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Predictors of Participation in Parenting Workshops Kevin P. Haggerty,1,2 Charles B. Fleming,1 Heather S. Lonczak,1 Monica L. Oxford,1 Tracy W. Harachi,1 and Richard F. Catalano1

Raising Healthy Children is a multi-year, experimental test of a school-based intervention that seeks to promote positive youth development and prevent problem behavior among children recruited into the project in the first or second grade of elementary school. The primary components of the intervention include staff development for teachers in classroom management and instruction, in-home services for high-risk children and their families, and parenting workshops for parents with students attending intervention schools. This paper examines predictors of attendance at parenting workshops. The study panel (n = 272) consists of families with a student who remained at an intervention school through the first five years of the project. Variables that were considered as predictors of parent attendance include social demographic characteristics, parent characteristics (at-risk behavior and smoking), and child characteristics (behavior problems and academic achievement). Parent education and parent’s perception of their child’s antisocial behavior both had positive and statistically significant bivariate associations with attendance. These two variables were also significantly positively associated with attendance in a multivariate model that included low-income and single-parent status, parent smoking and at-risk behavior, and parent rating of child’s antisocial behavior and academic performance. Parents with at-risk behaviors were not significantly more or less likely to attend workshops. KEY WORDS: participation; attendance; prevention; parenting workshops; universal intervention.

Parent training interventions have demonstrated effectiveness in reducing risk factors and enhancing protective factors for maladaptive family, parent and child outcomes (Bry & Krinsley, 1992; Dishion & Andrews, 1995; Farrington & Welsh, 1999; Kosterman, Hawkins, Spoth, Haggerty, & Zhu, 1997; Loeber & Stouthamer-Loeber, 1986; Patterson, 1992; Serketich & Dumas, 1996; Spoth, 1 Social

Development Research Group University Washington, Seattle, Washington. correspondence to Kevin Haggerty, Social Development Research Group, 9725 3rd Avenue, N.E., Suite 401, Seattle, Washington 98115; E-mail: [email protected].

2 Address

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Redmond, Haggerty, & Ward, 1995; Tremblay, Pagani Kurtz, Masse, & Vitaro, 1995; Webster Stratton, 1997) and have been shown to be one of the most costeffective strategies for preventing juvenile delinquency and adult criminal behavior (Greenwood, Model, Rydell, & Chiesa, 1998). Yet the promise of parent training programs is diminished by low recruitment and participation rates (Bauman, Foshee, Ennett, Hicks, & Pemberton, 2001; DeMarsh & Kumpfer, 1986; Fraser, Hawkins, & Howard, 1988; Spoth & Molgaard, 1993; Spoth & Redmond, 2000). Little research has addressed predictors of parent participation in universal programs (defined as programs intended for populations not selected on the basis of risks) (Mrazek, Haggerty, & Institute of Medicine Committee on Prevention of Mental Disorders, 1994). Some researchers have reported decreased participation among those who were most at risk for family-related problems (Dumas, 1986; Patterson, 1996; Wahler, 1980). For example, lack of participation or unfavorable attitudes toward programs have been associated with single motherhood (Dumka, Garza, Roosa, & Stoerzinger, 1997; Rohrbach et al., 1994; Wahler, Leske, & Rogers, 1979), low parent education (Spoth & Conroy, 1993; Spoth & Redmond, 2000; Wahler et al., 1979), and low family income (Rohrbach et al., 1994; Spoth, Redmond, Hockaday, & Shin, 1996; Wahler et al., 1979). Also, parents smoking, which has been identified as a risk factor for child smoking (Conrad, Flay, & Hill, 1992), has been found by Rohrbach and colleagues (1994) and Cohen and Linton (1995) to predict lower attendance at drug use prevention workshops. Although some interventions have had success in recruiting and retaining parents of children with behavior disorders (Webster Stratton, 1992, 1997), research investigating the effect of child behavior problems on program participation by parents is sparse (Biglan & Metzler, 1998). In one of the few investigations of this issue, Spoth and colleagues (1996) and Spoth, Goldberg, and Redmond (1999) used cross-sectional and longitudinal data from the same study and found minimal effects of parent reports of child risk factors (e.g., internalizing and externalizing problems) on participation in parenting workshops designed to prevent drug abuse among a universal population of children. Based on this and other research, Spoth and colleagues (1996) have concluded that perceived risk for child problems may not be a predominant influence on parent participation. Nonetheless, implementing effective parenting programs on a wide scale is impeded by an underlying assumption that the parents most in need of such programs are the least likely participate. It is not unusual to hear practitioners make comments such as, “The parents who don’t need parenting workshops are the ones who come” or “parents who have problems with their kids won’t attend.” Such beliefs are stated within the research community as well (e.g., Biglan & Metzler, 1998). Although researchers have reported a link between some social demographic characteristics (e.g., family income and parent education) and participation, the assumption that parent and child problem behaviors are

