<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03030352</url>
  </required_header>
  <id_info>
    <org_study_id>MOP-130576</org_study_id>
    <nct_id>NCT03030352</nct_id>
  </id_info>
  <brief_title>Promoting Children's Mental Health: The Effects of a Parenting Program</brief_title>
  <official_title>How to Talk so Kids Will Listen &amp; Listen so Kids Will Talk: A Randomized Controlled Trial Assessing the Impact of the French Workshop Format in the General Population</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Université de Montréal</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Canadian Institutes of Health Research (CIHR)</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>Université de Montréal</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      The objectives of the How-to parenting program are 1) to improve optimal parenting style, and&#xD;
      2) to foster children mental health (i.e. decrease in internalized and externalized problems,&#xD;
      and well-being). The investigators expect that parents assigned to experimental groups will&#xD;
      show improvements in parenting over time (i.e improvements in parental affiliation, parental&#xD;
      structure and parental attitude toward autonomy), whereas parents in control groups will not&#xD;
      show such improvements (i.e., stable or declining parenting quality). The investigators also&#xD;
      expect children of parents in experimental groups to experience improvements in child mental&#xD;
      health (i.e., fewer internalized and externalized psychological problems and increased&#xD;
      well-being), whereas children whose parents are on the wait list will not show improvements&#xD;
      over time (i.e., stable or deteriorating mental health and well-being).&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Raising children is a fundamental yet challenging task. While parents are highly invested in&#xD;
      their children's development, they also have a vast influence on it. Indeed, among&#xD;
      environmental factors, the most widely accepted predictor of children mental health is&#xD;
      parenting quality. Research has shown that optimal parenting is composed of three key&#xD;
      dimensions: structure, autonomy support, and affiliation (vs. permissiveness, psychological&#xD;
      control, rejection). For parents, providing all three key &quot;nutriments&quot; is not necessarily&#xD;
      natural or easy. Indeed, it can be challenging to (1) require children to adopt socially&#xD;
      desirable behaviors (2) without thwarting their need for self-determination, (3) while&#xD;
      preserving a positive parent-child relationship. In addition, available parenting resources&#xD;
      (e.g., diverse parenting books) are sometimes contradictory, abstract, and rarely tap all&#xD;
      three important parenting dimensions. Providing the general population with concrete and&#xD;
      complete parenting education is essential in helping parents with their important yet&#xD;
      challenging role.&#xD;
&#xD;
      The goal of the proposed research is to evaluate a parenting program (i.e., How-to program)&#xD;
      that addresses all three key dimensions of optimal parenting. This program is congruent with&#xD;
      basic developmental research and with knowledge from decades of motivation research devoted&#xD;
      to autonomy support and self-determination theory. The objectives of the How-to parenting&#xD;
      program are 1) to improve optimal parenting style, and 2) to foster children mental health&#xD;
      (i.e. decrease child' internal and external problems, and increase child' well-being). The&#xD;
      investigators expect that parents assigned to experimental groups will show improvements in&#xD;
      parenting over time, whereas parents in control groups will not show such improvements (i.e.,&#xD;
      stable or declining parenting quality). The investigators also expect children of parents in&#xD;
      experimental groups to experience improvements in mental health, whereas children whose&#xD;
      parents are on the wait list will not show improvements over time (i.e., stable or&#xD;
      deteriorating mental health and well-being).&#xD;
&#xD;
      The research team will recruit participants and conduct the study in four schools per year,&#xD;
      during four years. The How-to parenting program will be offered to parents of grade school&#xD;
      children (5 to 12 years old). Grade schools will be recruited through Montreal school boards.&#xD;
      Only one parent per family may participate in the study. If parents have more than one child&#xD;
      in grade school, they will be asked to identify the one who is closest to 9 years of age and&#xD;
      then answer questionnaires about this &quot;targeted&quot; child. The seven-week parenting program will&#xD;
      be offered to the experimental groups (one per school) each spring (Years 1 to 4). Each of&#xD;
      these 4 experimental groups will be paired with a wait list control group from the same&#xD;
      school. Parents from these control groups will be offered the program the following year&#xD;
      (Years 2 to 5). In total, 256 parents from different families (mothers or fathers) will be&#xD;
