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The Parent Perspective: Informing the Cultural Sensitivity of Parenting Programs in Rural Communities

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An Erratum to this article was published on 13 December 2007

Abstract

Using focus group methodology, this study examined parents’ perceptions of a behavioral parenting program offered in a rural, Appalachian community to parents of children with disruptive behavior problems. Parents were asked to comment on barriers to participation, strengths and weaknesses of the parenting program, and recommendations for program improvements. Results suggest that evidence-based parenting programs offer a unique form of social support beyond that received from the kinship communities that typically characterize rural society. However, fears of being judged by mental health professionals and distrust of others are significant cultural and interpersonal barriers that must be addressed through future program modifications. Data representing the parent voice provide rich and innovative ideas that serve to advance research associated with enhancing the cultural sensitivity of evidence-based parenting programs in rural communities.

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Notes

  1. The parenting program was derived from the evidence-based principals included in the protocols of the Defiant Child program (Barkley 1997) and the Community-Oriented Parenting Education (COPE) programs (Cunningham et al. 1996), both of which have substantial empirical support for their effectiveness (e.g., Anastopoulos et al. 1993; Cunningham et al. 1995; Pisterman et al. 1989). Sessions lasted 90 min, during which participants observed videotapes of exaggerated versions of parenting errors, discussed the observed errors and the impact these errors have on child behavior and parent–child relationships, learned effective parenting strategies, and collectively formulated solutions to the problem. Topics covered included: the cycle of noncompliance, positive attending, planned ignoring, effective instructions, time out (2 sessions), point systems, response cost, managing behavior in public places, and a review of all skills during a booster session. The parenting program was held at a local recreation facility, and dinner and childcare were provided. To evaluate treatment outcome during program implementation, parents were asked to complete a packet of questionnaires before the program began, at the end of the program, and at 2-month follow up. Parents received monetary compensation for completing the questionnaires, but not for attending the parenting group. The packet included a demographic questionnaire, The Ohio Scales (Ogles et al. 1999) problem severity and functioning subscales, and The Disruptive Behavior Stress Index (Johnson and Reader 2002) number of stressors and severity of stressors subscales.

  2. See Footnote 1.

References

  • Anastopoulos, A. D., Shelton, T. L., DuPaul, G. J., & Guevremont, D. C. (1993). Parent training for attention-deficit hyperactivity disorder: Its impact on parent functioning. Journal of Abnormal Child Psychology, 21, 581–596.

    Article  PubMed  Google Scholar 

  • Appalachian Regional Commission (2001). Partnering with parents for successful early childhood development. Washington, DC: Author.

    Google Scholar 

  • Arcury, T. A., Gesler, W. M., Preisser, J. S., Sherman, J., Spencer, J., & Perin, J. (2005). The effects of geography and spatial behavior on health care utilization among the residents of a rural region. Health Services Research, 40, 135–155.

    Article  PubMed  Google Scholar 

  • Barkley, R. A. (1997). Defiant children: A clinician’s manual for assessment and parent training (2nd ed.). New York, NY: Guilford Press.

    Google Scholar 

  • Barkley, R. A., Shelton, T. L., Crosswait, C., Moorehouse, M., Fletcher, K., Barrett, S., et al. (2000). Multi-method psycho-educational intervention for preschool children with disruptive behavior: Preliminary results at post-treatment. Journal of Child Psychology and Psychiatry, 41, 319–332.

    Article  PubMed  Google Scholar 

  • Barlow, J., & Stewart-Brown, S. (2000). Behavior problems and group-based parent education programs. Journal of Developmental and Behavioral Pediatrics, 21, 356–370.

    Article  PubMed  Google Scholar 

  • Baumrind, D. (1968). Authoritarian vs. authoritative parental control. Adolescence, 3, 255–272.

    Google Scholar 

  • Beaver, P. D. (1988). Appalachian cultural systems, past and present. In S. E. Keefe (Ed.), Appalachian mental health (pp. 15–23). Lexington: University Press of Kentucky.

