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The Filipino family initiative: preliminary effects of an evidence-based parenting intervention offered in churches on parent and child outcomes

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The Filipino family initiative: preliminary effects of an evidence-based parenting intervention offered in churches on parent and child outcomes

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Content 1

THE FILIPINO FAMILY INITIATIVE: PRELIMINARY EFFECTS OF AN EVIDENCE-BASED
PARENTING INTERVENTION OFFERED IN CHURCHES ON
PARENT & CHILD OUTCOMES

Joyce R. Javier, MD, MPH
Assistant Professor of Clinical Pediatrics
Division of General Pediatrics, Department of Pediatrics,
Children’s Hospital Los Angeles,
University of Southern California Keck School of Medicine

Degree Conferral Month: August 2015
The degree being conferred is: Master of Science in Clinical, Biomedical and Translational Investigations

Acknowledgements: The author would like to thank her Master’s Thesis Committee: Drs. Michele Kipke
(Chair), Lawrence Palinkas, and Stanley Azen and Drs. Jeanne Miranda, Carolyn Webster-Stratton, Sheree
Schrager, Dean Coffey, Lois Takahashi, and the Filipino Family Initiative Community Advisory Board for
their mentorship, collaboration, guidance, and support in this study. Funding for this work comes from the
SC CTSI (NIH/NCRR/NCATS) Grant # KL2TR000131 the NIH/NICHD Grant #K23HD071942-01A1.
2

DEDICATION

This thesis is dedicated to my husband, Gerald and my children, Noelani and Sofia. I give my
deepest expression of love and appreciation for the support you gave and the sacrifices you made during
this graduate program. It is also dedicated to my parents, sisters, and dearest grandmother, who never failed
to teach, guide, and support me.

3

TABLE OF CONTENTS
1. Abstract …………………………………………………………………………. 4
2. Background ……………………………………………………………………... 6
3. Methods ………………………………………………………………………… 8
4. Results ……………………………………………………………………………18
5. Discussion ………………………………………………………………………. 25
6. Conclusion ………………………………………………………………………. 27
7. Appendix ………………………………………………………………………… 29
8. References ………………………………………………………………………. 33

4

1. Abstract
Background: Filipinos, the second largest Asian subgroup in the U.S. with the highest concentration
living in Los Angeles County, have significant disparities in youth behavioral health and
academic outcomes compared to non-Hispanic whites and other Asian subgroups. Parenting programs
provided in childhood are effective in preventing the onset and escalation of behavioral health problems
and have been described as a community-identified solution to bridge the intergenerational gap between
Filipino immigrant parents and their children. Yet, participation rates in such programs are low, especially
among hard-to-reach minority populations such as Filipinos.
Objectives: The purpose of this study was to use community engagement to pilot-test an evidence-based
parenting program offered in partnership with a Catholic school and church as a behavioral health
prevention intervention for Filipino youth.
Design/Methods: Twenty-eight Filipino parents and their children ages 6-12 were randomly assigned to
either an intervention group or a waiting-list control group. Parenting practices, parenting stress, and the
children’s baseline behaviors were assessed. Parents in the intervention group attended a parenting program
consisting of 12 weekly 2-hour sessions. Control group parents received the intervention four months later.
Parents reported on parenting practices, parenting stress, and their children’s behavior at pre-, post- and 4-
month follow-up intervals (but control didn’t have 4-month post) vs pre- and post-intervention. Satisfaction
was assessed after completion of the program with a 40-item measure. ANCOV A was used to compare the
intervention group post-intervention versus the control group. Paired t-tests compared mean parenting
practices, parenting stress, and child behavior outcomes. Satisfaction was assessed descriptively.
Results: Twenty-two parents (78%) completed pre- and post- intervention assessments and the 12-week
parenting program. After completing the program, intervention group parents reported significantly
decreased use of physical punishment and decreases in parenting stress. Analyses of all participants
comparing pre- and post-intervention revealed parents reported significant improvements in positive verbal
5

discipline, significant reductions in parenting stress, and a decrease in physical punishment following the
parenting program. Families reported very high satisfaction with the content and format of the parenting
program (means ranged from 5.73 to 6.95 out of 7), and 81% of parents reported interest in continuing to
meet as a group after the intervention ended.
Conclusion: This study was conducted in the context of a pilot randomized controlled trial designed to
improve engagement of Filipino families in evidence-based parenting interventions. Results support the
benefits and feasibility of providing an evidence-based parenting program to Filipino parents of school-age
children in faith-based settings in order to prevent future behavioral health problems.