      recruited in participating schools (16 parents [8 in experimental group + 8 in control group]&#xD;
      in each of 4 schools, for 4 years). This sample size was chosen to achieve adequate power,&#xD;
      while keeping the study feasible given participation rate.&#xD;
&#xD;
      The How-to program highlights the importance of structure and teaches parents how to provide&#xD;
      it. Parents learn how to communicate expectations, give feedback, follow through with logical&#xD;
      consequences and use problem solving for recurrent problems. In addition, the program&#xD;
      perfectly captures what it means to be autonomy-supportive. Moreover, this style helps&#xD;
      children feel better about the rules and about themselves. These new skills empower parents&#xD;
      to exert their authority with confidence and, importantly, without guilt. Parents are then&#xD;
      more apt at providing structure effectively and consistently. With the How-to Parenting&#xD;
      program, parents learn how to listen and respond to their children in a way that helps&#xD;
      children feel loved and accepted for who they are.&#xD;
&#xD;
      The How-to parenting program consists of seven 2 ½-hour weekly sessions. It is a manual-based&#xD;
      program in which participants have their own exercise booklet containing parenting skills and&#xD;
      exercises. Groups are led by 2 group leaders and formed of 6 to 10 parents. The format of&#xD;
      this program optimizes learning by (1) linking group content with parents' needs, (2)&#xD;
      facilitating awareness with perspective taking activities, (3) offering concrete parenting&#xD;
      skills, (4) modeling the skills and providing practice in a predictable and non-judgmental&#xD;
      environment, (5) emphasizing the importance of implementing these skills at home for long&#xD;
      term behavioral change, and (6) offering tools (i.e., exercise booklet, skill summary) that&#xD;
      facilitate information retention.&#xD;
&#xD;
      All parents and children will complete the same questionnaires before randomization&#xD;
      (baseline), after the seven-week program (post-test), and again at 6-month and 1-year follow&#xD;
      ups to assess change over time. Data will also be collected from targeted children's&#xD;
      teachers. These teacher reports will be collected at school, at each assessment point. At&#xD;
      follow ups, teacher reports will be provided by participating children's new teachers (i.e.,&#xD;
      in October and April of the 2nd school year). All measures (except for the control variables)&#xD;
      are included at all four assessment times to allow change measurement. The investigators will&#xD;
      adopt an intent-to-treat approach, as this approach increases external and internal validity.&#xD;
&#xD;
      Parenting style measures were reviewed and selected to best reflect recent conceptualizations&#xD;
      of the three key parenting dimensions and to do so with the least overlap. Affiliation&#xD;
      (Parental Bonding Instrument), structure (Parenting Scale), and attitude toward autonomy&#xD;
      (How-to Parenting Skill Scale; Parental Autonomy Support Scale (P-PASS)) are assessed by&#xD;
      parents and children. Child mental health will be assessed using a multi-source approach&#xD;
      (parent, teacher and child reports). Parents will rate their child's internalized and&#xD;
      externalized psychological problems (Child Behavior Checklist; CBCL). Teachers are asked to&#xD;
      evaluate children's classroom and social problems (Teacher-Child Rating Scale; TCRS). The&#xD;
      problem subscales of the TCRS assess internalized (I-) and externalized-(E-) problems.&#xD;
      Teachers will also complete the competencies subscales of the TCRS, which evaluate&#xD;
      socio-emotional competencies (i.e., frustration tolerance, task orientation and social&#xD;
      skills).&#xD;
&#xD;
      In the present data, baseline, post-test, and 6-month and 1-year follow up measures are&#xD;
      nested within a parent, who are nested within a parenting group. To evaluate change over&#xD;
      time, the four assessment points (baseline, post-test, 6-month follow up, and 12-month follow&#xD;
      up) will be treated as repeated measures using a piecewise growth hierarchical linear&#xD;
      modelling (HLM). These analyses are chosen because they model change between each subsequent&#xD;
      time points, which allows for rates of change to differ across time. HLM models are&#xD;
      recommended for intervention studies in order to capture rates of change both in the&#xD;
      intervention period and in the follow up periods. The effect of the parenting program will be&#xD;
      evidenced by significant interactions between rates of change and experimental conditions.&#xD;
      These interactions should reveal that optimal parenting components (H1) and child mental&#xD;
      health indicators (H2) increase over time for participants in the experimental condition, but&#xD;
      not for participants in the control group.&#xD;
&#xD;
      By including all three dimensions of optimal, authoritative parenting, the How-to program&#xD;
      stands in contrast to the majority of existing parenting training programs. In general, most&#xD;
