***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This paper reports findings on parental engagement in a community-based parent training intervention . As part of a r and omized trial , 821 parents were offered group-based Triple P as a parenting skills prevention program . Program implementation was conducted by practitioners . The intervention was implemented between Waves 1 and 2 of a longitudinal study , with a participation rate of 69 % and a retention rate of 96 % . The study finds that a practitioner-led dissemination can achieve recruitment and completion rates that are similar to those reported in research er-led trials . Second , the study found that different factors are associated with the various stages of the parental engagement process . Family-related organizational and timing obstacles to participation primarily influence the initial stages of parental involvement . The strength of neighborhood networks plays a considerable role at the participation and completion stages of parental engagement . The general course climate and the intensity of program exposure predict the utilization of the program several months after the delivery Background The transition to adolescence is a time of increased vulnerability for risk taking and poor health , social and academic outcomes . Parents have an important role in protecting their children from these potential harms . While the effectiveness of parenting programs in reducing problem behavior has been demonstrated , it is not known if parenting programs that target families prior to the onset of significant behavioral difficulties in early adolescence ( 9 - 14 years ) improve the wellbeing of adolescents and their parents . This paper describes the rationale and methodology of a r and omised controlled trial testing the efficacy of a parenting program for the promotion of factors known to be associated with positive adolescent outcomes , such as positive parenting practice s , parent-adolescent relationships and adolescent behavior . Methods / Design One hundred and eighty parents were r and omly allocated to an intervention or wait list control group . Parents in the intervention group participated in the ABCD Parenting Young Adolescents Program , a 6-session behavioral family intervention program which also incorporates acceptance-based strategies . Participants in the Wait List control group did not receive the intervention during a six month waiting period . The study was design ed to comply with recommendations of the CONSORT statement . The primary outcome measures were reduction in parent-adolescent conflict and improvements in parent-adolescent relationships . Secondary outcomes included improvements in parent psychosocial wellbeing , parenting self-efficacy and perceived effectiveness , parent-adolescent communication and adolescent behavior . Conclusions Despite the effectiveness of parenting programs in reducing child behavioral difficulties , very few parenting programs for preventing problems in adolescents have been described in the peer review ed literature . This study will provide data which can be used to examine the efficacy of a universal parenting interventions for the promotion of protective factors associated with adolescent wellbeing and will add to the literature regarding the relationships between parent , parenting and adolescent factors . Trial Registration Australian New Zeal and Clinical Trials Registry ACTRN12609000194268 A r and omized prevention study for ethnic minority mothers assessed the intervention effects of Parent Management Training — Oregon Model ( PMTO ) on maternal parent practice s and child behavior . Ninety-six mothers from Somalia and Pakistan and their children aged 3 to 9 years were r and omized to PMTO or a wait-list condition ( WLC ) . Assessment s were carried out at the baseline and post-intervention , using st and ardized measures and a multi-agent approach . All analyses were based on the intention-to-treat principle . Analysis of covariance ( ANCOVA ) showed that PMTO was effective in enhancing parent practice s , with a decrease in harsh discipline and an increase in positive parenting . Moreover , PMTO produced reductions in motherreported child conduct problems . The largest effect sizes were found among mothers who attended more than 50 % of the PMTO group sessions . Teacher reports showed , however , that there were no significant intervention effects on conduct problems and social competence in kindergarten or school . The results emphasize the importance and feasibility of offering PMTO to ethnic minority families A large-scale population trial using the Triple P-Positive Parenting Program ( TPS ) was evaluated . The target population was all parents of 4- to 7-year-old children residing in ten geographical catchment areas in Brisbane ( intervention communities ) and ten sociodemographically matched catchment areas from Sydney ( 5 ) and Melbourne ( 5 ) , care as usual ( CAU ) comparison communities . All five levels of the Triple P multilevel system of intervention were employed ; including a local mass media strategy , a primary care strategy , and three more intensive levels of parenting intervention delivered by a range of service providers ( e.g. , health , education , and welfare sectors ) . Program outcomes were assessed through a computer-assisted telephone interview of a r and om sample of households ( N = 3000 ) in each community at pre-intervention and again at two years post-intervention . At post-intervention