Influence of Risk Factors for Child Disruptive Behavior on Parent Attendance at a Preventive Intervention.

* Disruptive behavior is the most frequent referral problem to youth mental health clinics (Kazdin, Siegel, & Bass, 1990) and can exact a heavy toll on individuals, families, and communities. A number of programs have been developed to prevent (Creenberg, Domitrovich, & Bumbarger, 2000) and treat (Brestan & Eyberg, 1998) disruptive behavior disorders. Given the critical role parents play in shaping children's behavior, it is important to involve parents in intervention. This is particularly important for parents of children with disruptive behavior problems because they tend to be less effective in managing their children's behavior and tend to use less positive parenting practices (Hawkins et al., 1998).Many studies have established the efficacy of behavioral parent training in reducing disruptive behavior in children (e.g., Brestan & Eyberg, 1998). Multicomponent programs that combine parent and child interventions have proven to be most effective in treating (Kazdin & Weisz, 2003) and preventing (Greenberg et al., 2000) disruptive behavior problems. For example, children who participated in a cognitive behavioral skills training program and whose parents were offered a simultaneous behavioral parent training program showed greater reductions in disruptive behavior and lower rates of substance use 1 year following intervention than children who received the child-only intervention (Lochman & Wells, 2004).Despite the improved outcomes of programs that include parent intervention components, engaging parents in such programs is often a significant challenge. Many programs experience low parent participation and attendance rates (e.g., Barkley et al., 2000; Haggerty et al., 2002; Lee, August, Bloomquist, Mathy, & Realmuto, 2006). Engaging parents is particularly difficult for prevention programs that seek to work with children and families before the child's disruptive behavior problems escalate to the point of causing significant legal, academic, or family problems (Coie et al., 1993; Haggerty et al., 2002). Parents typically do not seek out preventive services themselves and may not yet recognize the need for change. Consequently, parent attendance at preventive intervention sessions is often very low (e.g., in the 30% range; Garvey, iulion, Fogg, Kratovil, & Gross, 2006).Although overall parent attendance at preventive interventions is often quite low, many outcome studies include a subset of parents who attend most or all of the intervention sessions offered. This is an important source of variability to examine, as parent attendance (Lochman, Boxmeyer, Powell, Roth, & Windle, 2006) and engagement (Garvey et al., 2006; Reid, Webster- Stratton, & Baydar, 2004) in behavioral parent training significantly predict children's behavioral outcomes. For example, in the Early Risers program, higher rates of parent attendance were associated with better child academic outcomes (August, Bloomquist, Lee, Realmuto, & Hektner, 2006) and reduced parental distress (August, Realmuto, Hektner, & Bloomquist, 2001), especially for parents of the most disruptive children.Although a considerable amount of research has been devoted to examining the efficacy of parent training in reducing disruptive behavior problems, few empirical studies have examined factors that influence parent attendance, particularly for preventive interventions. The current study was undertaken to better understand the variability in parent attendance and to identify specific factors that predict attendance at parent sessions offered as part of a multicomponent targeted preventive intervention for at-risk aggressive children.Identifying Predictors of Parent AttendanceIn an effort to identify potential predictors of parent attendance in behavioral parent training, we examined the literature on risk and protective factors for child disruptive behavior problems. Three specific factor domains emerged that have consistently been found to predict children's risk for developing disruptive behavior problems. …