      interventions target children already showing behavioral problems or considered at risk and&#xD;
      focus on behavior management strategies such as planned ignoring or reinforcement. Results&#xD;
      from a recent meta-analysis provide support for the adoption of a program that encompasses&#xD;
      all of the three essential dimensions of optimal parenting. Indeed, results showed that&#xD;
      programs' components that were predictive of larger effects pertained to autonomy support,&#xD;
      affiliation and structure. Though no formal evaluation of the How-to program has been made,&#xD;
      one early study suggested that it was associated with better familial climate and parenting&#xD;
      practices.&#xD;
&#xD;
      This proposal is a first step toward implementing and evaluating a parenting program tailored&#xD;
      to the promotion of children's mental health. By improving parenting, it can ameliorate&#xD;
      children's life-course trajectories, thereby reducing mental health problems and their&#xD;
      associated costs. By offering parenting groups, this research project includes a significant&#xD;
      knowledge transfer component that will directly impact parents enrolled in the program.&#xD;
      Dissemination of findings will be made in schools, by giving school principals, teachers and&#xD;
      parents an easy-to-read summary of results. If the present randomized controlled trial and&#xD;
      following replication trials are successful, a wider dissemination/evaluation trial will be&#xD;
      implemented, making the program widely available to parents.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date>February 2014</start_date>
  <completion_date type="Actual">June 15, 2018</completion_date>
  <primary_completion_date type="Actual">April 28, 2017</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Prevention</primary_purpose>
    <masking>Single (Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Change in parenting style assessed by parents</measure>
    <time_frame>1 week post-intervention, 6 months and 1 year follow-up</time_frame>
    <description>Parenting Style will be assessed by a self-administered questionnaire with 3 subscales.&#xD;
Parental Bonding Scale, Parenting Structure Scale, and Parental Autonomy Support scale.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in children's mental health problems at home</measure>
    <time_frame>1 week post-intervention, 6 months and 1 year follow-up</time_frame>
    <description>Parents will rate their child's I- and E- psychological problems with a questionnaire composed with the Child Behavior Checklist CBCL.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in children's mental health problems at school</measure>
    <time_frame>1 week post-intervention, 6 months and 1 year follow-up</time_frame>
    <description>Teachers are asked to evaluate children's classroom and social problems with the Teacher-Child Rating Scale; TCRS. The problem subscales of the TCRS assess I- (shy-anxious) and E- (acting-out) problems.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in children's competencies at school</measure>
    <time_frame>1 week post-intervention, 6 months and 1 year follow-up</time_frame>
    <description>Teachers will complete the competencies subscales of the TCRS, which evaluate children' socio-emotional competencies (i.e., frustration tolerance, task orientation and social skills).</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in children's well-being</measure>
    <time_frame>1 week post-intervention, 6 months and 1 year follow-up</time_frame>
    <description>Children will assess their own well-being with a self-administered questionnaire with 3 positive indicators; self-esteem, life satisfaction and positive affect.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Change in parenting style assessed by children</measure>
    <time_frame>1 week post-intervention, 6 months and 1 year follow-up</time_frame>
    <description>Children will assess change in parenting style by answering a child report questionnaire.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in parent's mental health problems</measure>
    <time_frame>1 week post-intervention, 6 months and 1 year follow-up</time_frame>
    <description>Parents will assess their own mental health by rating their psychological symptoms (i.e., negative affect, PANAS; anxious and depressive symptoms, General Health Questionnaire).</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in parent's well-being</measure>
    <time_frame>1 week post-intervention, 6 months and 1 year follow-up</time_frame>
    <description>Parents will assess their own well-being with a self-administered questionnaire with 3 positive indicators; self-esteem, life satisfaction and positive affect.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in perceived parental competencies</measure>
    <time_frame>1 week post-intervention, 6 months and 1 year follow-up</time_frame>
    <description>Parents will assess their perceived parental competencies by rating the Basic Need Satisfaction in Relationships Scale.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in parental guilt</measure>