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impediments to program attendance has not been confirmed. Because this assumption has the potential to hinder the diffusion of efficacious parenting programs, it needs to be tested empirically. This paper reports on an examination of predictors of attendance at workshops offered as part of Raising Healthy Children (RHC), a multi-year intervention designed to prevent problem behaviors among a cohort of children recruited into the project in 1993 when the children were in early elementary school. The parent programs are embedded in a larger project that includes instructional staff development for teachers, summer camps and study clubs for students, in-home services for high-risk students who exhibited academic or behavioral problems, and parenting workshops. (For a detailed description of the study design and each component of the intervention, see Haggerty, Catalano, Harachi, & Abbott, 1998). Data collected prior to the delivery of the parenting programs are used to predict attendance at parenting workshops among families who remained in the program schools through the fifth year of the project. Variables used to predict program attendance include social demographic characteristics, parent behaviors (at-risk behavior and smoking), and child characteristics (parent report of antisocial behavior and academic performance). Both bivariate and multivariate associations between these predictor variables and parent attendance are analyzed.

METHODS Study Design and Sample In October of 1993 ten public schools from a suburban Seattle school district were randomly assigned to experimental and control conditions. In the fall of the first project year, letters were sent to families with either a first- or second-grade student in both experimental and control schools. To be eligible to participate, families included a parent who spoke English, Spanish, Vietnamese, or Korean and a child who attended a regular classroom and remained in a project school from baseline through the completion of student surveys in the spring of the first year. After receiving the advance letter, each family was approached through a home visit and was invited to participate in the data collection aspect of the project. Of the 1,239 students eligible to participate, 938 (76%) were enrolled in the project, 497 of whom were in intervention schools during the first year of the project. Among these 497 students, there were 19 sibling pairs. For this paper, the family was the unit of analysis; where there were data on siblings, only data on the older child was used. The analyses presented here also excluded families in which the student transferred out of intervention schools prior to the end of the fifth year of the project. This was done because school transfer might confound the relationship between baseline predictors and workshop attendance. For the 272 families with a student who

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stayed in intervention schools for five years, the ethnic composition of the parents who completed the baseline (fall of 1993) parent survey was 84% Caucasian, 7% Asian/Pacific Islander, and 9% other ethnic group. Eighty-five percent were mothers and twelve percent were fathers.3 As measured at baseline, 21% of the households included only one parent (versus any other two-parent configuration) and 16% of the families were receiving AFDC, food stamps or free/reduced school lunches. The subsample of 272 families analyzed here differed significantly from the 206 families of children who transferred out of intervention schools before the end of the first five years of the project with respect to single-parent and lowincome status. Families with students who transferred out of intervention schools were both more likely to have only one parent in the household (32% vs. 21%, X 2 = 7.46, p < .01) and be low income (26% vs. 16%, X 2 = 7.25, p < .01). Workshop Preferences In order to incorporate parent preferences into program planning, 356 parents in intervention schools were surveyed in the fall of 1993 to assess preferences for subject areas to be covered in parenting workshops, barriers for participation, and willingness to attend workshops that were offered. Over 90% of these parents were interested in workshops concerning ways for parents to provide academic support to their children. High percentages of parents were also interested in the topics of raising responsible children (90%), communicating with their children (85%), setting effective limits (79%), and handling misbehavior problems (78%). Parents were most likely to prefer to have the sessions held in the evening (59%) or weekday mornings (16%). Nearly all parents (97%) preferred that the workshops take place at their child’s school. Of the parents interviewed, only 20% had ever attended parenting skills programs before. Seventy percent reported that it was very likely or somewhat likely that they would participate in a five-session parenting skills training program if it was offered at their child’s school. Parents identified trained group leaders (86%), the length of the sessions (71%), the opportunity to talk with other parents (69%), and whether child care was provided at the sessions (60%) as important attributes in deciding whether they would participate in a parent training program. These preferences were taken into account in topic selection and workshop characteristics. Workshops Description Workshop sessions were conducted by two trained leaders at the intervention schools. Most workshop sessions were conducted during the evening, although 3 These

figures refer to biological or adopted mothers and fathers. A small minority (3.3%) of baseline interviews were completed by a step-father, grandmother, or other relative.