    Google Scholar 

  • Brestan, E. V., & Eyberg, S. M. (1998). Effective psychosocial treatments of conduct-disordered children and adolescents: 29 years, 82 studies, and 5,272 kids. Journal of Clinical Child Psychology, 27, 180–189.

    Article  PubMed  Google Scholar 

  • Couto, R. (1994). An American challenge: A report on economic trends and social issues in Appalachia. Dubuque, IA: Kendall.

    Google Scholar 

  • Cunningham, C. E., Boyle, M., Offord, D., Racine, Y., Hundert, J., Secord, M., et al. (2000). Tri-ministry study: Correlates of school-based parenting course utilization. Journal of Consulting and Clinical Psychology, 68, 928–933.

    Article  PubMed  Google Scholar 

  • Cunningham, C. E., Bremner, R., & Boyle, M. (1995). Large group community-based parenting programs for families of preschoolers at risk for disruptive behavior disorders: Utilization, cost effectiveness, and outcome. Journal of Child Psychology and Psychiatry and Allied Disciplines, 36, 1141–1159.

    Google Scholar 

  • Cunningham, C. E., Bremner, R., & Secord, M. (1996). COPE: The community parent education program. A school-based family systems oriented workshop for parents of children with disruptive behavior disorders. Hamilton, Ontario, Canada: COPE Works.

    Google Scholar 

  • DeLeon, P. H., Wakefield, M., & Hagglund, K. J. (2003). The behavioral health care needs of rural communities. In B. H. Stamm (Ed.), Rural behavioral health care: An interdisciplinary guide (pp. 23–31). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Denham, S. A., Meyer, M. G., & Toborg, M. A. (2004). Tobacco cessation in adolescent females in Appalachian communities. Family and Community Health, 27, 170–181.

    PubMed  Google Scholar 

  • Dumka, L. E., Roosa, M. W., Michaels, M. L., & Suh, K. W. (1995). Using research and theory to develop prevention programs for high risk families. Family Relations: Journal of Applied Family and Child Studies, 44, 78–86.

    Google Scholar 

  • Forehand, R., Middlebrook, J., Rogers, T., & Steffe, M. (1983). Dropping out of parent training. Behaviour Research and Therapy, 21, 663–668.

    Article  PubMed  Google Scholar 

  • Fredrickson, D. D., Jones, T. L., Molgaard, C. A., Carman, C. G., Schukman, J., Dismuke, S., et al. (2005). Optimal design features for surveying low-income populations. Journal of Health Care for the Poor and Underserved, 16(4), 677–690.

    PubMed  Google Scholar 

  • Frick, P. J., & Silverthorn, P. (2001). Psychopathology children. In P. B. Sutker & H. E. Adams (Eds.), Comprehensive handbook of psychopathology (3rd ed., pp. 881–920). New York: Kluwer Academic.

    Google Scholar 

  • Garland, A. F., Hough, R. L., McCabe, K. M., Yeh, M., Wood, P. A., & Aarons, G. A. (2001). Prevalence of psychiatric disorders in youths across five sectors of care. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 409–418.

    Article  PubMed  Google Scholar 

  • Greenlee, R., & Lantz, J. (1993). Family coping strategies and the rural Appalachian working poor. Contemporary Family Therapy: An International Journal, 15, 121–137.

    Article  Google Scholar 

  • Gross, D., Julion, W., & Fogg, L. (2001). What motivates participation and dropout among low-income urban families of color in a prevention intervention? Family Relations: Interdisciplinary Journal of Applied Family Studies, 50, 246–254.

    Google Scholar 

  • Hawley, K. M., & Weisz, J. R. (2005). Youth verses parent working alliance in usual clinical care: Distinctive associations with retention, satisfaction, and treatment outcomes. Journal of Clinical Child and Adolescent Psychology, 34, 117–128.

    Article  PubMed  Google Scholar 

  • Hollingshead, A. B. (1975). Four factor index of social status. New Haven, CT: Yale University Department of Sociology.

