Intervention Summary

Parenting Wisely

Parenting Wisely is a set of interactive, computer-based training programs for parents of children ages 3-18 years. Based on social learning, cognitive behavioral, and family systems theories, the programs aim to increase parental communication and disciplinary skills. The original Parenting Wisely program, American Teens, is designed for parents whose preteens and teens are at risk for or are exhibiting behavior problems such as substance abuse, delinquency, and school dropout. Parents use this self-instructional program on an agency's personal computer or laptop, either on site or at home, using the CD-ROM or online format. During each of nine sessions, users view a video enactment of a typical family struggle and then choose from a list of solutions representing different levels of effectiveness, each of which is portrayed and critiqued through interactive questions and answers. Each session ends with a quiz. All nine sessions can be completed in 2 to 3 hours. Parents also receive workbooks containing program content and exercises to promote skill building and practice.

Adaptations of the original Parenting Wisely program have been created for various groups of youth. One of these adaptations, Young Children, targets children ages 3-9 years. Although the studies reviewed in this summary primarily evaluated the original version of Parenting Wisely, the Young Children version was also evaluated, as were adaptations created to be implemented with groups of parents.

Descriptive Information

Areas of Interest	Mental health promotion Substance use disorder prevention
Outcomes	1: Child problem behaviors 2: Parental knowledge, beliefs, and behaviors 3: Parental sense of competence
Outcome Categories	Family/relationships Social functioning
Ages	0-5 (Early childhood) 6-12 (Childhood) 13-17 (Adolescent)
Genders	Male Female
Races/Ethnicities	Black or African American White Non-U.S. population
Settings	Other community settings
Geographic Locations	Urban Suburban Rural and/or frontier
Implementation History	Approximately 320,000 people have participated in Parenting Wisely. The program has been implemented in the United States, as well as in Australia, Canada, China, France, Ireland, New Zealand, Portugal, and the United Kingdom.
NIH Funding/CER Studies	Partially/fully funded by National Institutes of Health: Yes Evaluated in comparative effectiveness research studies: Yes
Adaptations	Program materials have been translated into Spanish and French.
Adverse Effects	No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories	Universal Selective Indicated

Quality of Research

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Gordon, D. A., Kacir, C. D., & Pushak, R. E. Effectiveness of an interactive parent training program for changing adolescent behavior for court-referred parents. Unpublished manuscript.

Study 2

Cefai, J., Smith, D., & Pushak, R. E. The Parenting Wisely Parent Training Program: An evaluation with an Australian sample. Unpublished manuscript, Royal Melbourne Institute of Technology.

Study 3

Kacir, C., & Gordon, D. Parenting Adolescents Wisely: The effectiveness of an interactive videodisk parent training program in Appalachia. Child and Family Behavior Therapy, 21(2), 227-251.

Study 4

Lagges, A., & Gordon, D. Use of an interactive laserdisc parent training program with teenage parents. Child and Family Behavior Therapy, 21(2), 19-37.

Study 5

Pushak, R. E., & Pretty, J. L. Individual and group use of a CD-ROM for training parents of children with disruptive disorders. Unpublished manuscript.

Study 6

Segal, D., Chen, P. Y., Gordon, D. A., Kacir, C. D., & Gylys, J. Development and evaluation of a parenting intervention program: Integration of scientific and practical approaches. International Journal of Human-Computer Interaction, 15, 453-468.

