Early Intervention For Families Experiencing Homelessness: A Randomized Trial Comparing Two Parenting Programs

Study Overview
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Brief Summary
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This study aims to compare the efficacy in delivering two evidence-based parenting programs to families and young children experiencing homelessness. Outcomes evaluated include feasibility, treatment completion, treatment satisfaction of delivery of interventions as well as child outcomes (e.g., behavior problems, trauma symptoms) and parenting outcomes (parenting stress and parenting skills).

Detailed Description
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The number of homeless families in the U.S. has increased since the 1980s to over half a million as of 2018. Most troubling, in 2013 (the most recent year for which census data is available) one in every 30 children in the U.S., or 2.5 million, experienced homelessness. In addition to having disproportionally higher rates of unmet health needs (e.g., acute health problems, trauma-related injuries), children experiencing homelessness have staggering mental health needs such that 78% suffer from at least one mental health issue (e.g., depression, behavior problems) along with academic/developmental delays. Given that over half of all homeless children in the US are under the age of 6, it is particularly important to investigate the effectiveness of evidence-based parenting programs within a homeless population. This study aims to compare the efficacy in delivering two evidence-based parenting programs to families and young children experiencing homelessness.

Official Title
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Early Intervention For Families Experiencing Homelessness: A Randomized Trial Comparing Two Parenting Programs

Conditions
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Behavior Problem, Parenting

Intervention / Treatment
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* Behavioral: Parent Child Interaction Therapy
* Behavioral: Child Parent Psychotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Any child between the ages of 2 and 5 and his/her mother who is currently homeless and living in the Lotus House shelter. Exclusion Criteria: Family is already involved in a parenting program or does not speak English or Spanish.

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 5 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Parent Child Interaction Therapy<br>Parents and children will receive 12 weekly sessions of PCIT. | Behavioral: Parent Child Interaction Therapy<br>* Parent-child Interaction therapy (PCIT; Eyberg and Robinson, 1982) s a manualized evidence-based behavioral parent training program that integrates social learning and attachment theories. Parents proceed through two distinct phases: Child-Directed Interaction (CDI) resembles traditional play therapy, and Parent-Directed Interaction (PDI) resembles clinical behavior therapy. During all sessions, the therapist coaches each parent in vivo in their use of the CDI and PDI skills with their child.<br>|
| Active Comparator: Child Parent Psychotherapy<br>Parents and children will receive 12 weekly sessions of CPP | Behavioral: Child Parent Psychotherapy<br>* Child-parent psychotherapy (CPP; Lieberman et al., 2005) is a relationship-based treatment that integrates attachment, cognitive-behavioral, social-learning, and psychodynamic theories. CPP focuses on the child-parent relationship as a way to improve the child's adaptive functioning. Various treatment strategies are employed including a focus on safety, affect regulation, the joint construction of a trauma narrative, and engagement in developmentally appropriate activities.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Eyberg Child Behavior Inventory (ECBI) | Change in overall externalizing behavior problems | 16 weeks after start of intervention | 
| Child and Adolescent Trauma Screener (CATS) | Change in overall PTSD symptom severity | 16 weeks after start of intervention | 
| Parenting Stress Index Short Form 4th edition (PSI-SF) | Change in overall level of parenting stress | 16 weeks after start of intervention | 
| The Dyadic Parent-Child Interaction Coding System | Change in positive and negative parenting skills observed during 5 minute child led play session | 16 weeks after start of intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Therapy Attitude Inventory | Mothers' satisfaction with treatment | 16 weeks after start of intervention | 
| Treatment Attendance | Percentage of families who completed the intervention | 16 weeks after start of intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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early intervention, parenting, homelessness, parent child interaction therapy, child parent psychotherapy, behavior problems, trauma symptoms