    Google Scholar 

  • Iezzoni, L. I., Killeen, M.B., & O’Day, B. L. (2006). Rural residents with disabilities confront substantial barriers to obtaining primary care. Health Services Research, 41(4, part1), 1258–1275.

    PubMed  Google Scholar 

  • Johnson, J. H., & Reader, S. K. (2002). Assessing stress in families of children with ADHD: Preliminary development of the Disruptive Behavior Stress Inventory (DBSI). Journal of Clinical Psychology in Medical Settings, 9, 51–62.

    Article  Google Scholar 

  • Kazdin, A. E., Holland, L., & Breton, S. (1991). Barriers to participation in treatment scale: Parent and therapist versions. New Haven, CT: Yale University.

    Google Scholar 

  • Kazdin, A. E., Holland, L., Crowley, M., & Breton, S. (1997). Barriers to participation in treatment scale: Evaluation and validation in the context of child outpatient treatment. Journal of Child Psychology and Psychiatry, 28, 1051–1062.

    Article  Google Scholar 

  • Kazdin, A. E., & Wassell, G. (1999). Barriers to treatment participation and therapeutic change among children referred for conduct disorder. Journal of Clinical Child Psychology, 28(2), 160–172.

    Article  PubMed  Google Scholar 

  • Kossak, S. N. (2005). Exploring the elements of culturally relevant service delivery. Families in Society: The Journal of Contemporary Social Services, 86,189–195.

    Google Scholar 

  • Lichter, D. T., & Campbell, L. A. (2005). Changing patterns of poverty and spatial inequality in Appalachia. Washington, DC: Appalachian Regional Commission.

    Google Scholar 

  • Lohmann, R. A. (1990). Four perspectives on Appalachian culture and poverty. Journal of the Appalachian Studies Association, 2, 76–88.

    Google Scholar 

  • Lundahl, B., Risser, H. J., & Lovejoy, M. C. (2006). A meta-analysis of parent training: Moderators and follow-up effects. Clinical Psychology Review, 26, 86–104.

    Article  PubMed  Google Scholar 

  • Miller, G. E., & Prinz, R. J. (2003). Engagement of families in treatment for childhood conduct problems. Behavior Therapy, 34, 517–534.

    Article  Google Scholar 

  • Morgan, D. L., & Krueger, R. A. (1998). The focus group kit. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Morrisey-Kane, E., & Prinz, R. J. (1999). Engagement in child and adolescent treatment: The role of parental cognitions and attributions. Clinical Child and Family Psychology Review, 2, 183–198.

    Article  Google Scholar 

  • Murphy, C. E., & Owens, J. S. (2006). Parents’ perceptions of barriers to children’s mental health care in Appalachian Ohio. Poster presented at the Research and Evaluation Enhancement Project Health Disparities Forum, Columbus, Ohio.

  • Nabors, L. A., Ramos, V., & Weist, M. D. (2001). Use of focus groups as a tool for evaluating programs for children and families. Journal of Educational and Psychological Consultation, 12, 243–256.

    Article  Google Scholar 

  • National Institute for Health and Clinical Excellence [NICE] (2006). Parent-training/education programmes in the management of children with conduct disorders. London, England, UK: Social Care Institute for Excellence.

    Google Scholar 

  • New Freedom Commission on Mental Health (2003). Achieving the promise: Transforming mental health care in America. Final report (No. DHHS Pub. SMA-03-3832). Rockville, MD: United States Department of Health and Human Services.

  • O’Fallon L. R., Tyson, F. L., & Dearry, A. (Eds.) (2000). Successful models of community-based participatory research. Washington, DC: National Institute of Environmental Health Sciences.

    Google Scholar 

  • Ogles, B. M., Melendez, G., Davis, D. C., & Lunnen, K. M. (1999). The Ohio youth problems, functioning, and satisfaction scales (short form): Users manual. Columbus, OH: Ohio Department of Mental Health.