Supplementary Materials

Developer's Comments on Intervention Fidelity

Developer's Comments on Measures

Outcomes

Outcome 1: Child problem behaviors
Description of Measures	This outcome was measured using the Eyberg Child Behavior Inventory (ECBI), a 36-item tool designed to assess parent perceptions of child behavior problems. The ECBI yields two scores: an intensity score, which is the frequency of each behavior, and a total problems score, which is the sum of the number of times a parent indicated the behavior was a problem. The Parent Daily Report was also used to measure this outcome. Parents report on their child's behavior using a list of 23 negative and 28 prosocial behaviors commonly displayed by children.
Key Findings	In one study, parents were randomly assigned to an intervention group receiving Parenting Wisely or to a usual care control group. Children of Parenting Wisely participants showed significant improvement on the ECBI total problems score (p < .001) compared with children of control group parents, a finding associated with a medium effect size (Cohen's d = 0.76). These children also showed a significant decrease in negative behaviors as measured by the Parent Daily Report compared with children of parents in the control group (p < .001). The effect size for this finding was also medium (Cohen's d = 0.69). In an Australian study, parents were randomly assigned to one of two groups receiving Parenting Wisely, one using a group format and one using an individual format, or to a wait-list control group. Children of parents who received Parenting Wisely showed significant improvement on the ECBI intensity score (p < .001) and total problems score (p < .001) at posttest compared with children of control group parents. The effect sizes were large (eta-squared = 0.26 and 0.29, respectively). At the 3-month follow-up, these children continued to show significant improvement on the ECBI intensity score and total problems score compared with children of control group parents (p < .001). The effect sizes for these findings were also large (eta-squared = 0.20 and 0.30, respectively). In a study conducted in Appalachia, parents were randomly assigned to an intervention group receiving Parenting Wisely or to a no-treatment control group. Children of Parenting Wisely participants showed significant improvement on both the ECBI total problems score and problem intensity score compared with children of control group parents at both the 1-month and 4-month follow-ups (p < .001). The effect sizes for both findings were large (eta-squared = 0.35 and 0.36, respectively). A Canadian study compared children of parents who received Parenting Wisely (the American Teens or Young Children version), in one of three ways: individually, in a group, or both individually and in a group. Children of parents in all groups showed significant improvement on both the ECBI intensity score and total problems score at the posttest and 1-year follow-up. Children of parents who completed only the individual program showed significant improvement on the ECBI intensity score (p < .01 at posttest, p < .05 at the 1-year follow-up) and total problems score (p < .01 at posttest, p < .05 at the 1-year follow-up). Likewise, children of parents who completed only the group program showed significant improvement on the ECBI intensity score (p < .0001 at both time points) and total problems score (p < .0001 at posttest, p < .001 at the 1-year follow-up). Children of parents who completed both the individual and group programs showed significant improvement on the ECBI intensity score after the individual sessions (p < .05), after the group sessions (p < .0001), and at the 1-year follow-up (p < .05). These children also showed significant improvement on the total problems score after the individual sessions (p < .01), after the group sessions (p < .0001), and at the 1-year follow-up (p < .05). One study compared parents who were randomly assigned to receive Parenting Wisely through either an interactive multimedia format (IM) or a noninteractive videotape (NV). Children of participants in both groups showed significant improvement in behavior as measured by the ECBI (p < .01), with the effect sizes being medium for the IM condition (Cohen's d = 0.78) and large for the NV condition (Cohen's d = 0.83). Significant improvement on the Parent Daily Report was also seen for both groups (p < .01), with the effect sizes being large for the IM condition (Cohen's d = 1.27) and medium for the NV condition (Cohen's d = 0.69).
Studies Measuring Outcome	Study 1, Study 2, Study 3, Study 5, Study 6
Study Designs	Experimental, Preexperimental
Quality of Research Rating	2.7 (0.0-4.0 scale)

Outcome 2: Parental knowledge, beliefs, and behaviors
Description of Measures	Parental knowledge, beliefs, and behaviors were assessed using four measures: The Parenting Knowledge Test, which consists of 34 multiple-choice questions designed to measure parental knowledge of the skills taught in the Parenting Wisely program. The Parental Attitudes Questionnaire, a 17-item tool designed to assess parental belief in the value of adaptive parenting practices over coercive practices. Responses are given using a 7-point rating scale. The Parent Behavior Questionnaire, an 8-item measure that assesses how often parents implemented specific parenting skills in the past month. The Daily Discipline Interview, which examines parents' discipline strategies in response to the 23 negative behaviors listed in the Parent Daily Report. Parents' descriptions of their discipline strategies were rated to be appropriate or inappropriate according to a coding system developed for the study.
Key Findings	In an Australian study, parents were randomly assigned to one of two groups receiving Parenting Wisely, one using a group format and one using an individual format, or to a wait-list control group. Both groups of parents receiving the program showed significant increases in parenting knowledge at posttest (p < .001). The effect sizes were large for parents receiving the individual format (eta-squared = 0.34) and group format (eta-squared = 0.30). At the 3-month follow-up, participants in both groups continued to show significant improvement (p < .001), with effect sizes again being large for parents receiving the individual format (eta-squared = 0.32) and group format (eta-squared = 0.34). In a study conducted in Appalachia, participants were randomly assigned to an intervention group receiving Parenting Wisely or to a no-treatment control group. At the 1-month follow-up, compared with the control group, intervention participants demonstrated increased knowledge of adaptive parenting practices (p < .001), a finding associated with a large effect size (eta-squared = 0.37). In a third study, pregnant and parenting teens were randomly assigned to an intervention group receiving Parenting Wisely or to a no-treatment control group. Parenting Wisely participants showed significant increases in parenting knowledge (p < .001) relative to the control group, a finding associated with a large effect size (Cohen's d = 1.38). They also showed improvement in their beliefs in the efficacy of adaptive over coercive parenting practices for their toddlers relative to the control group (p < .01). This effect size also was large (Cohen's d = 0.8). In another study, parents were randomly assigned to receive Parenting Wisely through either an interactive multimedia format (IM) or a noninteractive videotape (NV). Participants in both groups showed significant improvement on the Parent Behavior Questionnaire (p < .01) and the Parent Knowledge Test (p < .01). Only the NV group showed significant improvement on the Daily Discipline Interview (p < .01).
Studies Measuring Outcome	Study 2, Study 3, Study 4, Study 6
Study Designs	Experimental
Quality of Research Rating	2.7 (0.0-4.0 scale)

