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Study Detail

Shapiro, C., Kilburn, J., & Hardin, J. Prevention of behavior problems in a selected population: Stepping Stones Triple P for parents of young children with disabilities. Unpublished manuscript.

Program(s) Reviewed: Triple P-Home Visiting: Stepping Stones

Study Screening Details

Screening DecisionScreening Conclusion
Study Passes ScreensEligible for Review

Study Design Details

RatingDesignAttritionBaseline EquivalenceReassignmentConfounding Factors
ModerateRandomized Controlled TrialLowNot established on race/ethnicity, SES or baseline measures of the outcomeNoneNone
Notes:

Study 2 of 2 in this publication has low attrition for outcomes measured post-treatment (5 months) and rates moderate because the study did not establish that the groups in the analysis were equivalent at baseline, but has high attrition for outcomes measured at follow-up (12 months) and baseline equivalence was not established on race/ethnicity or SES. Therefore, the follow-up (12 month) outcomes in Study 2 rate low. Study 1 of 2 in the publication rates low. It is a randomized controlled trial with high attrition. Although baseline equivalence is established on outcome measures, it is not established on race/ethnicity or SES.

Study Characteristics

Study Participants

In Study 2 in the publication, caregivers of children age 2 or younger who were eligible for services under the Individuals with Disabilities Education Act (IDEA) Part C and who had no history of child maltreatment were eligible to participate in the evaluation. Families were also required to be on the caseload of an IDEA Part C service coordinator who had been trained in the Preventing Child Abuse and Neglect: Parent-Provider Partnerships in Child Care (PCAN) curriculum, which is designed to facilitate effective communication with caregivers. Caregivers deemed eligible for the study received two initial home visits to review consent forms and complete baseline assessments. At the conclusion of the second home visit, 40 caregivers were randomly assigned (20 to treatment and 20 to control). All caregivers in the study were mothers.

Mothers assigned to the treatment group were 32 years old, on average; 45 percent were white and 45 percent were African American. Mothers assigned to the control group were 29 years old, on average; 70 percent were white and 25 percent were African American. Mothers assigned to the control group had significantly lower household incomes than mothers assigned to the treatment group. Outcomes were measured post-treatment (5 months) and at follow-up (12 months). Analytic sample size for the treatment group was slightly lower because of attrition at post-treatment (19 mothers) and at follow-up (18 mothers).

Setting No information was provided.
Home Visiting Services Mothers in the treatment group received Stepping Stones Triple P (SSTP) in addition to IDEA Part C services delivered by a PCA N-trained coordinator. SSTP, a level 4 intervention in the Triple P hierarchy, is a variant of Triple P developed for parents of preadolescent children with disabilities. Sessions included an assessment of areas to target for intervention, giving feedback to parents on assessment findings using a guided participatory model, goal setting, positive parenting strategies, observation and support of parental implementation of parenting skills, planned activities training to promote generalization, and closure. If a DVD player was available, families watched segments of a training DVD created by the developers of SSTP. The DVD segments provided information on causes of child behavioral problems and illustrated the parenting strategies. If a DVD player was not available, the SSTP provider reviewed the relevant sections of the workbook with the parent and demonstrated skills as necessary.
Comparison Condition IDEA Part C services as usual, delivered by a PCA N-trained coordinator. Like those in the treatment group, mothers in the control group received two home visits for baseline assessments before the study began.
Staff Characteristics and Training Practitioners were trained and accredited SSTP providers. Two held master’s degrees in social work, two held bachelor’s degrees in social work and were licensed at the bachelor’s level, and one held a bachelor’s degree and had more than 20 years of experience in family services.
Funding Source National Quality Improvement Center on Early Childhood, which is funded by the Office on Child Abuse and Neglect, Administration for Children, Youth, and Families, U.S. Department of Health and Human Services
Author Affiliation None of the authors are developers of this program model.

Study Registration

Clinicaltrials.gov Identifier: NCT01424943

Study registration was assessed by HomVEE beginning with the 2014 review.

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