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					IT WORKS! FINDINGS FROM
THE NATIONAL EVALUATION OF PARENTS
ANONYMOUS® MUTUAL SUPPORT GROUPS


       Margaret (Peggy) L. Polinsky, MSW, PhD
           Director of Research & Evaluation
            Silvia Franco, Parent Leader
               Parents Anonymous® Inc.
                 Claremont, California

      California Child Welfare Evidence-Based Practice Symposium
                 January 30, 2009 – San Diego, California




                                                                   1
Overview for Today
   Background
   Research Questions & Heuristic
   Methodology
   Sample
   Research Findings
   Implications
   Discussion

                                     2
BACKGROUND – OJJDP/NCCD
 Office of Juvenile Justice and
  Delinquency Prevention (OJJDP)
  awarded 2 grants, 1 in 2000 and 1 in
  2005, to
   The National Council on Crime and
    Delinquency (NCCD) in Oakland, CA
   To conduct an evaluation study of
    Parents Anonymous®


                                         3
BACKGROUND–PARENTS ANONYMOUS®


   Parents Anonymous® Precept
   Parents Anonymous® Group Elements
   Parents Anonymous® Group Goals
   4 Therapeutic Principles of Parents
    Anonymous® Groups:
       Mutual Support
       Shared Leadership
       Parent Leadership
       Personal Growth

                                          4
OJJDP OBJECTIVES & GOALS


 Explore efficacy of Parents Anonymous®

 Update previous studies

 Increase methodological rigor




                                           5
 PARTICIPATORY EVALUATION APPROACH

Project Advisory Board, with Parent Leader

   NCCD: Madeline Wordes, PhD; Raelene
    Freitag, PhD; Angie Wolf, PhD
   Consultants: Keith Humphreys, PhD; Julian
    Rappaport, PhD
   Parents Anonymous® Inc.: Peggy Polinsky,
    PhD; Tanya Long, Parent Leader


                                           6
OVERARCHING RESEARCH QUESTION


  Does Parents Anonymous® work
  to reduce the risk of child
  maltreatment and, if so, for all
  parents or for some more than
  others?



                                     7
RESEARCH QUESTIONS
 Do Parents Anonymous® group
  participants improve their parenting
  behaviors and/or reduce their child
  maltreatment behaviors?
 Does Parents Anonymous® group
  participation reduce the potential risk
  factors for child maltreatment?
 Does Parents Anonymous® group
  participation increase the potential
  protective factors for child maltreatment?

                                               8
RESEARCH QUESTIONS (con’t)
 Are there differences in outcomes
  related to child maltreatment, risk
  factors, and protective factors among
  different types of group participants?
 What characteristics distinguish parents
  who continue group participation from
  those who do not?



                                             9
EVALUATION HEURISTIC
                        Individual
                          Parent
                      Characteristics
 Organization
Characteristics



   Group          Processes of Change
Characteristics    Shared Leadership
                   Mutual Support
                   Parents Anonymous® Ethos
    Group
  Facilitator
Characteristics

                                                Intervening
Parent Group                                   Characteristics
   Leader                Intermediate
Characteristics           Outcomes




                      Primary Outcome
                        Prevent Child
                        Maltreatment


                                                                 10
STUDY PHASES & DESIGN
 Process Evaluation (2001-2003)
 Outcome Evaluation (2003-2007)
   Quasi-experimental time-series design
   3 telephone interviews over 6 months
 Outcome Evaluation (2005-2007)
   One-time face-to-face interviews with
    Spanish-speaking Parents Anonymous®
    parents
 Uniqueness
                                      11
16 MEASURES
MEASURES OF CHILD
 MALTREATMENT OUTCOMES
 Parenting Distress – CAPI
 Parenting Rigidity – CAPI
 Psychological and Physical Aggression
  Towards Children – CTSPC


                                          12
MEASURES (con’t)
MEASURES OF RISK FACTORS
 Life Stress Scale - Kanner, et al.
 Parenting Stress Index-Short Form (PSI-SF)
 Emotional and Physical Violence between
  Partners – Conflict Tactics Scale (CTS)
 Alcohol Use-Short Michigan Alcoholism
  Screening Test (SMAST)
 Drug Use-Drug Abuse Screening Test (DAST)


