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Parents' Consumer Preferences for Early Childhood Behavioral Intervention in Primary Care

Riley, Andrew R. PhD*; Walker, Bethany L. PhD*; Wilson, Anna C. PhD*; Hall, Trevor A. PsyD, ABPdN*; Stormshak, Elizabeth A. PhD; Cohen, Deborah J. PhD

Journal of Developmental & Behavioral Pediatrics: December 2019 - Volume 40 - Issue 9 - p 669–678
doi: 10.1097/DBP.0000000000000736

Objective: Early childhood parenting interventions are increasingly delivered in primary care, but parental engagement with those interventions is often suboptimal. We sought to better understand parents' preferences for the content and delivery method of behavioral health guidance in pediatric primary care and to determine the relationship of those preferences with demographic characteristics, child behavior problems, and parenting style.

Methods: Participants were 396 parents of young children recruited from primary care offices. We collected measures of parental preferences (including behavioral topics, intervention strategies, and methods of delivery) for behavioral intervention in primary care, child behavior symptoms, parenting style, and demographic characteristics. Descriptive statistics were used to identify parents' most preferred behavioral topics and intervention delivery methods. We used a hierarchical regression approach to determine whether parenting style predicted parents' preferences beyond demographic and child-level factors.

Results: Nearly all parents (96%) endorsed a behavioral topic (e.g., aggression) as important. Most preferred to receive intervention during routine medical appointments. Child behavior problems correlated with parents' overall interest in behavioral guidance, but clinically significant symptoms did not differentiate interest in any single topic. Socioeconomic factors and negative parenting practices predicted some parental preferences. Notably, lax parenting generally predicted higher interest in behavioral intervention, whereas hostile and physically controlling parenting predicted lower interest.

Conclusion: Most parents are interested in behavioral guidance as part of primary care, but their preferences for the content and delivery of that guidance vary by known socioeconomic, child, and parenting risk factors. Tailoring intervention to parents' preferences may increase engagement with available interventions.

*Department of Pediatrics, Institute on Development & Disability, Oregon Health & Science University, Portland, OR;

Department of Counseling, Family and Human Services, College of Education, University of Oregon, Eugene, OR;

Department of Family Medicine, Oregon Health & Science University, Portland, OR.

Address for reprints: Andrew R. Riley, PhD, Department of Pediatrics, Institute on Development & Disability, Oregon Health & Science University, 707 SW Gaines St, Portland, OR 97239; e-mail:

Supported by the Agency for Healthcare Research and Quality (#K12HS022981), the Health Resources and Services Administration Graduate Psychology Education Program (#D40HP26865), and the National Center for Advancing Translational Sciences of the National Institutes of Health (#UL1TR002369). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.

Disclosure: The authors declare no conflict of interest.

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Received April 19, 2019

Accepted August 21, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.