Outcome 3: Parental sense of competence
Description of Measures	This outcome was measured using Parenting Sense of Competence (PSOC), a 16-item self-report measure designed to gauge parental efficacy and satisfaction.
Key Findings	In an Australian study, parents were randomly assigned to one of two groups receiving Parenting Wisely, one using a group format and one using an individual format, or to a wait-list control group. At posttest, parents who received Parenting Wisely in the individual format (p < .001) and in the group format (p = .05) showed improvement in satisfaction and efficacy. Effect sizes were large (eta-squared = 0.26) and small (eta-squared = 0.05), respectively. At the 3-month follow-up, only the parents who received the intervention in the individual format showed significant improvement (p < .001), a finding associated with a large effect size (eta-squared = 0.21).
Studies Measuring Outcome	Study 2
Study Designs	Experimental
Quality of Research Rating	2.8 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study	Age	Gender	Race/Ethnicity
Study 1	6-12 (Childhood) 13-17 (Adolescent)	56.9% Male 43.1% Female	100% White
Study 2	6-12 (Childhood) 13-17 (Adolescent)	50.9% Male 49.1% Female	100% Non-U.S. population
Study 3	6-12 (Childhood) 13-17 (Adolescent)	50% Female 50% Male	100% White
Study 4	13-17 (Adolescent)	88% Female 12% Male	88% White 12% Black or African American
Study 5	0-5 (Early childhood) 6-12 (Childhood) 13-17 (Adolescent)	70.1% Male 29.9% Female	100% Non-U.S. population
Study 6	6-12 (Childhood) 13-17 (Adolescent)	90% Female 10% Male	95% White 5% Black or African American

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

Reliability of measures
Validity of measures
Intervention fidelity
Missing data and attrition
Potential confounding variables
Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome	Reliability of Measures	Validity of Measures	Fidelity	Missing Data/Attrition	Confounding Variables	Data Analysis	Overall Rating
1: Child problem behaviors	2.9	2.9	2.8	2.7	2.6	2.6	2.7
2: Parental knowledge, beliefs, and behaviors	2.4	2.4	2.8	3.3	2.6	2.6	2.7
3: Parental sense of competence	3.0	3.0	2.8	2.5	2.5	3.0	2.8

Study Strengths

Most of the measures used have sufficient psychometric properties. The analyses used are standard in the field.

Study Weaknesses

Most of the studies had small sample sizes. The attrition rates were high in some studies. There were differences between some of the groups at pretest. In some cases, the participants received different types of clinical services. Some of the studies lacked control groups.

Readiness for Dissemination

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Family Works, Inc.. Parenting Wisely: American Teens. Athens, OH: Author.

Family Works, Inc.. Parenting Wisely: Young Children. Athens, OH: Author.

Gordon, D.. Parenting Wisely program workbook: Young children's version. Athens, OH: Family Works.

Gordon, D. Parenting Wisely program workbook. Athens, OH: Family Works.

Gordon, D. Breaking the boundaries in parenting education: Implications for service delivery.

Gordon, D. A., & Pushak, R. Treatment manual for teen version of Parenting Wisely, practitioner-assisted. Athens, OH: Family Works.

Implementation checklist

Pushak, R. E. Parenting Wisely teen: Parent group curriculum instructor's guide. Athens, OH: Family Works.

Sample Training Agenda

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

Availability of implementation materials
Availability of training and support resources
Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation Materials	Training and Support Resources	Quality Assurance Procedures	Overall Rating
3.8	4.0	4.0	3.9

Dissemination Strengths

Implementation materials are comprehensive and user-friendly and utilize multiple formats. While program materials are designed so that minimal additional support is needed, the developer offers on-site training and technical support to implementers upon request. Multiple outcome and process measures, along with the program design, contribute to quality assurance.

Dissemination Weaknesses

Implementation materials can be difficult to access and navigate in CD-ROM format.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description	Cost	Required by Developer
American Teens program kit (includes service provider's guide and program integrity guide)	$659 each	Yes
Additional parent workbooks	$6.75-$9 each depending on quantity purchased	Yes
Online version of American Teens program (includes service provider's guide and program integrity guide)	$39.95 with quantity discounts for bulk purchases of passwords	No
1-day, on-site training	$3,000 per site	No
Technical assistance by phone or email	Free	No