Nurturing Parenting Program – Infants, Toddlers and Preschoolers

Intervention URL: Nurturing Parenting Program – Infants, Toddlers and Preschoolers Website Address

Brief Description:

The Nurturing Parenting Programs are a family-centered trauma-informed initiative designed to build nurturing parenting skills as an alternative to abusive and neglecting parenting and child-rearing practices. The long term goals are to prevent recidivism in families receiving social services, lower the rate of multi-parent teenage pregnancies, reduce the rate of juvenile delinquency and alcohol abuse, and stop the intergenerational cycle of child abuse by teaching positive parenting behaviors. The Nurturing Programs target all families at risk for abuse and neglect with children birth to 18 years and include primary prevention, secondary prevention, and tertiary (treatment) programming.

The Nurturing Parenting Program (NPP) for Parents and their Infants, Toddlers and Preschoolers (birth to 5 years) was developed to help families who have been identified by child welfare agencies for past child abuse and neglect or who are at high risk for child abuse and neglect.

There are two components of the program - the group base program contains 27 sessions each lasting 2.5 hours. Parents and children meet concurrently in two separate groups. Two facilitators run parents’ group; two facilitators plus two volunteers run the children’s group. Parents and children engage in a 30-minute Nurturing Time with games, songs, snacks and more.

The home base program contains 55 sessions each 90 minutes in length. Parents, children and the Home Visitor work together for 30 minutes having fun and practicing skills. Parents and the Home Visitor work together for the first hour teaching nurturing parenting ideas and techniques.

A large number of evaluations of the Parents and their Infants, Toddler and Preschoolers program have consistently demonstrated positive impacts on parenting attitudes, knowledge, beliefs and behaviours, child abuse and neglect, children's behaviour and attitudes toward parenting and family interactions.

I. Basic Information

Primary Source Document

Type of Publication: Grey literature

Author(s)/Contributor(s): Bavolek SJ

Document Title: The Nurturing Parenting Programs.

Publication or Source: Justice Bulletin (Office of Juvenile Justice and Delinquency Prevention)

URL of Publication or Source: https://www.ncjrs.gov/pdffiles1/ojjdp/172848.pdf

Date of Primary Source Document: 2000-11-01

Language(s):

Web Links

To additional reports about the intervention:

Bavolek et al. (2013). Implementation of the nurturing parenting programs with Latino families in Imperial County, California.

Brotherson et al. (2012). Nurturing Parenting Program in ND. Project overview and year-end report for 2010-2011.

Maher, E. J., Marcynyszyn, L. A., Corwin, T. W., & Hodnett, R. Dosage matters: The relationship between participation in the Nurturing Parenting Program for infants, toddlers, and preschoolers and subsequent child maltreatment. Children and Youth Services Review 2011; 33(8), 1426-1434.

Montañez, M., Devall, E., & VanLeeuwen, D. M. Social capital: Strengthening Mexican-American families through parenting education. Journal of Family and Consumer Sciences 2010; 10(3), 27.

Hodnett, R. H., Faulk, K., Dellinger, A., & Maher, E. Evaluation of the Statewide Implementation of a Parent Education Program in Louisiana’s Child Welfare Agency: The Nurturing Parenting Program for Infants. Final evaluation report submitted to Casey Family Foundations 2009.

Bavolek, S., Keene, R., & Weikert, P. The Florida study: a comparative examination of the effectiveness of the nurturing programs. Final Report, DCF of Florida 2004.

Camp, J. M., & Finkelstein, N. Parenting training for women in residential substance abuse treatment: Results of a demonstration project. Journal of Substance Abuse Treatment 1997; 14(5), 411-422.

Bavolek et al. (1988). Reducing chronic neglect in Utah.

Bavolek, S. J., & Dellinger-Bavolek, J. Increasing the nurturing parenting skills of families in Head Start: Validation of the Nurturing Program for parents and children birth to five years. 1987.

To commentaries about the intervention:

Maher, E. J., Corwin, T. W., Hodnett, R., & Faulk, K. A cost-savings analysis of a statewide parenting education program in child welfare. Research on Social Work Practice 2012; 22(6), 615-625.

