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Improving Child Behavior through Reductions in Harsh Discipline: Impacts of a Tiered Video Feedback Intervention

Thu, March 23, 11:45am to 1:15pm, Salt Palace Convention Center, Floor: 1, Meeting Room 151 E-F

Abstract

Introduction
Parental harsh discipline during early childhood is associated with a variety of negative child outcomes, including increased risk of externalizing behaviors. Interventions that promote supportive parenting have been shown to be effective in reducing harsh discipline, even when it is only an indirect target of the program. For instance, both the Video Interaction Project (VIP), a primary preventive intervention that utilizes video feedback to promote parent self-reflection and responsive parenting in pediatric primary care, and the Family Check-Up (FCU), a secondary preventive program that uses video feedback to enhance parental motivation and address parenting and ecological factors that compromise caregiving quality through home visiting, have reduced parental harsh discipline. The Smart Beginnings (SB) program, a tiered intervention that combines VIP and FCU from birth to age 3, seeks to enhance impacts on supportive parenting and child school readiness by addressing family needs across levels of risk, providing a unique strategy to reduce harsh discipline and child externalizing problems. The current study examines the impact of SB on parent harsh discipline and children’s externalizing behaviors at age 4, and mediation of impacts on child behavior through reductions in harsh discipline.
Hypotheses
We hypothesized that parents randomly assigned to SB would use less harsh discipline and that their children would demonstrate fewer externalizing problems, that intervention effects on child externalizing would be mediated by reductions in harsh discipline, and that effects would be strongest for higher risk families.
Study Population
English- and Spanish-speaking, Medicaid-eligible mothers were recruited in postpartum units of hospitals in NYC and Pittsburgh (Table 1) and randomized to SB or usual care. The analytic sample was composed of 273 families with complete data, a subset of 124 of whom screened positive for one or more risk factors, including maternal depression, increased parental stress, reports of family violence, or child welfare agency involvement, during the intervention period.
Method
Parents reported on their use of harsh discipline using the Socolar Discipline Survey and on children’s externalizing behaviors using the Child Behavior Checklist (CBCL) when children were 48m. SB treatment group was assigned at enrollment. Data were analyzed using linear regression, controlling for study site (the level of randomization). Structural equation modeling was used to examine mediation.
Results
Regression analyses indicated that SB was marginally significant in reducing both harsh discipline and children’s externalizing behaviors in the overall sample (Table 1). However, for the subsample of families with increased risks, SB significantly predicted both lower levels of harsh discipline and reduced externalizing behavior (Table 1). Mediation analysis indicated that, among families with increased risks, there was a significant indirect effect of SB on children’s externalizing behavior through impacts on harsh discipline (Figure 1).
Conclusion
Results indicate that SB reduced the use of harsh discipline and child externalizing behavior, particularly for families with increased risks, one year after program completion. These findings provide evidence that interventions utilizing video feedback may provide an effective strategy for promoting supportive parenting and optimal child outcomes, particularly when such programs are tiered to meet families’ needs.

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