    <time_frame>1 week post-intervention, 6 months and 1 year follow-up</time_frame>
    <description>Parents will assess their guilt by rating the expanded PANAS.</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">315</enrollment>
  <condition>Child Development</condition>
  <arm_group>
    <arm_group_label>How-to Parenting Program</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>The How-to Parenting Program consists of seven 2 ½-hour weekly sessions. It is a manual-based program in which participants have their own exercise booklet containing parenting skills and exercises. Groups are led by 2 group leaders and formed of 6 to 10 parents.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Wait-list Control Group</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>Parents assigned to the wait-list control group will receive no intervention for the duration of the trial. The How-to Parenting Program will be delivered to them the following year. This delayed participation is ethically sound, as the program does not target at-risk families.</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>How-to Parenting Program</intervention_name>
    <description>The How-to Parenting Program addresses all three key dimensions of optimal parenting; autonomy support, affiliation and structure. With weekly workshops, the How-to-Parenting Program optimizes learning by (1) linking group content with parents' needs, (2) facilitating awareness with perspective taking activities, (3) offering concrete parenting skills, (4) modeling the skills and providing practice in a predictable and non-judgmental environment, (5) emphasizing the importance of implementing these skills at home for long term behavioral change, and (6) offering tools (i.e., exercise booklet, skill summary) that facilitate information retention.</description>
    <arm_group_label>How-to Parenting Program</arm_group_label>
    <other_name>How to talk so kids will listen &amp; listen so kids will talk</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Parents must have a child (5-12 years old) attending a participating grade school&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Inability to communicate in the language in which the study is conducted (i.e.,&#xD;
             French)&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Mireille Joussemet, Ph.D.</last_name>
    <role>Principal Investigator</role>
    <affiliation>Université de Montréal</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Geneviève Mageau, Ph.D.</last_name>
    <role>Principal Investigator</role>
    <affiliation>Université de Montréal</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>University of Montreal</name>
      <address>
        <city>Montreal</city>
        <state>Quebec</state>
        <zip>H3T 1J4</zip>
        <country>Canada</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Canada</country>
  </location_countries>
  <verification_date>October 2018</verification_date>
  <study_first_submitted>December 9, 2016</study_first_submitted>
  <study_first_submitted_qc>January 20, 2017</study_first_submitted_qc>
  <study_first_posted type="Estimate">January 25, 2017</study_first_posted>
  <last_update_submitted>October 12, 2018</last_update_submitted>
  <last_update_submitted_qc>October 12, 2018</last_update_submitted_qc>
  <last_update_posted type="Actual">October 15, 2018</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Université de Montréal</investigator_affiliation>
    <investigator_full_name>Mireille Joussemet</investigator_full_name>
    <investigator_title>Associate Professor</investigator_title>
  </responsible_party>
  <keyword>Child Mental Health</keyword>
  <keyword>Parenting</keyword>
  <keyword>Autonomy Support</keyword>
  <keyword>How-to Parenting Program</keyword>
  <keyword>Randomized Controlled Trial</keyword>
  <keyword>Primary Prevention</keyword>
  <keyword>Parental Mental Health</keyword>
  <keyword>Child Well-Being</keyword>
  <study_docs>
    <study_doc>
      <doc_type>Pilot Study of the How-to trial</doc_type>
      <doc_url>http://link.springer.com/article/10.1007/s10826-013-9751-0</doc_url>
    </study_doc>
  </study_docs>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03030352
org study id: MOP-130576
nct id: NCT03030352
lead sponsor: 
collaborator: 
has dmc: No
The objectives of the How-to parenting program are 1) to improve optimal parenting style, and
      2) to foster children mental health (i.e. decrease in internalized and externalized problems,
      and well-being). The investigators expect that parents assigned to experimental groups will
      show improvements in parenting over time (i.e improvements in parental affiliation, parental
      structure and parental attitude toward autonomy), whereas parents in control groups will not
      show such improvements (i.e., stable or declining parenting quality). The investigators also
      expect children of parents in experimental groups to experience improvements in child mental
      health (i.e., fewer internalized and externalized psychological problems and increased
      well-being), whereas children whose parents are on the wait list will not show improvements
      over time (i.e., stable or deteriorating mental health and well-being).