there were significantly greater reductions in the TPS communities in the number of children with clinical ly elevated and borderline behavioral and emotional problems compared to the CAU communities . Similarly parents reported a greater reduction in the prevalence of depression , stress and coercive parenting . Findings show the feasibility of targeting dysfunctional parenting practice s in a cost-effective manner and the public acceptance of an approach that blends universal and targeted program elements . Editors ’ Strategic Implication s : This is the first positive parenting program to demonstrate longitudinal , population -level effects for parents and children . The authors provide an excellent example of multilevel prevention planning , coordination , execution , and evaluation Despite the potential of parent training as a prevention and behavioral family intervention strategy , there are a number of important issues related to implementation ( e.g. , recruitment and retention of families ) . This paper presents recruitment and retention data from families enrolling in a r and omized controlled universal prevention trial for child behavior problems conducted in Germany . The recruitment rate averaged 31 % ( general project participation ) , with families of lower socioeconomic status ( SES ) participating at a lower rate . Project-declining families most often reported intrusion of privacy as their primary concern . In contrast , once parents were enrolled in the project , participation among those r and omized to the parent training group averaged 77 % ( program/intervention participation ) ; non-participation was mostly due to logistical issues . Parents accepting the offer of parent training were more likely to report child behavior problems than did declining parents . Although parents from more disadvantaged areas had a lower overall level of participation in the project once recruited , parents with children having higher levels of behavior problems indeed were more likely to participate in the intervention . Different recruitment methods may be required to engage high-risk families from socioeconomically disadvantaged areas to further improve community-level impact on child mental health Engaging and retaining families in mental health prevention and intervention programs is critically important to insure maximum public health impact . We evaluated r and omized-controlled trials testing methods to improve family engagement and retention in child mental health programs published since 1980 ( N = 17 ) . Brief , intensive engagement interventions in which providers explicitly addressed families ’ practical ( e.g.  schedules , transportation ) and psychological ( e.g.  family members ’ resistance , beliefs about the treatment process ) barriers as they entered treatment were effective in improving engagement in early sessions . The few interventions found to produce long-term impact on engagement and retention integrated  motivational interviewing , family systems , and enhanced family stress and coping support strategies at multiple points throughout treatment . Few interventions have been tested in the context of prevention programs . There are promising approaches to increasing engagement and retention ; they should be replicated and used as a foundation for future research in this area Three variants of a behavioral family intervention ( BFI ) program known as Triple P were compared using 305 preschoolers at high risk of developing conduct problems . Families were r and omly assigned to enhanced BFI ( EBFI ) , st and ard BFI ( SBFI ) , self-directed BFI ( SDBFI ) , or wait list ( WL ) . At postintervention , the 2 practitioner-assisted conditions were associated with lower levels of parent-reported disruptive child behavior , lower levels of dysfunctional parenting , greater parental competence , and higher consumer satisfaction than the SDBFI and WL conditions . Overall , children in EBFI showed greater reliable improvement than children in SBFI , SDBFI , and WL . By 1-year follow-up , children in all 3 conditions achieved similar levels of clinical ly reliable change in observed disruptive behavior . However , the EBFI and SBFI conditions showed greater reliable improvement on parent-observed disruptive child behavior This study was design ed to test hypotheses about family risk factors and their links to dosage and efficacy of a family-centered preventive intervention .  Participants were 172 families with an 11 year-old child r and omly assigned to the intervention condition in the Strong African American Families Program ( SAAF ) .  Two family risk factors , ratio of adults to children in the household and youth unconventionality , were negatively related to dosage , defined as number of intervention sessions attended . Dosage , in turn , was associated with changes in targeted parenting behavior across the 7 months between pretest and posttest . The effect of family risk factors on the link between program dosage and changes in parenting behavior was stronger for families experiencing more risks . The results highlight the need for engagement strategies for recruiting and retaining high-risk families in preventive interventions In an evaluation of the television series “ Driving Mum and Dad Mad , ” 723 families participated and were r and omly assigned to either a st and ard or technology enhanced viewing condition ( included additional Web-support ) . Parents in both conditions reported significant improvements from pre- to