    Google Scholar 

  • Orrell-Valente, J. K., Pinderhughes, E. E., Valente, E., Laird, R. D., & Conduct Problems Prevention Research Group (1999). If it’s offered, will they come? Influences on parents’ participation in a community-based conduct problems prevention program. American Journal of Community Psychology, 27, 753–783.

    Google Scholar 

  • Pelham, W. E., Wheeler, T., & Chronis, A. (1998). Empirically supported psychosocial treatments for attention deficit hyperactivity disorder. Journal of Clinical Child Psychology, 27, 190–205.

    Article  PubMed  Google Scholar 

  • Pisterman, S., McGrath, P. J., Firestone, P., Goodman, J. T., Webster, I., & Mallory, R. (1989). Outcome of parent-mediated treatment of preschoolers with attention deficit disorder with hyperactivity. Journal of Consulting and Clinical Psychology, 57, 628–635.

    Article  PubMed  Google Scholar 

  • Prinz, R. J., & Miller, G. E. (1994). Family-based treatment for childhood antisocial behavior: Experimental influences on dropout and engagement. Journal of Consulting and Clinical Psychology, 62, 645–650.

    Article  PubMed  Google Scholar 

  • Qualis Research Associates (1998). The Ethnograph (Version 5.0). Colorado Springs, CO: Author.

  • Serketich, W. J., & Dumas, J. E. (1996). The effectiveness of behavioral parent training to modify antisocial behavior in children: A meta-analysis. Behavior Therapy, 27, 171–186.

    Article  Google Scholar 

  • Sheldrick, R. C., Kendall, P. C., & Heimberg, R. G. (2001). The clinical significance of treatments: A comparison of three treatments for conduct disordered children. Clinical Psychology: Science and Practice, 8, 418–430.

    Article  Google Scholar 

  • Snowden, L. R., & Yamada, A. M. (2005). Cultural differences in access to care. Annual Review of Clinical Psychology, 1, 143–166.

    Article  PubMed  Google Scholar 

  • Spoth, R., Goldberg, C., & Redmond, C. (1999). Engaging families in longitudinal preventive intervention research: Discrete-time survival analysis of socioeconomic and social-emotional risk factors. Journal of Consulting and Clinical Psychology, 67, 157–163.

    Article  PubMed  Google Scholar 

  • Sue, S., & Zane, N. (1987). The role of culture and cultural techniques in psychotherapy: A critique and reformulation. American Psychologist, 42, 37–45.

    Article  PubMed  Google Scholar 

  • The Rural, Appalachian Youth and Families Consortium (1996). Parenting practices and interventions among marginalized families in Appalachia: Building on family strengths. Family Relations, 45, 387–396.

    Article  Google Scholar 

  • U.S. Department of Health and Human Services (2006). Health professional shortage areas. Retrieved September 15, 2006, from http://www.hpsafind.hrsa.gov/HPSASearch.aspx.

  • Webster-Stratton, C., & Hammond, M. (1997). Treating children with early-onset conduct problems: A comparison of child and parent training interventions. Journal of Consulting and Clinical Psychology, 65, 93–109.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Weiss, B., Han, S. S., Granger, D. A., & Morton, T. (1995). Effects of psychotherapy with children and adolescents revisited: A meta-analysis of treatment outcome studies. Psychological Bulletin, 117(3), 450–468.

    Article  PubMed  Google Scholar 

  • Wiehe, V. R. (1990). Religious influence on parental attitudes toward the use of corporal punishment. Journal of Family Violence, 5, 173–186.

    Article  Google Scholar 

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Correspondence to Julie Sarno Owens.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s10566-007-9046-y

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Owens, J.S., Richerson, L., Murphy, C.E. et al. The Parent Perspective: Informing the Cultural Sensitivity of Parenting Programs in Rural Communities. Child Youth Care Forum 36, 179–194 (2007). https://doi.org/10.1007/s10566-007-9041-3

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