Raising children is a fundamental yet challenging task. While parents are highly invested in
      their children's development, they also have a vast influence on it. Indeed, among
      environmental factors, the most widely accepted predictor of children mental health is
      parenting quality. Research has shown that optimal parenting is composed of three key
      dimensions: structure, autonomy support, and affiliation (vs. permissiveness, psychological
      control, rejection). For parents, providing all three key "nutriments" is not necessarily
      natural or easy. Indeed, it can be challenging to (1) require children to adopt socially
      desirable behaviors (2) without thwarting their need for self-determination, (3) while
      preserving a positive parent-child relationship. In addition, available parenting resources
      (e.g., diverse parenting books) are sometimes contradictory, abstract, and rarely tap all
      three important parenting dimensions. Providing the general population with concrete and
      complete parenting education is essential in helping parents with their important yet
      challenging role.

      The goal of the proposed research is to evaluate a parenting program (i.e., How-to program)
      that addresses all three key dimensions of optimal parenting. This program is congruent with
      basic developmental research and with knowledge from decades of motivation research devoted
      to autonomy support and self-determination theory. The objectives of the How-to parenting
      program are 1) to improve optimal parenting style, and 2) to foster children mental health
      (i.e. decrease child' internal and external problems, and increase child' well-being). The
      investigators expect that parents assigned to experimental groups will show improvements in
      parenting over time, whereas parents in control groups will not show such improvements (i.e.,
      stable or declining parenting quality). The investigators also expect children of parents in
      experimental groups to experience improvements in mental health, whereas children whose
      parents are on the wait list will not show improvements over time (i.e., stable or
      deteriorating mental health and well-being).

      The research team will recruit participants and conduct the study in four schools per year,
      during four years. The How-to parenting program will be offered to parents of grade school
      children (5 to 12 years old). Grade schools will be recruited through Montreal school boards.
      Only one parent per family may participate in the study. If parents have more than one child
      in grade school, they will be asked to identify the one who is closest to 9 years of age and
      then answer questionnaires about this "targeted" child. The seven-week parenting program will
      be offered to the experimental groups (one per school) each spring (Years 1 to 4). Each of
      these 4 experimental groups will be paired with a wait list control group from the same
      school. Parents from these control groups will be offered the program the following year
      (Years 2 to 5). In total, 256 parents from different families (mothers or fathers) will be
      recruited in participating schools (16 parents [8 in experimental group + 8 in control group]
      in each of 4 schools, for 4 years). This sample size was chosen to achieve adequate power,
      while keeping the study feasible given participation rate.

      The How-to program highlights the importance of structure and teaches parents how to provide
      it. Parents learn how to communicate expectations, give feedback, follow through with logical
      consequences and use problem solving for recurrent problems. In addition, the program
      perfectly captures what it means to be autonomy-supportive. Moreover, this style helps
      children feel better about the rules and about themselves. These new skills empower parents
      to exert their authority with confidence and, importantly, without guilt. Parents are then
      more apt at providing structure effectively and consistently. With the How-to Parenting
      program, parents learn how to listen and respond to their children in a way that helps
      children feel loved and accepted for who they are.