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some sessions were offered during the daytime to accommodate parents with different schedules. Parents were recruited by take-home fliers delivered to the classrooms, direct-mail fliers, and phone calls from RHC staff. Child care and snacks were provided for all of the workshop sessions. Transportation was offered as needed. Workshops were open to all parents who had children in the targeted age range at the intervention schools, including parents of children who were not enrolled in the data collection aspect of the study. Topic areas were covered in workshops that involved either a series of linked sessions or a stand-alone session. There were three workshops that included five or six sessions, two three-session workshops, four two-session workshops, and twenty-three single-session workshops. All single- and two-session workshops covered material derived from the multiple-session workshops described below. Based on the interest of parents in helping with their children’s school success, the first five-session workshop focused on this area, using the How to Help Your Child Succeed In School (Developmental Research and Programs, 1991a) curriculum. This series was offered nine times in the first three years of the project. It consisted of five two-hour sessions and was designed to help parents enhance their children’s school experience. The first two sessions focused on developing a home learning routine, learning through play and talk, and communicating with the school. Parents then chose three topics from the following: helping with homework, strengthening children’s reading and language skills, strengthening math skills, teaching skills to children, and coping with problems at school. The program provided activities and learning games for parents to use with children, as well as a guided practice session to provide parents with an immediate opportunity to implement strategies learned in the workshop with their child. A three-session follow-up workshop, One Step Ahead, was offered to parents of students in fourth, fifth or sixth grade. The key focus areas were to help parents implement strategies to foster homework completion and strengthen reading, writing and math skills. Parents also indicated interest in learning how to better handle child behavior problems and improve parent–child communication. Raising Healthy Children: Pro-Active Family Management addressed these issues and was offered nine times during the second and third years of the project. This series of five two-hour workshop sessions was designed to teach parents family management skills through instruction in: (a) creating and communicating a family mission statement; (b) using family meetings and setting limits and expectations in the family; (c) effective discipline strategies; (d) teaching children to be problem-solvers; and (e) managing family conflict. A three-session follow-up workshop, Parenting for Respect and Responsibility, was offered to parents of fourth- through sixth-grade students. The curriculum focused on family communication skills, discipline strategies, and techniques for parents to provide emotion coaching to their children. Preparing for the Drug (Free) Years (PDFY) (Developmental Research and Programs, 1991b), a five- or six-session skills training program based on the social

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development model (Catalano & Hawkins, 1996; Hawkins & Weis, 1985), was offered 12 times during the third, fourth and fifth years of the project. Its primary objective was to enhance parents’ skills in order to promote family bonding and thus reduce family-relevant risks for adolescent substance abuse. One session included children and involved teaching peer resistance skills to children; the remainder focused on helping parents identify potential risk factors in their children for adolescent substance abuse, setting a family policy on drug use, managing parental anger effectively, and enhancing the children’s role in the family as the they mature. Measures Participation in parenting workshops was measured primarily by the total number of workshop sessions attended during the first five years of the project. This measure provided the best representation of overall parent attendance; it is a somewhat limited measure of exposure to parent training curricula in that it counts attendance at one session of a multiple-session workshop the same as attendance at a stand-alone workshop. However, number of sessions attended is closely associated with number of different workshops attended (Pearson’s r = .84) and is thus an adequate measure of curriculum exposure as well as actual attendance. RHC is a longitudinal study in which parents, teachers, and students are surveyed yearly in order to assess the effectiveness of the intervention as well as key variables in a child’s social development. Potential predictors of participation were measured primarily with data from a survey of parents conducted by phone in the fall of 1993, prior to the start of the intervention in February 1994. Predictor variables were chosen based on review of the participation literature and were designed to represent family risk level (as indicated by social demographic variables and parent behavior) and child behavior problems. A measure of lowincome status was derived from whether the family qualified for public assistance or free/reduced lunch program in the 1993/94 school year. Single-parent status was based on whether the child lived with only one parent at the time of the baseline parent survey. Parent education was measured by the mean of the highest level of schooling completed by the student’s parents based on a 9 point ordinal response option. Two aspects of parent behavior were identified. Parent use of cigarettes was measured by parent’s report of whether the parent or the parent’s partner smoked cigarettes in the month prior to the baseline survey. Thirty-eight percent of families had a parent who smoked. A dichotomous measure of parent at-risk behavior was based on whether the respondent or their partner had done any of the following: (a) hit their partner in the prior year or, in the prior month, (b) used illicit drugs (c) drank alcohol three times per day or more, or (d) drank five drinks of alcohol in one occasion once a week or more. Fourteen percent of families included a parent who had engaged in at least one of these behaviors.