6

2. Background
Filipinos are the second largest Asian subgroup in the U.S. with the largest number living in Los
Angeles County (Hoeffl EM, Rastogi S, Kim MO, & Shahid H, 2010). Compared to whites and other
Asian subgroups, Filipino youth have a disproportionately heavy burden of behavioral health problems,
including depressive symptoms, suicidal ideation, substance use, adolescent pregnancy, and HIV/AIDS
cases (Javier JR, Lahiff M, Ferrer RR, & Huffman LC, 2010). Filipino youth also have significant mental
health risk factors, including parents with high levels of unmet mental health needs and exposure to harsh
discipline (Runyan DK et al., 2010; Sanchez F & Gaw A, 2007). Despite these behavioral health
challenges, Filipino youth have low rates of mental health care and preventive care utilization (Javier JR,
Huffman LC, & Mendoza FS, 2007; Yu SM, Huang ZJ, & Singh GK, 2004; Yu SM, Zhihuan JH, & Singh
GK, 2010). Filipino Americans also seek mental health services at a much lower rate when compared with
other Asian American groups (Gong F, 2003; Ying YW & Hu L, 1994). Given the disparity between
mental health needs and service utilization among Filipino Americans, research aimed at describing factors
that influence help-seeking is growing (David EJR, 2010).
David suggests that cultural mistrust and colonial mentality (i.e., also referred to as internalized
oppression) (David EJR, 2008)plays a significant role in limiting mental health help-seeking attitudes
among Filipino Americans, contributing to a mental health services utilization rate that is approximately
one-third of expected utilization (David EJR, 2010). Other factors found to be contributing to
underutilization include cultural stigma (Sanchez F & Gaw A, 2007), avoidance of shame to self or family;
and reliance on religious and indigenous folk healing resources (Nadal KL & Monzones J, 2010). Filipinos
have historically strong associations with religious institutions. In the U.S, 65% of Filipinos are Catholic
(Pew Research Center's Forum on Religious and Public Life, 2012). Thus, collaborating with the faith
community is a culturally congruent approach to engaging this population (Javier JR et al., 2014).
7

The Surgeon General’s Conference on Children’s Mental Health stated that the prevention of
behavioral health problems in youth is a national priority (U.S. Public Health Service, 2000). Recent
national tragedies have also brought the prevention of youth mental health disorders into the forefront
(Nardi, 2013). Parenting practices strongly affect child behavior problems (O'Connor TG, Deater-Deckard
K, Fulker D, Rutter M, & Plomin R, 1998b; Patterson GR, 1998). Children’s challenging behaviors can
elicit coercive and/or detached parenting, with low nurturance and affection (Calkins SD, 2002; O'Connor
TG, Deater-Deckard K, Fulker D, Rutter M, & Plomin R, 1998a). Parent training programs have been
shown to alter parents’ behavior and presumably in response, children’s behavior (Brestan EV & Eyberg
SM, 1998; Serketich WJ & Dumas JE, 1996). Although efficacious parent training programs exist,
participation is typically low, especially among low-income, urban, minority populations (Spoth R &
Redmond C, 2000).
The Incredible Years Parent Training Program (IYP) is a social cognitive learning theory based
intervention that is designated as a Blueprints Model Program (Webster-Stratton C & Reid MJ, 2010) for
its demonstrated effectiveness in preventing early onset conduct problems. The program is based on a
flexible collaborative model that allows for cultural adaptation in its implementation with diverse
populations (Webster-Stratton C, 2009). A large scale meta-analysis of behavioral and cognitive-behavioral
group parenting programs for children ages three to 12 years concluded that there is strong evidence that
such programs are cost effective interventions for improving parenting practices, parental mental health,
and significant child conduct problems (Furlong M et al., 2012). IYP was used in nine of the 13 studies that
met the stringent criteria to be selected for this meta-analysis.
Among Asian American groups, a pilot study of IYP with a sample of Korean American mothers
(Kim E, Cain KC, & Webster-Stratton C, 2008) that divided the mothers in two subgroups by level of
acculturation, resulted in increases in positive discipline among both subgroups and a decrease in harsh
discipline in the less acculturated group. Employing a wait list randomized control design, a pilot study
8

