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Background
Caregivers critically impact early child development. However, factors associated with poverty, including lack of housing, food security, medical resources and income dramatically hinder caregiver functioning, precipitating deleterious downstream effects on children’s development (McLeod & Shanahan, 1993; Gershoff & Aber et al., 2007). Large, randomized controlled trials of parenting interventions for vulnerable caregivers reveal post-intervention improvements in caregiver functioning and reductions in stress, two variables related to child outcomes (Cuevas et al., 2014; Garner, 2013; Shonkoff & Garner, 2011). Unfortunately, such designs are often not feasible or acceptable within community organizations (Shonkoff & Fisher, 2013). IDEAS Impact Framework was developed with the goal of accelerating the development and implementation of innovative early childhood programs through fast-cycle pilot tests co-created and administered within community settings (Schindler & Fisher et al., 2017). Using a single-group design, the present study examined the effects of community-delivered, caregiver-targeted interventions on caregiver stress and executive functioning (EF) across nine community sites. We hypothesized that improvements in parental stress and caregiver EF would be observed. Furthermore, the association between caregiver EF and parenting stress across time was examined via path analysis.
Procedures
Data from nine community-led programs were aggregated (average intervention duration: 10 weeks). The interventions employed strategies such as parent psychoeducation, computerized training, and video-coaching. Community-sites collected information on parental stress and caregiver EF at pre and post-intervention. Data were aggregated across instruments using percentile scores. EF was measured using the Behavior Rating Inventory of Executive Function-Adult (Roth & Gioia, 2005), Minnesota Executive Function Scale (Carlson & Zelazo, 2014), or NIH Toolbox (Gershon & Cella et al., 2010). Parental distress was measured using the parental distress subscale of the Parenting Stress Index-Short Form (Abidin, 1990). Paired-samples t-tests were conducted to examine programmatic effects on caregiver stress and EF. To explore the influences of caregiver stress on EF, path analysis was conducted (Figure 1).
Results
Caregivers demonstrated significant improvements in EF from pre-test (M=46.24, SD=27.09) to post-test (M=50.49, SD=28.25); t (130) = -2.48, p = .01, Cohen’s d= -.22, and significant reductions in parental distress from pre-test (M=29.92, SD=9.20) to post-test (M=27.07, SD=10.32); t (149) = -3.88, p < .001, Cohen’s d = .32. The path model (RMSEA = .00, CFI = 1.00, TLI = 1.03, R2 = .416) revealed that when controlling for pre-test caregiver EF scores, caregiver EF at post-test was a significant predictor of caregiver parental distress (β = -.11, p < .05; Figure 1).
Discussion
Results demonstrated that aggregated community-level programing was significantly associated with improvements in caregiver EF and parental stress, consistent with more methodically rigorous studies (Sweet & Appelbaum, 2004). These results also highlight the feasibility of researcher and community-site partnerships in collecting research-quality intervention data lending itself to data aggregation. One limitation of the present study is the lack of control groups. Thus, it is unclear if intervention effects are due specifically to active components of the intervention. Taken together, the current study demonstrates the feasibility in evaluating brief, community-delivered interventions for caregivers facing adversity.