Randomized cluster trial of a parenting program in Chile: Key mediators in the decrease in behavior problems in preschool children

Abstract

Background: Parenting training is a proven strategy for the promotion of positive parenting practices and for the prevention and treatment of behavior problems in children. The processes that explain this efficacy are less clear. The aim of this study was to assess the mediating role of parenting practice modification, encouraged through the implementation of a universal parenting training program, for the decrease of behavior problems in 3- to 6-year-old children. Method: A cluster randomized trial was carried out in 19 educational centers in low and middle socioeconomic areas. A total of 178 families received the program and 154 of them were the control group. The following parenting practices were assessed: positive reinforcement, involvement, inconsistency, unsuitable treatment behaviors and physical punishment, as well as hostility and humiliation behaviors. Parent–child interaction was also assessed using an observational instrument. A multiple mediation analysis was carried out, identifying the indirect effects. Results: Reduction of harsh discipline and physical punishment, and parental inconsistency mediated the effects observed in the reduction of child behavior problems during the program. Conclusion: Within Chilean families, harsh discipline, physical punishment, and parental inconsistency are important aspects to be considered in the implementation of universal parenting training programs.