with a referred high risk sample of Chinese American immigrant parents, provided preliminary evidence of
efficacy in reducing clinical levels of child behavior problems (Lau AS, Fung JJ, Ho LY, Liu LL, &
Gudino OG, 2011).The children in this study with the highest levels of behavior problems benefitted the
most. To our knowledge, IYP has not been studied among Filipino Americans, which is surprising given
their prominence among the immigrant populations of the U.S. A previous qualitative study and needs
assessment involving multiple Filipino community stakeholders identified providing parent training to
parents of school-age children as a community-identified solution to mental health prevention among
adolescent youth (Javier JR et al., 2014). Our decision to use IYP in this pilot study is based on its
demonstrated prevention, treatment, and cost effectiveness, as well as its cultural adaptability. The aim of
this pilot study is to provide preliminary data about the efficacy and feasibility of the IYP when offered in a
faith-based setting to Filipino parents. We anticipate that the results obtained will provide preliminary
estimates of the magnitude of the effect size and variance of the intervention for further study.
3. Methods
3.1 Participants
The study was presented to parents as a prevention program called The Filipino Family Initiative
(FFI) to reduce the anticipated cultural barriers to participation that might be associated with having a child
with behavior problems or attending a “parent training class” that might imply something is wrong with the
participants’ parenting (Flores N, Supan J, Kreutzer C, Coffey DM, & Javier JR, 2015). Parents were
recruited over a five month period from churches, schools, and community-based organizations using
letters, fliers, and word-of-mouth. Sixty-one parents responded to outreach efforts and were assessed for
eligibility. Eligibility criteria included being an English speaking self-identified Filipino parent over the
age of 18 years with a child between the ages of six and 12 years old. Parents of children with a
developmental disability were excluded from the study and referred elsewhere for IYP. Of the parents who
responded, 60 (98%) met eligibility criteria; 30 (49%) declined to participate; and two parents initially
agreed to enroll but later declined prior to randomization because of scheduling conflicts. A total of 28
9

(46%) consenting parents agreed to join FFI. The most common reasons for non-participation were
scheduling conflicts and inability to commit the time required for participation. Forty percent of the 30
parents who refused to participate did not provide a reason for non-participation. After providing a
complete description of the study to participants, written informed consent was obtained.
During the course of the parent training groups, six parents (two in the first wave of intervention groups
and four in the second wave of intervention groups) discontinued participation, yielding a retention rate of
79%. The total number of parents completing the groups was 22 (two fathers, 18 mothers, and 2
grandmothers who were legal guardians). Even though all caregivers for each child were invited to
participate in FFI, none of the families had more than one parent participating. See Figure 1 for flow of
participants through this pilot randomized intervention study.
Figure 1. CONSORT diagram for Filipino Family Initiative Study

Table 1 describes demographics of participants. Parents were predominantly first generation
immigrants who were born in the Philippines (86%). Self-identified ethnicity was 85% Filipino, 11%
10

biracial Filipino, and 4% Caucasian. The primary languages spoken at home were English (59%) and
Tagalog (41%). Mean scores on the subscales of A Short Acculturation Scale for Filipino Americans (dela
Cruz FA, Padilla GV, & Agustin EO, 2000), described in the Measures section below, show that on
average the sample used and preferred more English than Philippine language(s) at work, home, and with
friends; more Philippine language(s) than English for media; and had a moderate preference for more
Filipinos than Americans in social relations.