      The How-to parenting program consists of seven 2 ½-hour weekly sessions. It is a manual-based
      program in which participants have their own exercise booklet containing parenting skills and
      exercises. Groups are led by 2 group leaders and formed of 6 to 10 parents. The format of
      this program optimizes learning by (1) linking group content with parents' needs, (2)
      facilitating awareness with perspective taking activities, (3) offering concrete parenting
      skills, (4) modeling the skills and providing practice in a predictable and non-judgmental
      environment, (5) emphasizing the importance of implementing these skills at home for long
      term behavioral change, and (6) offering tools (i.e., exercise booklet, skill summary) that
      facilitate information retention.

      All parents and children will complete the same questionnaires before randomization
      (baseline), after the seven-week program (post-test), and again at 6-month and 1-year follow
      ups to assess change over time. Data will also be collected from targeted children's
      teachers. These teacher reports will be collected at school, at each assessment point. At
      follow ups, teacher reports will be provided by participating children's new teachers (i.e.,
      in October and April of the 2nd school year). All measures (except for the control variables)
      are included at all four assessment times to allow change measurement. The investigators will
      adopt an intent-to-treat approach, as this approach increases external and internal validity.

      Parenting style measures were reviewed and selected to best reflect recent conceptualizations
      of the three key parenting dimensions and to do so with the least overlap. Affiliation
      (Parental Bonding Instrument), structure (Parenting Scale), and attitude toward autonomy
      (How-to Parenting Skill Scale; Parental Autonomy Support Scale (P-PASS)) are assessed by
      parents and children. Child mental health will be assessed using a multi-source approach
      (parent, teacher and child reports). Parents will rate their child's internalized and
      externalized psychological problems (Child Behavior Checklist; CBCL). Teachers are asked to
      evaluate children's classroom and social problems (Teacher-Child Rating Scale; TCRS). The
      problem subscales of the TCRS assess internalized (I-) and externalized-(E-) problems.
      Teachers will also complete the competencies subscales of the TCRS, which evaluate
      socio-emotional competencies (i.e., frustration tolerance, task orientation and social
      skills).

      In the present data, baseline, post-test, and 6-month and 1-year follow up measures are
      nested within a parent, who are nested within a parenting group. To evaluate change over
      time, the four assessment points (baseline, post-test, 6-month follow up, and 12-month follow
      up) will be treated as repeated measures using a piecewise growth hierarchical linear
      modelling (HLM). These analyses are chosen because they model change between each subsequent
      time points, which allows for rates of change to differ across time. HLM models are
      recommended for intervention studies in order to capture rates of change both in the
      intervention period and in the follow up periods. The effect of the parenting program will be
      evidenced by significant interactions between rates of change and experimental conditions.
      These interactions should reveal that optimal parenting components (H1) and child mental
      health indicators (H2) increase over time for participants in the experimental condition, but
      not for participants in the control group.

      By including all three dimensions of optimal, authoritative parenting, the How-to program
      stands in contrast to the majority of existing parenting training programs. In general, most
      interventions target children already showing behavioral problems or considered at risk and
      focus on behavior management strategies such as planned ignoring or reinforcement. Results
      from a recent meta-analysis provide support for the adoption of a program that encompasses
      all of the three essential dimensions of optimal parenting. Indeed, results showed that
      programs' components that were predictive of larger effects pertained to autonomy support,
      affiliation and structure. Though no formal evaluation of the How-to program has been made,
      one early study suggested that it was associated with better familial climate and parenting
      practices.

      This proposal is a first step toward implementing and evaluating a parenting program tailored
      to the promotion of children's mental health. By improving parenting, it can ameliorate
      children's life-course trajectories, thereby reducing mental health problems and their
      associated costs. By offering parenting groups, this research project includes a significant
      knowledge transfer component that will directly impact parents enrolled in the program.
      Dissemination of findings will be made in schools, by giving school principals, teachers and
      parents an easy-to-read summary of results. If the present randomized controlled trial and
      following replication trials are successful, a wider dissemination/evaluation trial will be
      implemented, making the program widely available to parents.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Prevention
masking: Single (Outcomes Assessor)
measure: Change in parenting style assessed by parents
time frame: 1 week post-intervention, 6 months and 1 year follow-up
description: Parenting Style will be assessed by a self-administered questionnaire with 3 subscales.