                                         13
MEASURES (con’t)
MEASURES OF PROTECTIVE FACTORS
 Quality of Life Scale - Andrews & Withey
 Social Support – NSSQ
   Emotional/Instrumental
   General
 Parenting Sense of Competence (PSOC)
 Nonviolent Discipline Tactics (CTSPC)
 Family Functioning - McMaster Family
  Assessment Device (FAD)
                                         14
 STUDY PROCEDURES
 100 groups randomly selected from 230
 Group Facilitators contacted, consented and
  trained to recruit parents
 Study goals and benefits explained to parents
  new to group
 Interested parents contacted Study 800# or
  mailed in information
 Researchers called parents, conducted
  informed consent, assigned ID #, conducted
  first interview within week

                                                15
STUDY BENEFITS TO PARENT
PARTICIPANTS

 Talk to an interested person
 Confidentiality
 $50 for first interview
 $75 for second interview
 $100 for third interview

                                 16
PARTICIPANT ELIGIBILITY
REQUIREMENTS
 At least 18 years old
 Living with at least 1 child between
  birth and 17
 New to Parents Anonymous®
 (had not attended more than 5
  Parents Anonymous® group meetings
  during the month or year prior to
  recruitment date)

                                     17
INTERVIEW DESIGN
 Computer Assisted Telephone Interview
  (CATI) – data entered directly into
  database
 One-hour structured interview
 5 domains:
     Demographics & background
     Child maltreatment outcomes
     Child maltreatment risk factors
     Child maltreatment protective factors
     Experience with Parents Anonymous®
                                              18
PARTICIPANTS
 232 parents completed 3 interviews
 206 included in analysis (due to
  retroactive determination that 26 had attended
  group more than 5 times)
 From 54 groups in 19 states
 Sample was representative of the
  general population of Parents
  Anonymous® parents

                                               19
DATA ANALYSIS
 SPSS data files each double-checked for
  accuracy, then merged into single file
 Descriptive statistics, histograms,
  frequency distributions, examination of
  outliers
 Regression analysis assessing scale score
  change over time and differential influence
  on variability in scale score change by
  parent and group characteristics
   Few significant findings led to scrapping plans
    for higher order analyses
   Only t-test results

                                                      20
ANALYSIS GROUPINGS
 Demographic and Background
  variables coded as binary
 Parents who continued through the
  study period (6 months): n=188
 Parents who dropped out after first
  interview: n=18



                                        21
BINARY CODING (N=206)

 Gender: Female (91%) /Male (9%)
 Ethnicity: African American (48%)/White
  (42%)/Other(10%)
 Education: <HS (21%)/HS or more (79%)
 Income: Low (<$13,000 annually) (48%)/High (52%)
 Child with special needs: Yes (50%)
 Prior help-seeking for parenting: Yes (72%)
 Physical or mental illness history: Yes (49%)
 Alcohol or drug abuse history: Yes (18%)
 History of CPS Contact: Yes (27%)
 Mandated attendance: Yes (15%)

                                                22
LOW RISK OF CHILD MALTREATMENT
 Baseline: Parents reported little
  abusive behavior
   CTSPC average scores (scale: 1-5)
     0.71 for psychological aggression
     0.21 for physical aggression
   Average Risk Factors scores low
   Average Protective Factors scores high



                                             23
STATISTICALLY
 SIGNIFICANT
   RESULTS



                24
   REDUCED CHILD
   MALTREATMENT OUTCOMES
                                                         N=188
                                                                              83%
                              73%               65%
                                                                  56%




                     Decreased         Decreased Reduced Use            Stopped
                      Parenting         Parenting      of               Physically
                      Distress           Rigidity Psychological          Abusing
                                                   Aggression            Children
                                                                         (n=52)*
*Only for those who reported physically abusing their children.

                                                                                     25
  REDUCED RISK FACTORS
                                                N=188
                    86%
                                       71%

                                                        40%
                                                                      32%



           High Stressed      Reduced Life   Reduced Any Form Reduced Drug/
          Parents Reduced      Stressors        of Domestic    Alcohol Use
           Parental Stress                        Violence
              (n=46)*
*Only for those in top 25% of Parental Stress scores.                         26
   INCREASED PROTECTIVE FACTORS
                     90%            88%
                                                    84%

      67%                                                          69%             67%




 Quality of Life  Emotional and    Parenting    General Social Use of Non-        Family
   (N=188)         Instrumental    Sense of         Support       Violent       Functioning
                     Support     Competence         (n=49)*     Discipline       (n=44)*
                     (n=43)*        (n=49)*                   Tactics (n=51)*
*Only for those 25% scoring"worst" on these scales.
                                                                                         27
GENERAL FINDINGS
 All parents benefited, but benefit was
  especially consistent for those
  parents most in need on each
  measure at baseline.
 The parents most in need at baseline
  showed statistically significant
  improvement on all child
  maltreatment, risk, and protective
  factors.