Overall, the sample was well educated with 68% having a college or graduate degree, and 89% having
at least some college level education. Two-thirds (68%) of the participants were working full-time, 18%
part-time, and 14% were seeking employment. Annual household income was greater than $45,000 for
11

64% of the sample; between $10,000 and 45,000 for 21% of the sample; and under $10,000 for 11% of the
sample. Mean age was 42 years (SD = 9.4 years). Among the caregivers participating in the study, 82%
reported being married or living together. Nearly all of the identified children in the study (91%) were born
in the U.S. Of the identified children, 54% were female and 46% male.
3.2 Evidence-Based Community/Partnership Model
We adopted the Evidence-Based Community/Partnership Model proposed by Wells and colleagues as
an approach to bringing evidence-based interventions to a community setting (Mendel P, Meredith LS,
Schoenbaum M, Sherbourne CD, & Wells KB, 2008). Wells, et al. advocate use of the model because
community stakeholders may not necessarily develop strategies incorporating evidence-based solutions.
The adopted approach included a needs assessment that identified offering evidence-based parenting
program as a prevention program in churches would be a culturally congruent strategy to prevent Filipino
adolescent mental health disparities (Javier JR et al., 2014). Then, negotiation among community
stakeholders, practitioners, and researchers took place in order to arrive at a set of shared goals that
included linkage with an evidence-based solution as a first step. This process of negotiation was conducted
by the first author through the use of a community forum to increase awareness regarding the problem and
a series of meetings with key stakeholders within two predominantly Filipino churches. Strategies were
developed to reduce stigma and reluctance to participate in research; and to overcome barriers to making
time available to participate in a two-hour weekly parenting group for 12 weeks.
A community partnership was formed through the creation of a community advisory board (CAB),
consisting of leaders from two Catholic churches in the Historic Filipinotown district of Los Angeles;
leaders from Search to Involve Pilipino Americans (SIPA), the largest and oldest community-based
organization serving Filipino Americans in Los Angeles; and evidence-based practice health experts. The
CAB provided feedback regarding recruitment methods and what aspects of the parent training intervention
12

should be highlighted during recruitment. A plan was developed to offer the parent training group as a
workshop, FFI that would take place concurrently with catechism classes on Saturday mornings.
3.3 Measures
Demographic Questionnaire
Participants completed a demographic questionnaire, assessing family structure, income and education
levels, and preliminary health information about the child and family.
A Short Acculturation Scale for Filipino Americans (ASASFA)
ASASFA (dela Cruz FA et al., 2000) is a 12-item acculturation measure used to describe the level of
acculturation of the sample. Factor analysis of both English and Tagalog language versions yielded three
factors: Language use and preference at work, home, and with friends; language use and preference for
media; and ethnic preference in social relations. The Likert scale measure produces scores ranging from
12 (lowest level of acculturation) to 60 (highest level of acculturation). Internal consistency is very good
(α= .85). In this study, only the English version was used.
Child Behavior Checklist for Ages 6-18 (CBCL)
The CBCL (Achenbach TM, 1991) is a commonly used 118-item parent questionnaire for rating
emotional and behavior problems in school age children and was administered by computer pre- and post-
intervention. Internal consistency is excellent for the Internalizing, Externalizing, and Total Problems
subscales (Cronbach’s alpha coefficients range between .90 and .97).
Eyberg Child Behavior Inventory (ECBI)
The ECBI (Eyberg S & Pincus D, 1999) is a list of 36 disruptive child behaviors for which the parent is
asked to rate the current frequency of each behavior on a Likert scale from 1 (never) to 7 (always); and to
answer yes or no for each behavior if that behavior is a problem for the parent. Internal consistency is
excellent for the Intensity Scale (α = .95) which is the sum of the frequency ratings for all behavior.
13