Parental Bonding Scale, Parenting Structure Scale, and Parental Autonomy Support scale.
measure: Change in children's mental health problems at home
time frame: 1 week post-intervention, 6 months and 1 year follow-up
description: Parents will rate their child's I- and E- psychological problems with a questionnaire composed with the Child Behavior Checklist CBCL.
measure: Change in children's mental health problems at school
time frame: 1 week post-intervention, 6 months and 1 year follow-up
description: Teachers are asked to evaluate children's classroom and social problems with the Teacher-Child Rating Scale; TCRS. The problem subscales of the TCRS assess I- (shy-anxious) and E- (acting-out) problems.
measure: Change in children's competencies at school
time frame: 1 week post-intervention, 6 months and 1 year follow-up
description: Teachers will complete the competencies subscales of the TCRS, which evaluate children' socio-emotional competencies (i.e., frustration tolerance, task orientation and social skills).
measure: Change in children's well-being
time frame: 1 week post-intervention, 6 months and 1 year follow-up
description: Children will assess their own well-being with a self-administered questionnaire with 3 positive indicators; self-esteem, life satisfaction and positive affect.
measure: Change in parenting style assessed by children
time frame: 1 week post-intervention, 6 months and 1 year follow-up
description: Children will assess change in parenting style by answering a child report questionnaire.
measure: Change in parent's mental health problems
time frame: 1 week post-intervention, 6 months and 1 year follow-up
description: Parents will assess their own mental health by rating their psychological symptoms (i.e., negative affect, PANAS; anxious and depressive symptoms, General Health Questionnaire).
measure: Change in parent's well-being
time frame: 1 week post-intervention, 6 months and 1 year follow-up
description: Parents will assess their own well-being with a self-administered questionnaire with 3 positive indicators; self-esteem, life satisfaction and positive affect.
measure: Change in perceived parental competencies
time frame: 1 week post-intervention, 6 months and 1 year follow-up
description: Parents will assess their perceived parental competencies by rating the Basic Need Satisfaction in Relationships Scale.
measure: Change in parental guilt
time frame: 1 week post-intervention, 6 months and 1 year follow-up
description: Parents will assess their guilt by rating the expanded PANAS.
arm group label: How-to Parenting Program
arm group type: Experimental
description: The How-to Parenting Program consists of seven 2 ½-hour weekly sessions. It is a manual-based program in which participants have their own exercise booklet containing parenting skills and exercises. Groups are led by 2 group leaders and formed of 6 to 10 parents.
arm group label: Wait-list Control Group
arm group type: No Intervention
description: Parents assigned to the wait-list control group will receive no intervention for the duration of the trial. The How-to Parenting Program will be delivered to them the following year. This delayed participation is ethically sound, as the program does not target at-risk families.
intervention type: Behavioral
intervention name: How-to Parenting Program
description: The How-to Parenting Program addresses all three key dimensions of optimal parenting; autonomy support, affiliation and structure. With weekly workshops, the How-to-Parenting Program optimizes learning by (1) linking group content with parents' needs, (2) facilitating awareness with perspective taking activities, (3) offering concrete parenting skills, (4) modeling the skills and providing practice in a predictable and non-judgmental environment, (5) emphasizing the importance of implementing these skills at home for long term behavioral change, and (6) offering tools (i.e., exercise booklet, skill summary) that facilitate information retention.
arm group label: How-to Parenting Program
other name: How to talk so kids will listen & listen so kids will talk
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
last name: Mireille Joussemet, Ph.D.
role: Principal Investigator
affiliation: Université de Montréal
last name: Geneviève Mageau, Ph.D.
role: Principal Investigator
affiliation: Université de Montréal
facility: 
country: Canada
responsible party type: Principal Investigator
investigator affiliation: Université de Montréal
investigator full name: Mireille Joussemet
investigator title: Associate Professor
study doc: 