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The proposed project will produce and test the first combined group-online prevention program for reintegrating parents - "ADAPT: After Deployment Adaptive Parenting Tools". We will conduct a randomized effectiveness trial of the program, compared with a 'services as usual' (tip sheet) comparison group among 400 military families identified in the RFA as a special population: reintegrating Army National Guard parents.
Combat deployment and related challenges are family stressors, associated with more negative parent-child interactions, ineffective and coercive parenting practices and lower levels of parenting satisfaction. Disrupted parenting practices are well-known predictors of risk for child adjustment difficulties that are precursors to youth substance use, including behavior problems, school failure, deviant peer association, and depression . These child adjustment problems can contribute to continuing parental stress, increasing parental distress, and further disrupting parenting. Despite this, no parenting interventions have been empirically tested for reintegrating military families deployed to OEF/OIF.
PMTO is a well-established empirically supported intervention targeting highly stressed parents that applies Social Interaction Learning theory. Similar to family stress and stress amplification models, SIL posits that parenting mediates the effects of family stressors on child adjustment. That is, deployment and related stressors would be expected to impair social interactional patterns, leading to increases in coercion, decrements in positive parenting, and increased risk for child maladjustment. PMTO interventions have demonstrated efficacy and effectiveness, showing benefits for children including reductions in behavior problems that are precursors to substance use, actual substance use, and internalizing problems, as well as increases in social competence and school adjustment. Moreover, recent findings indicate that strengthening parenting practices contributes to improved outcomes for parents themselves. While PMTO interventions have been implemented in multiple diverse contexts, no study to date has adapted and examined PMTO among military populations. Data from studies of the current wars demonstrate a strong need for accessible prevention interventions that reduce parent stress, enhance parenting, and promote family resilience.
Specific aims of this study are as follows:
Examine the usability and feasibility of an adapted PMTO prevention program: After Deployment: Adaptive Parenting Tools/ADAPT
Assess effectiveness of and satisfaction with ADAPT (group and web enhancement) program compared with a services-as-usual comparison group, among 400 reintegrating MN Army National Guard (MN ARNG) families with 6-12 year old children.
Within the ADAPT intervention group, detail and describe responsiveness to intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ADAPT | Experimental | Parents participate in a 14-week in person group based version of ADAPT with web-enhanced online ADAPT materials. |
|
| Comparison Group | No Intervention | Parents receive services as usual (pamphlets, brochures, etc) on parenting typically found at a VA or Dr.'s office. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ADAPT | Behavioral | Two hour, once a week in-person parenting program for 14 weeks plus use web-enhanced supplemental ADAPT materials |
|
| Measure | Description | Time Frame |
|---|---|---|
| Assess effectiveness of the After Deployment: Adaptive Parenting Tools/ADAPT program | Compare child adjustment with parental adjustment | Change from Baseline, at 6 months , at 12 months , at 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Examine dosage and participation in ADAPT. | Report dosage for group (face-to-face) vs web components of ADAPT | Change from Baseline, at 6 months, at 12 months, at 24 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Abigail Gewirtz, PhD | University of Minnesota | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42406485 | Derived | Chan ACY, Lee SK, Hanson AN, Gewirtz AH, Piehler TF. Online versus telehealth delivery of a parenting program for postdeployed military families: Child internalizing and externalizing symptoms as moderators of response. J Consult Clin Psychol. 2026 Jun;94(6):353-363. doi: 10.1037/ccp0001018. | |
| 42081045 | Derived |
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This study is a two-group randomized controlled effectiveness trial with baseline and three follow-up assessment points
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| Cheng CH, Lee SS, Gewirtz AH. Effects of the ADAPT Military Parenting Program on Parenting Behaviors in a Subsample of Deployed Mothers. Prev Sci. 2026 Apr;27(4):623-629. doi: 10.1007/s11121-026-01927-x. Epub 2026 May 4. |
| 38546621 | Derived | Gewirtz AH, DeGarmo DS, Lee S. What works better? 1-year outcomes of an effectiveness trial comparing online, telehealth, and group-based formats of a military parenting program. J Consult Clin Psychol. 2024 May;92(5):310-319. doi: 10.1037/ccp0000882. Epub 2024 Mar 28. |
| 36057024 | Derived | DeGarmo DS, Gewirtz AH, Li L, Tavalire HF, Cicchetti D. The ADAPT Parenting Intervention Benefits Combat Exposed Fathers Genetically Susceptible to Problem Drinking. Prev Sci. 2023 Jan;24(1):150-160. doi: 10.1007/s11121-022-01424-x. Epub 2022 Sep 3. |