Coaching via cell phone can improve parenting

Some while ago I heard talking about ‘Blackberry orphans’, children who were neglected because of the mobile fascination of their parents. Still the cell phone can also be used in a positive way for parenting. In the first randomized trial of the effects of cell phone use, University of Kansas and Notre Dame researchers found that when parenting coaches texted and called mothers who had participated in a home-based parenting program, they were much more likely than the other mothers in the study to learn and use positive parenting strategies — both immediately following and six months after the program ended. They were less depressed and stressed than the control group who didn’t receive parent training as well as the mothers who did receive the same parenting program but without the cell phone component.

But it didn’t only have an effect on the mothers as the press release discloses:

Further, following the parenting program, their children were more adaptable, less anxious and had better communication and social skills, according to Judy Carta, KU professor of special education, who directed the study published in the November 2013 Pediatrics.

The study is the first to test the effectiveness of cell phones as a way of increasing parents’ engagement in home-based parenting programs and keep them from dropping out, said Carta.

“Parents who most need to learn positive ways to interact with their children are often the most likely to drop out of parenting programs,” she said. “Ultimately, this is about preventing child maltreatment by showing parents a different, more positive way to interact with their children.”

The intervention used in the study, Planned Activities Training, is a brief program — five 90-minute home-based sessions — aimed at preventing children’s challenging behavior by giving parents strategies to use in everyday routines around getting ready for school, bedtime and eating dinner.

Parent coaches, known as home visitors, texted mothers twice a day, five days a week as well as calling them at least once a week with reminders from the PAT program along with words of encouragement and suggestions for free activities available in the community that they could do with their children.

“The cell phone allowed the mother and the home visitor to become more connected, said Kathryn Bigelow, KU assistant research professor. “The texts and calls extended the home visits outside of the home.”

With the addition of the cell phone, this relatively short intervention had big effects on parenting, said Bigelow, and since the dropout rate was half of what it was for the group that didn’t include the cell phone component, the model is cost-efficient and really feasible, she said.

“In home visiting programs, parents typically miss about one out of three scheduled home visits,” said Carta, “so when we think about the cost benefit of including cell phones, we know that when parents don’t show up for home visits, it is really expensive for home visiting programs.”

Home visiting is part of the Affordable Health Care Act, said Carta. “That’s given states a whole new impetus to identify evidence-based home visiting programs. Our study will become part of that evidence base.”

Abstract of the research:

BACKGROUND AND OBJECTIVES: Although home visiting programs have been documented to improve parenting in high-risk families, their effectiveness is diminished when parents disengage from programs. Cellular phones offer an approach to promoting parent engagement and enhancing parenting outcomes. Our objective was to examine whether mothers in a parenting intervention, Planned Activities Training (PAT), or cellular phone-enhanced version (CPAT) of the intervention would demonstrate greater use of parenting strategies after treatment and at 6 months post-treatment compared with a wait-list control (WLC).

METHODS: A sample of 371 low-income mothers and their 3.5- to 5.5-year-old children were randomly assigned to condition and assessed at pre-test, post-intervention, and 6 months post-intervention. Treatment efficacy was evaluated through observations of mother-child interactions as well as maternal interviews about depression, parenting stress, and child behaviors.

RESULTS: Mothers receiving PAT and CPAT demonstrated more frequent use of parenting strategies and engaged in more responsive parenting than mothers in the WLC. Mothers receiving CPAT used more PAT parenting strategies than mothers in the other 2 groups and experienced greater reductions in depression and stress. Children of mothers receiving PAT and CPAT demonstrated higher rates of positive engagement, and children of CPAT mothers demonstrated higher levels of adaptive behaviors than children in the WLC. Importantly, changes in parenting, depression, and stress predicted positive child behaviors.

CONCLUSIONS: PAT and CPAT conditions improved parenting strategies and child engagement and reduced children’s challenging behaviors. The addition of cellular phones to a home visiting program enhanced maternal responsivity and reduced depression and stress.

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