitudes, but the magnitude of improvements was small: participants' average number of risk factors decreased by only one fifth of a standard deviation. Improved behaviors did not translate into reduced youth delinquency. The findings suggest that with some adjustments to improve program targeting and address pressing family challenges, the intervention may have a more meaningful impact on caregiving practices and youth behaviors and delinquency levels. [ABSTRACT FROM AUTHOR]

• This is one of the first analyses of the differential impact of an evidence-based teen pregnancy prevention program conducted among subgroups of Native youth. • Results guide dissemination and future research efforts for the 31 tribal communities currently implementing the RCL program. • Specific findings show that RCL is particularly effective among youth who are under the age of 15 at the time of participation, and that additional tailoring will optimize this program for older adolescents. This study reports the differential impact of an evidence-based teen pregnancy prevention program among subgroups of participating Native American youth. This randomized controlled trial included N = 534 Native Americans ages 11–19. Participants were randomly assigned 1:1 (intervention: 266; control: 268) to the Respecting the Circle of Life intervention (RCL) versus a control condition. Logistic and linear regression was used to examine intervention impact at 9- and 12- months post-intervention among the subgroups of males, females, younger (11–14 years) and older (15–19 years) youth. Girls and boys in the intervention group (RCL) had improved condom self-efficacy (Adjusted mean difference (AMD) and 95% CI girls: 0.56 (0.34–0.79); boys: 0.55 (0.32–0.77); both p < 0.0001) and contraceptive use self-efficacy at 9 months (AMD (95% CI) girls: 0.40 (0.16–0.63); boys: 0.40 (0.17–0.63); girls p = 0.001, boys p = 0.0009) compared to those in the control group. Study group differences were sustained for girls at 12 months but not for boys (condom use self-efficacy AMD (95% CI) girls: 0.54 (0.34–0.75); contraceptive use self-efficacy girls: 0.47 (0.24–0.70); both p < 0.0001). Boys in the RCL group had higher 12-month sexual/reproductive health knowledge (AMD (95% CI) boys: 2.15 (0.45–3.85); p = 0.01) compared to those in the control group, but girls did not. Girls in the RCL group had increased intention to use a condom at 12 months (OR (95 %CI): 1.69 (1.00–2.86); p = 0.05) compared to those in the control group, whereas boys in the RCL group had decreased intention to have sex in the next year at 9 months (OR (95% CI): 0.39 (0.21–0.73); p = 0.003) compared to boys in the control group. RCL Participants ages 11–14 had improved sexual/reproductive health knowledge at 12 months (AMD (95% CI): 1.96 (0.79–3.13); p = 0.001) compared to control participants of the same age. They also had improved condom and contraceptive use self-efficacy at 9 months (condom use self-efficacy AMD (95% CI): 0.65 (0.46–0.83); contraceptive use self-efficacy: 0.47 (0.28–0.65); both p < 0.0001) and 12-months (AMD (95% CI): 0.43 (0.25–0.61); 0.35 (0.16–0.54); p < 0.0001 and p = 0.0004, respectively) compared to control participants of the same age. There were no statistically significant impacts among participants ages 15–19. This is one of the first analyses of the differential impact of an evidence-based teen pregnancy prevention program conducted among subgroups of Native youth. Results guide dissemination and future research efforts, including that RCL is particularly effective among youth who are under the age of 15 at the time of participation, and that additional tailoring will optimize this program for older adolescents. [ABSTRACT FROM AUTHOR]

This study of ethnic minority mothers assessed the intervention effects of Parent Management Training — Oregon Model (PMTO) on maternal mental distress. Ninety-six mothers from Somalia and Pakistan and their 3-year-old to 9-year-old children were randomized with respect to enrollment in PMTO or a wait-list condition. Immigrants living in European countries report having significantly more mental distress than natives. Surprisingly, the results in this current study showed that there were low levels of mental distress at enrollment in PMTO among the sample. An analysis of covariance showed that PMTO was not effective in alleviating maternal mental distress in this sample. Ethnicity, family size and the child's age served as moderators on the relationship between enrollment in PMTO or the wait-list condition and maternal mental distress outcomes. None of the subgroup analyses were in favor of the intervention. The results emphasize the importance of research on parent training with immigrant families. [ABSTRACT FROM AUTHOR]