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Two aspects of child behavior were assessed using parent baseline survey data. The first was child antisocial behavior using items taken from the Teacher Observation of Classroom Adaptation—Revised (Werthamer-Larsson, Kellam, & Ovesen-McGregor, 1990) and Child Behavior Checklist (Achenbach, 1991). The child antisocial behavior scale was based on 10 items (e.g., “How often is your child cruel or mean to others?” and “How often does your child lie?”) and had a Cronbach’s alpha of .78. Each of the ten items offered a three-point response option of “never,” “sometimes,” and “often.” Parent rating of academic problems was based on two items: “In terms of his/her performance in reading, what type of student is your child?” and “In terms of his/her performance in math, what type of student is your child?” Both of these items offered a five-point response option ranging from “far below average” to “superior.” The Pearson correlation between the two items was .28. In the sample analyzed here, the academic problems measure was not available for one subject whose parent answered “don’t know” to both items. RESULTS Eighty percent of the 272 families had a parent attend at least one RHC parent training session within the first five years of the project. The mean number of sessions attended was 5.64 (s.d. = 6.95, range 0–39). For many families, this represents attendance at multiple sessions of one or two different workshops. The mean number of different workshop series attended was 1.86 (s.d. = 2.01, range 0–12) and 71% of families had a parent attend no more than two different workshop series. Bivariate relationships between predictor variables and attendance were assessed with Pearson correlations or t-tests. Parent education had a modest, but statistically significant bivariate relationship with attendance, as more highly educated parents attended more sessions (r = .13, p < .05). The mean number of sessions attended among families with a parent respondent who had more than a high school education was 6.31 (s.d. = 7.49) compared to 3.60 (s.d. = 4.41) among families that did not include a parent respondent with more than a high school education. Parent report of child antisocial behavior was also positively associated with attendance (r = .18, p < .01), with parents who reported their children to be more antisocial attending more sessions. Parents whose children were in the highest quartile on the antisocial scale attended a mean of 8.28 (s.d. = 7.91) sessions compared to a mean of 4.70 (s.d. = 6.33) sessions for parents of children scored in the lower three quartiles. Table I displays the results of an ordinary least squares regression model predicting number of workshop sessions attended. Parent education and parent report of child antisocial behavior were negatively associated (r = −.15), and thus entering them into the same model revealed that each variable had a slightly stronger

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Haggerty, Fleming, Lonczak, Oxford, Harachi, and Catalano Table I. Multivariate Associations Between Social Demographic, Parent and Child Variables and Parent Attendance at Workshop Sessions (n = 271a )

Social demographic variables Single parent household Parent education Low income Parent characteristics Parent antisocial behavior Parent smokes Child characteristics Antisocial behavior Academic performance

B

s.e.

−1.419 0.712∗ 1.375

1.062 0.286 1.188

−0.589 −0.487

1.229 0.927

4.194∗∗ −0.723

1.362 0.645

a One

case was dropped from the multivariate analyses due to missing data on the academic problems measure. ∗p < .05, ∗∗ p < .01.

