Modification to a systematically braided parent-support curriculum: Results from a feasibility pilot.

OBJECTIVES: There are a variety of parent-support programs designed to improve parenting and, thereby,the safety and well-being of children. Providers trained in multiple programs are likely to select components of interventions they feel will meet the needs of the families they serve leaving out aspects they deem unnecessary orredundant. In so doing, the fidelity of the evidence-based program is at risk. A potential solution is systematic braiding in which evidence-based programs are combined such that the fidelity to each original model and its implementation are maintained. METHODS: Drawing on qualitative feedback from a prior iteration, this paper discusses results of a feasibility and acceptability pilot of a modified version of the systematically braided Parents as Teachers and SafeCare at Home (PATSCH) curriculum This modification removed a provider-perceived "redundant" portion from the original PATSCH curriculum. A pre-post design (N=18) was used to evaluate the efficacy of the modified curriculum. RESULTS: Significant improvements were seen in trained parent behaviors surrounding home safety and child health. There was also improvement in self-reported parenting behaviors, the portion of the braided curriculum removed, suggesting that the PAT curriculum adequately teaches these skills. Providers and parents were highly satisfied with themodified curriculum. CONCLUSIONS: If a curriculum is modified to reflect provider and parent preferences, then the potential for delivery without fidelity is minimized.

Braiding Two Evidence-based Programs for Families at-risk: Results of a Cluster Randomized Trial.

Child maltreatment is a significant public health problem best addressed through evidence-based parent-support programs. There is a wide range of programs with different strengths offering a variety of options for families. Choosing one single evidence-based program often limits the range of services available to meet the unique needs of families. This paper presents findings from a study to examine the systematic braiding of two evidence-based programs, Parents as Teachers and SafeCare at Home (PATSCH), with the goal to provide a more robust intervention for higher risk families. A cluster randomized effectiveness trial was conducted to examine if PATSCH improved parenting behaviors known to decrease the risk for child maltreatment compared to Parents as Teachers (PAT) Alone. Parents (N= 159; 92 PAT Alone; 67 PATSCH) were enrolled to complete a baseline, 6-month and 12-month assessment. Results indicate the groups did not differ on number of environmental hazards in the home, parents' health care decision-making abilities, child abuse potential, and physical assault over time. However, with regard to the potential for child abuse, the PATSCH group showed a decrease in nonviolence discipline and increase in psychological aggression compared to the PAT group. Further research is needed to better examine this concept and its implications for the field.

Implementing a braided home-based parent-support curriculum: Lessons learned / Introducción de un currículo de apoyo parental «enlazado» con base en el hogar: lecciones aprendidas

A singular parent-support program is limited in its ability to address multiple child and family needs. One innovative solution is braiding, a process in which two evidence-based programs are systematically combined as a newly tailored, cohesive curriculum. In this paper we describe the systematic braiding of two parent-support curricula, Parents as Teachers(R)and SafeCare(R) We highlight implementation challenges to inform future planning and braiding efforts. Based on qualitative data (n=13), we discuss five lessons learned, including identifying a pedagogical approach and sustainability at the model- and site-level. Implications and future directions for braiding and implementation are also discussed

El programa de apoyo parental en solitario se ve limitado por su capacidad para abordar las múltiples necesidades de niños y familias. Una solución innovadora es el braiding (enlazado), un proceso en el que se combinan sistemáticamente dos programas basados en evidencia, como currículo cohesivo y de nuevo diseño. En este documento describimos el braidingsistemático de dos currículos de apoyo parental, «Parents as Teachers(R)»y «SafeCare(R)». Hacemos hincapié en las dificultades de su introducción para informar sobre la planificación futura y los resultados del braiding. Basándonos en los datos cualitativos (n=13), comentamos cinco lecciones aprendidas, incluyendo la identificación de un enfoque pedagógico y la sostenibilidad en relación con el modelo y la localización. También abordamos las direcciones futuras en cuanto a braiding y su introducción

Implementing a Braided Home-based Parent-support Curriculum: Lessons Learned.

A singular parent-support program is limited in its ability to address multiple child and family needs. One innovative solution is braiding, a process in which two evidence-based programs are systematically combined as a newly tailored, cohesive curriculum. In this paper we describe the systematic braiding of two parent-support curricula, Parents as Teachers® and SafeCare®. We highlight implementation challenges to inform future planning and braiding efforts. Based on qualitative data (n = 13), we discuss five lessons learned, including identifying a pedagogical approach and sustainability at the model- and site-level. Implications and future directions for braiding and implementation are also discussed.