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Objective: Problematic maternal alcohol use confers risk for child maltreatment, though the effect on specific aspects of parenting is unclear. This study examined concurrent and prospective links among maternal alcohol use history, care neglect, supervisory neglect, and harsh or inconsistent discipline. Method: Multimethod multisource data were utilized to assess deficient parenting in 311 economically disadvantaged mothers at high risk of child maltreatment. Structural equation modeling was used to test hypothesized relations. Results: Maternal history of alcohol use was associated with more inconsistent discipline and higher levels of subsequent supervisory neglect. Secondary analyses among two-parent families found that paternal substance misuse was associated with maternal care neglect and poor supervision. Conclusions: Among low socioeconomic status families, maternal alcohol use increases the risk of inconsistent discipline and inadequate supervision. Inconsistent discipline may also lead to punitive parenting practices. Given the potential effect of paternal substance use on maternal parenting, findings highlight the importance of screening all caregivers for substance use in child welfare and research contexts to clarify when and how to intervene most effectively.

Background In recent decades, evidence-based practices (EBPs) have been broadly promoted in community behavioural health systems in the United States of America, yet reported EBP penetration rates remain low. Determining how to systematically sustain EBPs in complex, multi-level service systems has important implications for public health. This study examined factors impacting the sustainability of parent-child interaction therapy (PCIT) in large-scale initiatives in order to identify potential predictors of sustainment. Methods A mixed-methods approach to data collection was used. Qualitative interviews and quantitative surveys examining sustainability processes and outcomes were completed by participants from 12 large-scale initiatives. Results Sustainment strategies fell into nine categories, including infrastructure, training, marketing, integration and building partnerships. Strategies involving integration of PCIT into existing practices and quality monitoring predicted sustainment, while financing also emerged as a key factor. Conclusions The reported factors and strategies impacting sustainability varied across initiatives; however, integration into existing practices, monitoring quality and financing appear central to high levels of sustainability of PCIT in community-based systems. More detailed examination of the progression of specific activities related to these strategies may aide in identifying priorities to include in strategic planning of future large-scale initiatives. Trial registration ClinicalTrials.gov ID NCT02543359; Protocol number PRO12060529. Electronic supplementary material The online version of this article (doi:10.1186/s12961-017-0230-8) contains supplementary material, which is available to authorized users.

Children's emotion dysregulation, children's appraisals, maternal psychological functioning, and harsh discipline were investigated as potential mediators in the putative link between exposure to intimate partner violence and poor child outcomes. Participants included 132 children ages 6-8 and their mothers who had been enrolled in a longitudinal study of parenting and children's social development. The mothers were receiving some form of government-based economic assistance or other social services, and were currently involved in a romantic relationship. Results of structural equation modeling indicated children's emotion dysregulation mediated the links between exposure to intimate partner violence (IPV) and both internalizing and externalizing problems. Harsh discipline mediated the link between exposure to IPV and externalizing, but not internalizing, symptoms. Child appraisals and maternal psychological functioning mediated the link between exposure to IPV and internalizing, but not externalizing, symptoms.

Background Evidence-based treatments (EBTs) are available for treating childhood behavioral health challenges. Despite EBTs’ potential to help children and families, they have primarily remained in university settings. Little empirical evidence exists regarding how specific, commonly used training and quality control models are effective in changing practice, achieving full implementation, and supporting positive client outcomes. Methods/design This study (NIMH RO1 MH095750; ClinicalTrials.gov Identifier: NCT02543359), which is currently in progress, will evaluate the effectiveness of three training models (Learning Collaborative (LC), Cascading Model (CM), and Distance Education (DE)) to implement a well-established EBT , Parent-Child Interaction Therapy, in real-world, community settings. The three models differ in their costs, skill training, quality control methods, and capacity to address broader implementation challenges. The project is guided by three specific aims: (1) to build knowledge about training outcomes, (2) to build knowledge about implementation outcomes, and (3) to test the differential impact of training clinicians using LC, CM, and DE models on key client outcomes. Fifty (50) licensed psychiatric clinics across Pennsylvania were randomized to one of the three training conditions: (1) LC, (2) CM, or (3) DE. The impact of training on practice skills (clinician level) and implementation/sustainment outcomes (clinic level) are being evaluated at four timepoints coinciding with the training schedule: baseline, 6 (mid), 12 (post), and 24 months (1 year follow-up). Immediately after training begins, parent–child dyads (client level) are recruited from the caseloads of participating clinicians. Client outcomes are being assessed at four timepoints (pre-treatment, 1, 6, and 12 months after the pre-treatment). Discussion This proposal builds on an ongoing initiative to implement an EBT statewide. A team of diverse stakeholders including state policy makers, payers, consumers, service providers, and academics from different, but complementary areas (e.g., public health, social work, psychiatry), has been assembled to guide the research plan by incorporating input from multidimensional perspective. Trial registration ClinicalTrials.gov: NCT02543359