Parenting Stress Index-Short Form (PSI-SF)
The PSI-SF (Abidin RR, 1995) is a 36-item questionnaire measures parenting stress related to parent-
child problem areas in parents of children ages one month to 12 years. The Short Form version used yields
a Total Stress Score. Internal consistency was very good (α = .89) in the current study.
The LIFT Parenting Practices Interview (PPI)
Used in many studies of outcome for parent training programs, the PPI is a 73-item questionnaire
adapted from the Oregon Social Learning Center’s Discipline questionnaire(Webster-Stratton C, Reid MJ,
& Hammond M, 2001). An exploratory factor analysis use to adapt the measure identified four factors
underlying the scale: Harsh parenting (e.g. raising voice, spanking, slapping, and threatening punishment);
inconsistent discipline (e.g. letting child get away with things, giving up trying to discipline); appropriate
discipline (e.g. use of time out for aggression, removing privileges or assigning extra chores as
consequences); and positive parenting strategies (e.g. use of praise, affection, and rewards to reinforce
positive behaviors). For the current study we focus on three areas of parenting in this measure and
calculated the following Cronbach’s alpha coefficients: Appropriate discipline .71; positive verbal
discipline .72; and Physical Punishment .80. Appendix 1 shows reliabilities at three time points for each
measure.
Parent Satisfaction Questionnaire (PSQ)
The PSQ is a 40-item Likert type scale that measures parent satisfaction regarding the overall program,
teaching format, specific parenting techniques, evaluation of group leaders, and feelings about the parent
group (Webster-Stratton C & Reid MJ, 2010). This measure was developed by the developer of the
Incredible Years and has been used in multiple previous studies evaluating the program (Kim E et al.,
2008; Webster-Stratton C & Taylor T, 2001).
3.4 Research Design
A mixed methods research design was employed in this pilot study to provide data about the efficacy
and feasibility of using IYP with Filipino parents in a faith-based setting. A sample size of 28 participants
14

was estimated based on feasibility rather than on analytic needs to provide preliminary estimates of effect
sizes and variance of the intervention for further study with this population.
3.5 Procedures
All of the procedures were reviewed and approved by the Institutional Review Board of Children’s
Hospital Los Angeles. Informed consent was obtained from all study participants. Participants were
recruited from two Catholic churches, an associated Catholic school, and the surrounding community in an
area of downtown Los Angeles called Historic Filipinotown from October 2010- January 2011. Once all
parents completed the pre-intervention assessment, the families were randomly assigned to the intervention
group (IYP immediately) or the control group (3-month wait-list), using a computer-generated
randomization list. The IYP was offered in two waves in the spring and summer of 2012. Each wave
consisted of two 12-week groups meeting on Saturdays; one in the morning and one in the afternoon. At
the end of the first wave and focus group, the second wave began. Parents missing a group were offered
make up sessions prior to the start of the group the following week or at another time during the week.
Make up sessions consisted of viewing two to three key video vignettes, a review of the parenting
principles developed during the missed session, and at least one role play of the skills illustrated.
Participating parents attended the 12-week parent training workshop for two hours each week at a
parochial school providing catechism training to children. The workshops were facilitated by the first
author who is a pediatrician and the second author who is a senior psychologist and certified Incredible
Years peer coach both of whom completed the 3-day authorized training in the intervention. Also in
attendance was a Tagalog-speaking research assistant who served to transcribe the group interaction and
interpret for the parents when needed.
The parent training workshop consisted of the Incredible Years School Age BASIC Parent Program for
parents of children ages six to 12 years. This social cognitive learning theory based program shows
vignettes of real parents from diverse backgrounds modeling parenting skills in effective and ineffective
ways. The parents in the group are treated as the experts in their children’s behavior while the group
15

leaders, through leading the discussion with key questions and brainstorming the benefits and barriers of
specific techniques, help the parents develop principles that the parents can use to achieve their self-
identified goals for participation in the group. These principles are restated in terms of the benefit for the
child. Parents then practice the techniques related to the principles in the role of the parent or the child.
Group leaders coach the role plays to be fun experiences for the participants and then debrief the group
about what the participants did well and how it felt to play the role of the parent or the child.
Through this process, the parents are able to develop empathy for their children and a self-reflective
stance regarding their own parenting, as well as confidence to go home and practice the skills with their
own children. The process also affords parents the opportunity to openly discuss their own cultural values
related to a particular skill and brainstorm with the group how to implement the skill in a culturally
congruent way that helps them achieve their goals for their children. The parenting skills in the program are
arranged in a colorful pyramid with the positive relationship building skills, such as child-directed special
time activities; use of descriptive commenting in doing academic, social, and emotion coaching; and
effective use of praise and tangible rewards to motivate desired behaviors on the bottom of the pyramid.
This illustrates how these skills are to be the frequent and foundational building blocks to a positive
relationship with the child. At the top of the pyramid are positive discipline skills to be used less
frequently; such as giving clear commands; instituting household rules and routines; the use of selective
attention and ignoring as well as consequences and time-out as a time for both the parent and the child to
calm down.
Description of Assessment Protocol
Participants completed all outcome measures three times. Figure 2 provides an overview of the

16

assessment protocol for this study.