unique association with attendance (controlling for other variables in the model) than its overall association with attendance. To test whether the relationships between predictor variables and attendance was consistent across topic areas, three logistic regression models were estimated predicting whether families had a parent attend any session of PDFY, How to Help Your Child Succeed in School, and Pro-Active Family Management. In each case, higher parent education and higher reports of child antisocial behavior were positively associated with attending at least one workshop session and no other variables were significantly predictive. Results of analyses examining the relationship of predictor variables and other measures of attendance (e.g., number of five-session workshop sessions attended, number of single-session workshops attended, and whether families had a parent attend any workshop sessions) were similarly consistent with the results presented in Table I, all showing higher attendance among families with more highly educated parents and children reported to be more antisocial. DISCUSSION The purpose of this study was to investigate assumptions about parent status and their at-risk behavior, and child behavior problems, as impediments to parent participation in universal parenting workshops. The results are consistent with other research (Spoth & Redmond, 2000; Wahler et al., 1979) showing level of parent education as a predictor of workshop participation. Parents who are more highly educated appear to be slightly more receptive to interventions that involve group workshops in a school setting. None of the other indicators of family risk level were associated with attendance. Single parenthood, low-income status,

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parent smoking, and parent at-risk behavior were not predictive of parent participation in RHC workshops. The findings support the argument of Spoth and Redmond (2000) that while parent education is a weak but consistent predictor of attendance, no aspect of parent behavior or family socio-economic status is a clear indication that parents will or will not attend parent workshops. Thus universal parenting programs appear likely to attract a diverse range of parents. The most striking finding is the significant, though modest, positive association found between parent report of child’s antisocial behavior and attendance. Though other studies have found child’s risks unrelated to parent participation (Bauman, Ennett, Foshee, Pemberton, & Hicks, 2001; Spoth et al., 1999), here it was found that parent report of child antisocial behavior had a unique and significant association with parent participation in universal programs. This further serves to contradict the assumption that universal programs will be less able to attract the families who are most in need of services. In the case of the RHC intervention, it is likely that parents attended parenting workshops in order to learn strategies to manage their children’s disruptive or aggressive behavior. Reports of academic problems were not predictive of workshop attendance, including attendance at the How to Help Your Child Succeed in School series. Perhaps due to high levels of parent interest, reflected in the preference survey, a majority of parents were motivated to attend this workshop. Although How to Help Your Child Succeed in School and other workshops addressed academic issues, these workshops taught parenting techniques that could be used with children of all academic skill levels and did not focus on helping parents with children who were struggling with academics. Several limitations to these findings should be considered. RHC parenting workshops were offered as part of a comprehensive set of services at intervention schools. Higher attendance levels among parents who reported antisocial behavior on the part of their children may be partially attributed to the fact that some of these parents received home-based services for families with indicated high-risk children. The introduction to the project through individualized services may have made these parents more likely to attend workshops, Sixty-three of the families in the analysis sample received at least one in-home service visit. These families did, on average, attend more workshop sessions than families who did not receive inhome visits (m = 7.52 vs. m = 5.08, p < .05). However, after adding a variable for whether a family received in-home services to the multivariate model predicting session attendance, the association between attendance and parent report of child antisocial behavior remained positive and statistically significant (b = 3.43, s.e. = 1.40, p < .05). Unlike interventions that take place over a shorter time span, RHC did not attempt to recruit all eligible parents to the same workshop; instead, workshops in a variety of formats were offered over multiple years. The project was successful at getting a majority of families (80%) to have some exposure to the workshops, although many came to sessions of only one or two workshops. Since the workshops

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overlapped and reinforced one another with respect to teaching dimensions of effective parenting, the rates of participation still constitute an acceptable level of participation comparable with other preventive interventions. However, caution should be exercised in generalizing from the findings of this project due to the unique design of the intervention. An additional limitation of this study is that in order not to confound willingness to attend workshops with likelihood of transferring out of intervention schools, the sample was limited to families who had a child in an intervention school for the first five years of the project. These families were significantly more well-off financially and more likely to be two-parent families than families who had a child leave intervention schools prior to the end of five years. Among the 478 families of children in intervention schools at the inception of the project, singleparent status did have a significant negative association with attendance controlling for other variables in the multivariate model (b = −1.51, s.e. = .679, p < .05). In other words, single-parent attendance was lower among the original sample but this was partially attributable to the fact that the children in these households were less likely to remain in intervention schools. It should also be noted that the sample for this study was drawn from a suburban school district in a relatively prosperous area of the country. The sample had fairly low representation of minorities and low-income families. The proportion of the sample that was economically disadvantaged was also diminished by the need to limit analyses to those families who had a child stay in the intervention schools for five years. This was done so as not to confound the willingness of parents to attend workshops with the likelihood that their children would transfer schools. Still, the analysis sample was by no means uniformly affluent. One in five households was headed by a single parent and one in seven qualified for some form of public assistance. Thus the sample is similar to many populations to which universal interventions are likely to be offered. This study takes one step forward in determining predictors of participation in parenting workshops. Parenting workshops offered over time with a variety of services can encourage parents of diverse backgrounds and parents with children exhibiting problem behavior to attend universal parenting programs. Future research must continue to examine how universal parent training can best be marketed, to identify the most effective strategies for recruitment and retention to increase overall parent participation, and to determine effective modes of disseminating parenting information other than depending on school-based workshop formats. The evidence of universal parent- and family-centered approaches as preventive interventions is strong (Kumpfer, 1997; Spoth et al., 1999). For example, a five-session parenting program delivered when a child is in sixth grade can change the trajectory of alcohol use over a four-year period (Park et al., 2000). The promise of wide-scale dissemination of such parenting programs can be diminished by practitioner assumptions that the parents most in need of such programs