Barth, R. P., Landsverk, J., Chamberlain, P., Reid, J. B., Rolls, J. A., Hurlburt, M. S., ... & Kohl, P. L. Parent-training programs in child welfare services: Planning for a more evidence-based approach to serving biological parents. Research on Social Work Practice 2005; 15(5), 353-371.

To visual media-based documentation (photographs, videos, etc.) about the intervention:
Nurturing Parenting Programs – Evidence-based programs for the prevention and treatment of child abuse and neglect. Program developer PowerPoint Presentation.

Type of Practice

Promising Practice

II. Intervention Focus

Intervention Goal / ObjectiveLevel(s) TargetedEquity Focus
Reduce the rate of alcohol abuse in high-risk families (long-term objective)
  • Individual level
  • Interpersonal level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.
Reduce the rate of juvenile delinquency among high-risk youth (long-term objective)
  • Individual level
  • Interpersonal level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.
Stop the intergenerational cycle of child abuse in families by building nurturing parenting skills (long-term objective)
  • Individual level
  • Interpersonal level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.
Reduce the rate of recidivism in families receiving social services (long-term objective)
  • Individual level
  • Interpersonal level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
Teach family members to promote healthy physical and emotional development for themselves and others (intermediate objective)
  • Individual level
  • Interpersonal level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.
Increase communication, expressiveness family support and cohesion within the family (intermediate objective)
  • Individual level
  • Interpersonal level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.
Help parents substitute nurturing behaviors for abusive ones (intermediate objective)
  • Individual level
  • Interpersonal level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.
Increase family members’ awareness of their own and each other’s needs, strengths, and weaknesses (intermediate objective)
  • Individual level
  • Interpersonal level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.
Lower the rate of multiple pregnancies among teenage girls (long-term objective)
  • Individual level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.
Develop positive self-concept and self-esteem in all family members (intermediate objective)
  • Individual level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.

Priority/Target Population for Intervention Delivery

Life Stage

Ethnic/Culture/Language-specific Designations: No/no mention

Health Issue(s) that is/are addressed by the Intervention

Disease Prevention

Health Promotion

Risk Reduction

III. Intervention Context

Intervention's Country of Origin: United States

Geographic Level of Intervention

Community Size where the Intervention has been Implemented: Communities of various sizes

Settings

Educational Settings

Other Community Settings

IV. Social Determinants of Health Focus

Determinants of Health Focus

The population addressed in the intervention faces the following challenges/risks

V. Health Promotion Values, Theories, Strategies and Activities

Values Inherent in the Intervention

Theories/Conceptual Frameworks

Use of Health Promotion Theories

Type of Health Promotion Strategy

Specific Activities of the Intervention

Equity Focused Activities

VI. Intervention Outcomes

Outcomes

Long-term positive outcome(s) - Intervention demonstrated long-term positive outcome(s) that were related to the primary objective(s) and persisted one year more beyond the intervention period.

Ongoing results from research and evaluation were collected and acted on?

Yes. Updated research information, e.g., brain development, socialization learning, is incorporated into program as it becomes available