Participants completed the assessments in person at a convenient location using computer assisted
survey software. The pre-intervention assessment, which included demographic variables, took about 60
minutes to complete and the post-intervention assessment took 45 minutes to complete. All of the measures
except the ECBI were administered at baseline, three months and six months. The ECBI was administered
during the first and final sessions of the intervention. Participants received $50 for each assessment
completed and $20 for their participation in a focus group. They also received up to $100 for their
participation in the Incredible Years (i.e., $7.50 was deducted from the $100 for each missed workshop).
Of note, we implemented a standard operating procedure for positive responses to survey items that may
raise concern about abuse or neglect (i.e., have you hit or slap your child in the past? Has your child been
left alone without adult supervision?). If a parent answered yes to any of the items, subsequent questions
were asked to ensure a report to Child Protective Services was not warranted. None of the participants
required such a report.
3.6 Data Analysis
The data were analyzed using SPSS 22 (IBM Corp, 2013). First, all of the variables were examined
for normality. All of the variables were normally distributed with the exception of the following items:
Child Behavior Checklist (internalizing, externalizing, and total problems). An outlier from the control
17

group was found when examining these variables. Due to non-normal distribution of these variables, non-
parametric tests were run for these variables.
Differences in study variables between the groups were compared using oneway ANOVA. The
primary hypotheses were that the intervention group would improve more than the control group on four
primary outcome variables (e.g., parenting stress, appropriate discipline, positive verbal discipline, and
physical punishment). Five secondary outcome variables included child behavior symptoms including
internalizing, externalizing and total problems on the child behavior checklist scale and the total problems
and intensity as measured by the ECBI. To examine the robustness of our findings, these nine hypotheses
were tested using ANOVA, ANCOVA, and pre-post paired t-tests with and without the outlier (See
Appendices for full analyses). First, two-group analysis of covariance (ANCOVA), in which pre-
intervention scores serve as covariates in order to control for baseline functioning was performed with and
without the outlier. Because these two analytic approaches produce similar findings, we only report only
analyses with the outlier. Results without the outlier are in the Appendices (Appendix 2 and 3). We also
performed oneway ANOVA for each of the hypotheses with and without the outlier and found different
findings for the CBCL variables. When the outlier was not included, we had two major findings: 1) the
intervention group showed significant decreases in externalizing and total problem behaviors, compared
with the wait-list control group at Time II; 2) the wait-list control group parents showed significant
improvements in their child’s externalizing behaviors and total problem behaviors post treatment compared
to pretreatment (Appendix 4). When the outlier was included, no treatment effect was found for parent’s
perceived child’s externalizing behaviors and total problem behaviors post treatment compared to
pretreatment (Appendix 3). We chose to present ANCOVA results in order to control for baseline
functioning or pre-group differences.
Effect size was calculated using Cohen’s d (Cohen J, 1992). In order to further describe the treatment
effect, we also conducted pre-post paired t-tests of the eight outcomes for all participants. Since 6 parents
18

withdrew from the study before completion, these separate analyses were conducted in order to maximize
the sample size for the immediate post-intervention analysis.

4. Results
4.1 Pre-intervention group equivalence and descriptive data
A comparison of the demographic variables for Groups A and B is presented in Table 1. Means and
standard deviations of all dependent measures for Groups A and B at Time 1 are presented in Table 3.

4.2 Pre-post comparison for all participants using paired t-test
Table 2 shows pre-post comparisons for all participants using paired t-tests results. After the parenting
program, parents had significant improvements in parenting stress, increased use of positive verbal
discipline, decreased physical punishment, and decreased externalizing and total problem behaviors.
Nonparametric analysis methods (i.e., Wilcoxon signed –rank tests) was used due to non-normal
19

distribution of CBCL variables.