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will not attend. This study contributes to the sparse literature base that examines predictors of family participation in multi-session universal parenting interventions and provides evidence that universal programs can successfully recruit both high- and low-risk families. ACKNOWLEDGMENTS This research was supported by research grant # RO1 DA08093 from the National Institute on Drug Abuse. The authors gratefully acknowledge the Edmonds School District #15 for their support and cooperation in the Raising Healthy Children Program. They would also like to thank Cleve Redmond and Dick Spoth for their comments on prior versions of the manuscript. REFERENCES Achenbach, T. M. (1991). Manual for the Teacher’s Report Form and 1991 Profile. Burlington: University of Vermont Department of Psychiatry. Bauman, K. E., Ennett, S. T., Foshee, V. A., Pemberton, M., & Hicks, K. (2001). Correlates of participation in a family-directed tobacco and alcohol prevention program for adolescents. Health Education and Behavior, 28, 440–461. Bauman, K. E., Foshee, V. A., Ennett, S. T., Hicks, K., & Pemberton, M. (2001). Family matters: A family-directed program designed to prevent adolescent tobacco and alcohol use. Health Promotion, 2, 81–96. Biglan, A., & Metzler, C. W. (1998). A public health perspective for research on family-focused interventions. In R. S. Ashery, E. B. Robertson & K. L. Kumpfer (Eds.), Drug abuse prevention through family interventions. NIDA Research Monograph No. 177 (pp. 430–458). Rockville, MD: National Institute on Drug Abuse, U.S. Department of Health and Human Services. Bry, B. H., & Krinsley, K. E. (1992). Booster sessions and long-term effects of behavioral family therapy on adolescent substance use and school performance. Journal of Behavior Therapy and Experimental Psychiatry, 23, 183–189. Catalano, R. F., & Hawkins, J. D. (1996). The social development model: A theory of antisocial behavior. In J. D. Hawkins (Ed.), Delinquency and crime: Current theories (pp. 149–197). New York: Cambridge University Press. Cohen, D. A., & Linton, K. L. P. (1995). Parent participation in an adolescent drug abuse prevention program. Journal of Drug Education, 25, 159–169. Conrad, K. M., Flay, B. R., & Hill, D. (1992). Why children start smoking cigarettes: Predictors of onset. British Journal of Addiction, 87, 1711–1724. DeMarsh, J. P., & Kumpfer, K. L. (1986). Family-oriented interventions for the prevention of chemical dependency in children and adolescents. In S. Griswold-Ezekoye, K. L. Kumpfer & W. J. Bukoski (Eds.), Childhood and chemical abuse: Prevention and intervention (pp. 117–151). New York: Haworth. Developmental Research and Programs. (1991a). How to Help Your Child Succeed in School. Seattle, WA: Author. Developmental Research and Programs. (1991b). Preparing for the Drug Free Years Curriculum. Seattle, WA: Author. Dishion, T. J., & Andrews, D. W. (1995). Preventing escalation in problem behaviors with highrisk young adolescents: Immediate and 1-year outcomes. Journal of Consulting and Clinical Psychology, 63, 538–548. Dumas, J. E. (1986). Parental perception and treatment outcome in families of aggressive children: A causal model. Behavior Therapy, 17, 420–432.

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