postintervention in their child 's behavior , dysfunctional parenting , parental anger , depression , and self-efficacy . Short-term improvements were maintained at 6-months follow-up . Regressions identified predictors of program outcomes and level of involvement . Parents who watched the entire series had more severe problems at preintervention and high sociodemographic risk than parents who did not watch the entire series . Few sociodemographic , child , or parent variables assessed at preintervention predicted program outcomes or program engagement , suggesting that a wide range of parents from diverse socioeconomic status benefited from the program . Media interventions depicting evidence -based parenting programs may be a useful means of reaching hard to engage families in population -level child maltreatment prevention programs AIMS This research examines adolescent perceptions of neighborhood disorganization and social capital to determine if they are associated with  adolescent alcohol or drug ( AOD ) use , AOD dependence  , and access to AOD treatment .  DESIGN This is a secondary analysis of data from the 1999 and 2000 National Survey on Drug Use and Health ( NSDUH ) . The NSDUH is a cross-sectional survey of a r and om sample of the non-institutionalized United States population and is conducted in respondents ' homes . PARTICIPANTS Youth between the ages of 12 and 17 , yielding a sample size of 38,115 respondents . MEASUREMENTS  Neighborhood disorganization  was self-reported by youth in response to eight items ; 10 items measured social capital . AOD use was also self-reported . AOD dependence was assessed by a series of questions regarding symptoms and impairment that is consistent with the criteria specified in the DSM-IV . RESULTS A little more than half of the youth reported never using alcohol or drugs ( 54.3 % ) , 41.1 % reported lifetime AOD use , and 4.6 % were AOD dependent . Two percent reported receiving AOD treatment . Medium and high levels of social capital were negatively associated with AOD use and dependence . Social capital was unrelated to access to AOD treatment . Neighborhood disorganization was positively associated with AOD use , dependence , and access to treatment . CONCLUSIONS After controlling for individual- and family-level characteristics , neighborhood disorganization and social capital were associated with AOD use and dependence . The findings suggest that subjective measures of social context may be an important component of the complex biopsychosocial model of adolescent AOD addiction and treatment utilization BACKGROUND : The majority of knowledge related to implementation of  family-based substance use prevention programs is based on programs delivered in school and community setting s. The aim of this study is to examine procedures related to implementation effectiveness and quality of two  family-based universal substance use prevention programs  delivered in health care setting s , the Strengthening Families Program : For Parents and Youth 10 - 14 ( SFP ) and Family Matters ( FM ) . These evidence -based programs were delivered as part of a larger r and om control intervention study design ed to assess the influence of program choice vs. assignment on study participation and adolescent substance use outcomes . We also assess the effects of program choice ( vs. assignment to program ) on program delivery . METHODS : A mixed method case study was conducted to assess procedures used to maximize implementation quality and fidelity of family-based prevention programs delivered in health care setting s. Families with an 11 year old child were r and omly selected for study participation from health plan membership data bases of 4 large urban medical centers in the San Francisco Bay Area . Eligible families were initially r and omized to a Choice study condition ( families choose SFP or FM ) or Assigned study condition ( assigned to FM , SFP or control group ) ; 494 ethnically diverse families were selected for participation in study programs . RESULTS : Successful implementation of family prevention programs in health care setting s required knowledge of the health care environment and familiarity with established procedures for developing ongoing support and collaboration . Ongoing training of program deliverers utilizing data from fidelity assessment appeared to contribute to improved program fidelity over the course of the study . Families who chose FM completed the program in a shorter period ( p<.0001 ) and spent more time implementing program activities ( p=0.02 ) compared to families assigned to FM . SFP " choice " families attended more sessions than those assigned to SFP ( 3.5 vs. 2.8 ) , ( p=0.07 ) . CONCLUSION : Program choice appeared to increase family engagement in programs . The goals and approach of universal family-based substance use prevention programs are congruent with the aims and protocol s of adolescent preventive health care services . Future effectiveness trials should assess approaches to integrate evidence -based family prevention programs with adolescent health services In this article , we address three questions concerning the long 
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Discussion There was a lack of consistent evidence for predictors of parental engagement .
Nonetheless , preliminary evidence suggests that engagement enhancement strategies modelled on theories , such as the Health Belief Model and Theory of Planned Behaviour , may increase parents ' engagement .