                                       28
ONE PARENT’S EXPERIENCE WITH
PARENTS ANONYMOUS®
 Silvia Franco
     Parent
     Parent Leader
     Parent Group Leader
     Group Facilitator




                               29
FINDINGS FOR SPANISH-
LANGUAGE PARENTS

 In a separate segment of the study, 36 parents
  from Spanish-language Parents Anonymous®
  groups in 2 states were assessed with semi-
  structured, in-person, qualitative interviews.
 At the beginning of Parents Anonymous® group
  attendance:
   The parents reported isolation, mental
     health issues, stress, and dysfunctional
     family life


                                              30
Spanish-Language Parents (con’t)
 After attending Parents Anonymous® groups:
   Parents reported more social support, better
     parenting practices, greater satisfaction with
     parenting, higher family functioning, and a
     higher sense of their own worth and
     capabilities.
 The interviewees also reported that the Parents
  Anonymous® group provided confidentiality and
  respect and a willingness to share, explore and
  resolve personal problems.


                                                 31
WHY PARENTS DECIDED TO
ATTEND PARENTS ANONYMOUS®
    Want to be a better parent (40%)
    Want to meet other parents (34%)
    Mandated (15%)
    To get help coping with stress (14%)
    Help others (7%)
    Help with childcare (7%)
    Be in a place where others listen (5%)
    Help to stop hurting their children (1%)

                                                32
IMPACT OF PARENTS ANONYMOUS®
ATTENDANCE – PARENT REPORTING
 Received the services needed to raise
  healthy children (96%)
 Formed relationships with other
  Parents Anonymous® group members
  (77%)
 Parenting became easier (77%)



                                      33
IMPACT OF ATTENDANCE (con’t)
 Changed the way they parent (71%)
   Improved problem solving skills (43%)
   Learned new parenting and discipline
    ideas and methods (43%)
   Became more patient (11%)
   Learned more about child development
    (11%)
   Improved communication skills (9%)


                                            34
STUDY LIMITATIONS
 Not a randomized controlled trial
   Effects may have been due to other
    factors besides Parents Anonymous®
   Participants were volunteers, who may
    have been different from non-volunteers.
 Few parents were at-risk for child
  maltreatment at baseline, limiting the
  statistical analyses.

                                          35
STUDY STRENGTHS
 Longitudinal, time-series design
 Inclusion of child maltreatment risk
  factors not studied before in relation
  of effects of parent support groups:
     alcohol/drugs
     mental health
     family functioning
     domestic violence

                                           36
SUMMARY & IMPLICATIONS
 The broad-based approach to family
  strengthening offered by Parents
  Anonymous® appears to allow parents to
  address their most pressing needs while at
  the same time providing a safety net,
  buffering the impact of the process of
  change across other factors.
 Parents Anonymous® seems to allow
  parents with differing backgrounds and
  differing needs to address and solve their
  particular issues, especially parents with
  the most acute needs upon entry.

                                           37
DISCUSSION QUESTIONS
 EPB designation is mandated these
  days, creating an even greater need
  for evaluation studies such as the one
  presented here, but it is still difficult
  to get funding. How has your
  organization dealt with this issue?




                                          38
DISCUSSION QUESTIONS
 When referring parents for services,
  do Child Welfare staff know how to
  find EBP programs? If not, what can
  be done to increase awareness of
  ways to identify EBP programs?




                                         39
DISCUSSION QUESTIONS
 This study provides information
  showing that Parents Anonymous®
  mutual support groups are an
  effective strategy for preventing child
  abuse and neglect. What do you
  think Child Welfare staff attitudes are
  about the parent mutual support
  group approach, in relation to other
  child maltreatment prevention
  approaches?
                                        40
CONTACT INFORMATION
Peggy Polinsky, MSW, PhD
Director of Research & Evaluation
Parents Anonymous® Inc.
675 West Foothill Blvd., Suite 220
Claremont, CA 91101
Tel: 909-621-6184, Ext. 213
E-mail: ppolinsky@parentsanonymous.org

                                   41

				
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