Abstract: The role of subsequent school contexts in the long-term effects of early childhood interventions has received increasing attention, but has been understudied in the literature. Using data from the Chicago School Readiness Project (CSRP), a cluster-randomized controlled trial conducted in Head Start programs, we investigate whether the intervention had differential effects on academic and behavioral outcomes in kindergarten if children attended high- or low-performing schools subsequent to the preschool intervention year. To address the issue of selection bias, we adopt an innovative method, principal score matching, and control for a set of child, mother, and classroom covariates. We find that exposure to the CSRP intervention in the Head Start year had significant effects on academic and behavioral outcomes in kindergarten for children who subsequently attended high-performing schools, but no significant effects on children attending low-performing schools. Policy implications of the findings are discussed. [Copyright &y& Elsevier]

Abstract: The purpose of this paper was to examine the effectiveness of home visiting as a means of improving parental, child, and maternal outcomes and preventing child abuse and neglect. A randomized controlled trial was conducted in a large southwestern metropolitan area. One hundred and ninety-five women were randomly assigned to the Healthy Families Arizona experimental or control conditions. Significant results favoring the experimental group in contrast to the control group were found on some measures in each of five domains including violent parenting behavior, parenting attitudes and practices, parenting support, mental health and coping, and maternal outcomes. [Copyright &y& Elsevier]

• Significant positive effects were found for GTP when compared with the CAU condition. • The GTP effects were maintained at 6- and 12-months follow-ups. • GTP can be an important tool for parenting intervention with low-income families. Parenting is a challenging endeavor, particularly for low-income families, who are often exposed to multiple stressors known to jeopardize children's development. Research indicates that evidence-based parenting interventions mitigate the adverse effects of growing up in low-income families. The purpose of the current study is to evaluate the efficacy of Group Triple P – Positive Parenting Program in a sample of Portuguese low-income families assisted by social welfare services. A randomized control trial to evaluate the effects of the Group Triple P program was implemented in a community setting. Low-income families were randomly assigned to one of two conditions: Group Triple P intervention or Care-As-Usual intervention. Outcome measures included child behavior problems, parental practices, parental sense of competence, parental adjustment, parental stress levels, and family social support network. Data were collected at baseline (before the intervention), immediately after the intervention (3-months after baseline), 6-, and 12-months after the intervention. After the intervention, Group Triple P participants reported less children behavior problems, improvements in parenting practices, and in parental sense of competence, as well as an increase in family social support network. These effects remained stable six- and 12-months after the intervention. Group Triple P was found to be an effective intervention when delivered in a community setting to low-income families, demonstrating enduring positive effects in all outcomes. Trial registration : ISRCTN19620485 (Retrospectively registered in 11/08/2018). [ABSTRACT FROM AUTHOR]

• Study presents a culturally tailored entrepreneurship education program for Native American youth living in communities with economic, education, and behavioral and mental health disparities. • Results show the program reduced substance use and violence toward others. • This strength-based, social determinants approach holds promise to address the most vexing issues facing U.S. youth living in poverty. This study reports the impact of an entrepreneurship education intervention designed and evaluated specifically for its impact on substance use, suicide and violence-related outcomes among Native American adolescents. This randomized controlled trial included N = 394 Native Americans ages 13–16. Participants were randomly assigned 2:1 (n = 267:127) to the Arrowhead Business Group intervention versus a control condition. Logistic mixed effects regression models examined within group and between group differences in trajectory from baseline to 24 months follow-up. Fewer intervention vs. control participants used marijuana at 6-, 12- and 24-months post-intervention (19.6% vs. 28.0%, p = 0.032; 20.4% vs. 31.8%, p = 0.01; and 24.1% vs. 31.4%, p = 0.047). All violence-related measures (suicide attempts, carrying a weapon, missing school because felt unsafe, fighting, and fighting at school) statistically significantly declined between baseline and 24 months for both groups. Positive between group differences favoring intervention participants were observed at 6-months for missing school because felt unsafe, and at 24-months for fighting at school. While alcohol use increased for both groups over time, control participants experienced a two-fold higher increase in binge alcohol use than intervention participants (control: 7.1–16.7% vs. intervention: 8.1–13.0%). This is the first report in the US literature of a youth entrepreneurship intervention designed and evaluated to promote behavioral and mental health outcomes. It shows promise for reducing substance abuse and violence toward self and others, the largest health disparities for Native American youth. [ABSTRACT FROM AUTHOR]

