Parent Program to Improve Child Behavior Problems

Improving Child Behavior Problems in the Primary Care Setting

The purpose of this research study is to learn whether or not a brief parenting program called Child Adult Relationship Enhancement (CARE) offered at a primary care office can help improve behavior problems in children who are 2-6 years old.

The study will be a randomized controlled trial (RCT) of the CARE intervention. The study will include 2-6 year old children who receive their primary care at the Children's Hospital of Philadelphia, South Philadelphia Primary Care clinic and whose caregiver and/or doctor has concern about a behavior problem in the child. The caregivers will also be subjects in the study.

Child-caregiver pairs who agree to be in the study will be randomly assigned to receive the CARE training immediately or in 3-4 months.

The CARE intervention will last 6 weeks and child behavior and parenting will be measured at baseline, 6-8 weeks, and 14-18 weeks. Investigators will also measure parent satisfaction with the CARE intervention.

• Child Adult Relationship Enhancement (CARE) is a group parent training program.
• The goals of the program are to teach parents skills that help their children successfully reach developmental milestones while increasing positive behaviors.
• The program also was designed to help parents manage and decrease negative child behaviors.
• Each training will be led by 2 therapists and 4-10 parents will attend the CARE program together.
• Children do not attend the training but parents are encouraged to practice the skills learned at CARE between the sessions.

Inclusion Criteria:

1. Caregiver is 18 years or older
2. Caregiver is English speaking
3. Child is 2-6 years old
4. Caregiver reports that child has a behavior problem
5. Child attends CHOP South Philadelphia Primary Care for primary care
6. Parental/guardian permission is provided (informed consent)

Exclusion Criteria:

1. Child has a cognitive age less than 2 years old as determined by the referring clinician
2. Child is already receiving behavioral health therapy or medication (other than medication for Attention Deficit Hyperactivity Disorder)