Outcomes and Impact

Outcomes and Impact Chart
Level of ImpactDescription of OutcomeEquity Focus
Individual LevelThere was a significant positive improvement in Oppressing Children’s Power and Independence subscale from pre- to post-test (percent change: 0.03, effect size = 0.29, p<.001).Outcomes reported for people living in conditions of disadvantage are compared to outcomes for people living in more advantaged conditions.
Individual LevelThere was a significant positive improvement in the Inappropriate Parental Expectations subscale from pre- to post-test (percent change: 0.06, effect size = 0.45, p<.001). Outcomes reported for people living in conditions of disadvantage are compared to outcomes for people living in more advantaged conditions.
Individual LevelThere was a significant positive improvement in the Parent-Child Role Reversal subscale from pre- to post-test (percent change: 0.03, effect size = 0.20, p<.001). Being female or having a partner meant greater positive change in scores on this subscale; difference scores for females, on average, were 1.70 points higher than for males, and difference scores for those with partners were 1.19 points higher than for those without partners. Extent of parent participation was a factor in explaining differences in scores as well. Those who participated in at least 14 out of 16 weeks of sessions (either group and/or home sessions) had greater gains (by 1.06 points on average) than those who did not.Outcomes reported for people living in conditions of disadvantage are compared to outcomes for people living in more advantaged conditions.
Individual LevelThere was a significant positive improvement in the Parental Lack of an Empathic Awareness of Children’s Needs subscale from pre- to post-test (percent change: 0.09, effect size = 0.71, p<.001). The higher the participant’s income and the more children participated, the greater the gains in empathy. For every $1000 dollars of increase in income, on average there was a 0.09 point increase in change in the subscale For each additional session a child participates in, there was a 0.14 point positive increase in change in attitudes about empathic awareness of children’s needs.Outcomes reported for people living in conditions of disadvantage are compared to outcomes for people living in more advantaged conditions.
Individual LevelThere was a significant positive improvement in the Strong Belief in the Use and Value of Corporal Punishment subscale from pre- to post-test (percent change: 0.09, effect size = 0.67, p<.001).Outcomes reported for people living in conditions of disadvantage are compared to outcomes for people living in more advantaged conditions.

Strengths of the Intervention

Challenges of the Intervention

VII. Adaptation

Implementation History

Multiple implementations - Different settings/populations/providers - The intervention showed significant adaptability as it has been implemented in different settings or with different populations or by different provider(s). This can include multiple implementations during the same time period. Each implementation of the intervention must have been substantially the same and must have demonstrated positive results for the primary objectives of the intervention.

Expertise Required for Implementation Within the Context of the Intervention

Requires specialized skills that are easily available within the context - The intervention requires the participation of personnel with advanced skills (e.g. medical doctors, epidemiologists, social workers) but that are easily available within the intervention context.

Do the results indicate that the intervention can be generalized to the general target population?

Yes
Large number of studies in different contexts and with diverse populations; small number of studies found significantly greater positive impacts in groups who received the intervention compared to those who did not.

Has this intervention been replicated or adapted from or to another jurisdiction?

Replication specified:

The program has been broadly studied and disseminated; it has been implemented in all 50 US states and in large number of countries worldwide.

Bavolek et al. (2013). Implementation of the nurturing parenting programs with Latino families in Imperial County, California.

Brotherson et al. (2012). Nurturing Parenting Program in ND. Project overview and year-end report for 2010-2011.

Maher, E. J., Marcynyszyn, L. A., Corwin, T. W., & Hodnett, R. Dosage matters: The relationship between participation in the Nurturing Parenting Program for infants, toddlers, and preschoolers and subsequent child maltreatment. Children and Youth Services Review 2011; 33(8), 1426-1434.

Montañez, M., Devall, E., & VanLeeuwen, D. M. Social capital: Strengthening Mexican-American families through parenting education. Journal of Family and Consumer Sciences 2010; 10(3), 27.

Hodnett, R. H., Faulk, K., Dellinger, A., & Maher, E. Evaluation of the Statewide Implementation of a Parent Education Program in Louisiana’s Child Welfare Agency: The Nurturing Parenting Program for Infants. Final evaluation report submitted to Casey Family Foundations 2009.

Bavolek, S., Keene, R., & Weikert, P. The Florida study: a comparative examination of the effectiveness of the nurturing programs. Final Report, DCF of Florida 2004.

Camp, J. M., & Finkelstein, N. Parenting training for women in residential substance abuse treatment: Results of a demonstration project. Journal of Substance Abuse Treatment 1997; 14(5), 411-422.

Bavolek et al. (1988). Reducing chronic neglect in Utah.

Adaptation specified:

International Rescue Committee. (2011). Family based intervention against child abuse and neglect for young parents involved in a youth and livelihoods program in Liberia: A pilot project to build evidence around the potential for parenting skills trainings to protect children from abuse, neglect, and exploitation.