• Thirty-two RCTs tested effectiveness of psychotherapy for child sexual abuse victims. • Comparison across treatment types was difficult because outcome measures differed. • Treatment types did not differ in their effectiveness to improve mental health. • Trauma narration is an effective treatment component for child sexual abuse victims. • More large RCTs, with long-term follow-up and uniform outcome measures are needed. Childhood sexual abuse (CSA) can have major implications for child mental health on the short-term, but also for developmental outcomes later in life, especially when left untreated. Yet, there is no consensus about best practices in psychotherapy for child and adolescent CSA-victims. In this study, we therefore systematically reviewed existing literature on the effectiveness of different types of psychotherapy, as well as specific treatment components, for improving CSA-victims' mental-health outcomes. We searched databases (PsycINFO, PubMed, Scopus, Web of Science) for randomized controlled trials (RCTs) examining effectiveness of psychotherapy for child or adolescent victims of CSA. This search yielded 32 RCTs testing effectiveness of cognitive behavioral therapy (with and without adaptation to CSA), trauma-focused cognitive behavioral therapy, group therapy, prolonged-exposure treatment, eye movement desensitization and reprocessing, and play therapy. For each type of psychotherapy, some studies demonstrated evidence for its effectiveness in improving CSA-victims' mental health, but other studies did not. We also found some evidence that certain therapy approaches might be specifically effective for specific groups of clients, i.e., TF-CBT for highly vulnerable and traumatized clients, group therapy for girls, and briefer approaches for younger children. Regarding treatment components, trauma narration and pharmacotherapy appeared to enhance effectiveness of psychotherapy. A thorough comparison between studies was difficult, because control-groups and measured outcomes differed greatly. Therefore, the field needs more rigorous large-scale RCTs, with long-term follow-up and more uniformity in outcome measures, investigating the effectiveness of specific treatment components, to be able to draw evidence-based conclusions about best practices for CSA-victims. [ABSTRACT FROM AUTHOR]

• ACT and DBS were well accepted by participants in a middle-income country (Brazil). • Attendance rates of the interventions were high (ACT = 64.2%; DBS = 76.6%). • Few variables predicted attendance rates in this study. Parent training programmes have significant potential to improve the quality of children's early environments and thereby their development and life-course outcomes. The aim of this study was to identify and explain the extent to which parents engaged in two group-based training programmes, offered to high-risk families enrolled in a randomized controlled trial study called PIÁ in Southern Brazil. The programmes were: (1) ACT: Raising Safe Kids, a 9-week programme aiming to reduce harsh parenting and maltreatment and improve positive parenting practices; (2) Dialogic book-sharing (DBS), an 8-week programme aiming to promote parental sensitivity and improve child cognitive development and social understanding. Of the 123 mothers randomly allocated to the ACT programme, 64.2% (n = 79) completed the course, and of 124 mothers allocated to DBS, 76.6% (n = 95) completed the course. After the interventions, mothers were very positive about the experience of both programmes but highlighted practical difficulties in attending. In adjusted regression analyses, only two variables significantly predicted ACT course completion (maternal age and distance between the intervention site and household); no significant predictor was found for DBS attendance. We conclude that although high completion rates are possible, there are important challenges to engaging parents of young children in training programmes, and practical difficulties occurring during training courses may be more important for attendance than baseline participant characteristics. [ABSTRACT FROM AUTHOR]