Bavolek, S. J., & Dellinger-Bavolek, J. Building nurturing parenting skills in teenage parents.

Briefly describe in what ways the intervention must not be modified without compromising expected positive results

3 criteria for successful implementation:

  1. Assessing the needs of the family and implementing the right program, the right model with the right dosage and monitoring individual and family progress
  2. Maintaining program fidelity (i.e., to program philosophy, staffing, assessment and dosage)
  3. Employing trained and competent professionals and paraprofessionals capable of facilitating the growth of parents and children.

Is the intervention ongoing or complete?: Complete, Total duration - 2 years

Are there supports available for implementation?
Yes - Facilitator training and Training for Trainers program

Are there resources and/or products associated with the interventions?
Yes - Program manuals, resource materials, DVDs and CDs; games; assessments and evaluations; instructional aids; certificates of completion

Developers/Implementers of the Intervention

Stephen J. Bavolek, Ph.D.

Family Nurturing Center - Main Office

Asheville, North Carolina

(262) 652.6501

Email

Author, Nurturing Parenting Programs

Type of funding used to develop/implement the intervention

Length of funding (for intervention development/implementation)

Other resources used to develop/implement the intervention

Duration/Timing for Implementation

Time used to develop the intervention: Initial 3 day facilitator training

Time used to implement the intervention: Up to 27 weeks for the group based program; Up to 55 weeks for the home-based program

Time used to evaluate the intervention: Incorporated in implementation

Implementers

VIII. Quality and Type of Evidence

Type of Publication: Grey literature

Author(s)/Contributor(s): SJ Bavolek

Document Title: The Nurturing Parenting Programs.

Publication or Source: Justice Bulletin (Office of Juvenile Justice and Delinquency Prevention)

URL of Publication or Source: https://www.ncjrs.gov/pdffiles1/ojjdp/172848.pdf

Date of Primary Source Document: 2016-01-04

Language:

Stakeholder Information Sources (in the Evaluation Study)

Who conducted the evaluation?

Other: Case Family Programs (Foundation)

Research protocol was reviewed by an ethics committee and/or included a set of ethical guidelines: No information available on this topic

Research Limitations

Limitations identified by authors:

The study is limited by missing data. In the two analytic samples used to assess the impact of participation and demographics on parental attitudes and repeat maltreatment, approximately 30 percent of the data were dropped due to missing outcome or demographic data. This amount of missing data compromises the generality and representativeness of findings. If those participants who had missing data are significantly different from those who didn’t, results may not be applicable to the target population we are investigating.

This study design did not incorporate random controlled assignment nor did it involve a comparison group, which limits the ability to infer causality or to generalize findings.

Limitations identified by others: The authors reported that monitoring intervention fidelity across sites was challenging, and many sites likely did not fully adhere to the intervention model.

Nature of Processes

Quality assurance methods were used: No information available on this topic

Evaluation Study Design

Quantitative Study: Quasi - Experimental Design, Pre-Post Test

Quasi-Experimental Design, Pre-Post Test

Sample: The same individual participants were followed over time, linking their pre- and post-intervention responses. - Yes

Measures: The outcome measures were objective (e.g. biochemically validated nicotine levels) or tangible (e.g. number of cigarettes smoked per day) - No/no mention

At least one of the outcome measures were validated (e.g. against a gold-standard measure, assessed for reliability, content validity, or based on previous population surveys or measurement studies) - Yes

Data Collection: The outcomes were assessed before and after the intervention was delivered for a clear comparison before and after the intervention took place - Yes

Follow-up Time Period: There was sufficient time to see an effect between the time before the intervention and after it (e.g. a change in knowledge could be immediate, but a change in behaviour will require several months or longer) - Yes

Statistical Tests: Statistical analyses were performed such as "p" values, confidence intervals, power calculations and/or T tests, Chi-square tests or repeated measures ANOVAs - Yes

General Trends: General population trends were identified and accounted for in the discussion of findings (e.g. given that there was no randomization, there was discussion of how the results were the same or different than the general trends or might have been influenced by trends that were taking place in the environment) - No/no mention