• This study tested the effects of parental involvement in supported playgroups. • Participating actively in the playgroup significantly reduced parenting stress. • Toddlers whose parents were involved showed improved social-communicative behavior. • Parental involvement is crucial to achieving the desired benefits of playgroups. This paper reports a randomized controlled trial in which the effects of parental involvement in supported playgroup on parenting stress and toddler social-communicative behavior were tested. Participants were 58 toddlers (M age = 20.60 months, SD = 1.85; 25 boys and 33 girls) and their parents. The parent-toddler dyads were randomly assigned to either parent-involved or parent-uninvolved playgroup. Before and after the seven-week playgroup program, we used the Parental Stress Scale to measure parenting stress, and the Communicative Development Inventory to measure the toddlers' communicative behavior. Observational data of toddler behavior during the playgroup were also obtained in the first, forth, and last session of the program. Results showed that parents from the parent-involved group experienced a reduction in parenting stress following the program, whereas those from the parent-uninvolved group did not. Although toddlers from both groups showed increased communicative behavior after the program, the increment in the parent-involved group was significantly greater than the parent-uninvolved group. Toddlers from the parent-involved group also exhibited greater improvements in engagement in playgroup activities and interactions with other adults and peers across the program period. The findings suggest that parental involvement is crucial in reaping the benefits of supported playgroup. [ABSTRACT FROM AUTHOR]

• The intervention was not more effective than services as usual at improving outcomes. • This may relate, in part, to implementation issues; fidelity could be improved. • It may also reflect the relative lack of behavioral components in the program. The aim of the study was to evaluate the implementation and effectiveness of a therapeutic parenting program that targets parents of children aged 6 to 11 years identified as having behavioral and emotional difficulties. The intervention comprises two parts, delivered sequentially: a 10–12-week group-based program for all parents, and one-to-one sessions for up to 12 weeks with selected parents from the group-based element. In a randomized controlled trial, 264 participants were allocated to the Inspiring Futures program (intervention) or services as usual (control) arms with follow-up assessments at 16 (post-group program) and 32 (post-one-to-one sessions) weeks. The primary outcome was the parent-rated Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score at 32 weeks. Secondary outcomes included parent-rated SDQ subscales, parent coping strategies, empathy in parenting and parenting skills. All 264 participants were included in outcome analyses. There was no statistically significant effect on SDQ Total Difficulties (standardized mean difference: −0.07; 95% CI: −0.30 to 0.16; p = 0.54). There were no sub-group effects. Only 1 of 40 comparisons between the trial arms for secondary outcomes across both follow-ups was statistically significant at the 5% level. The mean number of group sessions attended by intervention arm participants was 6.1 (out of 10 to 12) and only 1 in 20 intervention arm participants received one-to-one support. Independent observation indicated scope to improve fidelity in terms of adherence, quality and participant responsiveness. The intervention is not more effective than services as usual at improving targeted outcomes. This may be related, in part, to implementation issues but arguably more to the inability of a non-behavioral intervention to improve caregiving adequately, particularly when it is not targeted at new parents who have experienced trauma or deprivation early in life or subsequently. [ABSTRACT FROM AUTHOR]

• VIPP-FC is an adaptation of the evidence-based VIPP-SD to use in foster care. • VIPP-FC not effective in improving sensitive parenting behavior or attitudes. • Results may be explained by selection bias and ceiling effect. • Include foster families in need for help and support in future research. The current randomized controlled trial examined the effectiveness of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline in Foster Care (VIPP-FC) on parenting behavior and attitudes in foster parents (N = 60, 31–61 years, 83% female). The intervention group (n = 30) received VIPP-FC, consisting of six sessions. During the first four sessions, a specific theme from Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD; e.g., attachment vs. exploration behavior), and an additional foster care theme (e.g., subtle or missing attachment signals) are discussed. Each theme is discussed during the consecutive sessions and the last two sessions are booster sessions during which all themes are discussed. The control group (n = 30) received a dummy intervention consisting of six telephone calls about general child developmental topics. The Ainsworth Scales for sensitivity and non-interference, the Erickson scale for supportive presence, and the Questionnaire Attitudes towards Parenting were used to measure parental sensitivity, sensitive discipline, and attitudes towards parenting, respectively. The intervention and control group did not differ on demographic characteristics or outcome variables at pretest. Multilevel analyses based on the intent-to-treat principle yielded no evidence that VIPP-FC was more effective in improving foster parents' sensitive parenting behavior or eliciting more positive attitudes compared to the control condition. We suggest that the outcomes in this study may be explained by a possible selection bias, which may have resulted in a ceiling effect. Future research might include foster families that experience more severe challenges (i.e., elevated levels of child behavior problems) or indicate a need for help and support. [ABSTRACT FROM AUTHOR]