4.3 Pre- and post- between-group hypothesis testing using ANCOVA
Table 3 shows that intervention group parents reported decreased parenting stress and decreased use of
physical punishment. The remaining hypotheses were not supported (e.g., no group differences on
appropriate discipline, positive verbal discipline, internalizing and externalizing behavior, and total
problems.

20

Table 3. Means & Standard Deviations for Child and Parenting Behaviors at Time I, II, & III (Full Sample)

Time I Time II Time III
Dependent
Measures
A
(n = 12)
(not treated)
B
(n = 12)
(not treated)
A
(n = 12)
(treated)
B
(n = 12)
(not treated)
A
(n = 12)
B
(n = 10)
(Both groups treated)
PSI
PSI total
score
60.0 ± 13.23 61.33 ± 23.22 48.6 ± 10.0
c
60.58 ± 16.27 47.92 ± 13.65 54.20 ± 12.58
PSI parental
distress
20.00 ± 5.31 20.42 ± 7.70 18.42 ± 7.14 19.67 ± 7.60 14.58 ± 3.63 18.0 ± 6.50
PSI parent-
child
dysfunctional
interaction

18.08 ± 3.34

17.67 ± 6.47

14.50 ± 3.26
c

17.67 ± 4.42

15.83 ± 4.68

17.40 ± 5.38
PSI difficult
child
21.92 ± 6.96 25.36 ± 10.36 15.67 ± 3.45
c
*

23.25 ± 7.71 17.50 ± 5.89 18.80 ± 4.66

PPI
Appropriate
discipline
4.82 ± 0.82 4.54 ± 0.86 4.92 ± 0.74 4.70 ± 0.89 4.92 ± 1.07 4.98 ± 0.664
Positive
verbal
discipline
5.64 ± 0.69 5.45 ± 0.86 6.04 ± 0.60 5.50 ± 0.77
a
6.18 ± 0.565 5.89 ± 0.831
Physical
punishment
1.31 ± 0.26 1.69 ± 0.80 1.08 ± 0.09
c
*

1.43 ± 0.45 1.10 ± 0.241 1.27 ± 0.630

CBCL
Internalizing 3.75 ± 3.82 5.67 ± 5.60 2.17 ± 2.55 4.45 ± 4.32 1.83 ± 2.44 2.56 ± 2.07
Externalizing 2.25 ± 1.55 7.58 ± 6.22 1.25 ± 1.42 4.36 ± 3.17
a
1.50 ± 2.28 1.44 ± 1.51
Total
Problems
12.67 ± 6.85 25.00 ± 19.02 8.00 ± 7.52 18.00 ±12.17
a
7.08 ± 8.28 9.00 ± 5.57

a
p < .05 Group B posttreatment Time III vs. pretreatment Time II (paired t-tests)
b
p < .001, Group B posttreatment Time III vs. pretreatment Time II (paired t-tests)
c
p < .05, Group A posttreatment Time II vs. Group B pretreatment Time II (ANCOV).
d
p < .001 Group A posttreatment Time II vs Group B pretreatment Time II (ANCOV).
*Levene's Test of Equality of Error Variances

is significant for ANOVA/ANCOVA
PSI, Parenting Stress Index; PPI, Parenting Practice Index; CBCL, Child Behavior Checklist

4.4. Changes in use of positive verbal discipline, appropriate discipline, parenting stress, use of
physical punishment, and child behavior problems.
Figure 3 presents a graphical representation of the statistical interaction of positive verbal discipline,
parenting stress, physical punishment, and child behavior problems for Groups A and B at Times I, II, and
III. In summary, two variables parenting stress (including total score, parent-child dysfunctional
interaction, and difficult child) and physical punishment showed significant changes in the predicted
direction. Follow up assessment showed that the treatment effects noted for Group A children continued to
be maintained. The parallel change in Group A when it was treated from Time I to Time II, with group B
from Time II to Time III after receiving the intervention is a striking feature of the parenting stress
21

variables. Interestingly, for physical punishment, Group B appears to have improved even before they
received the intervention.

Figure 3. Changes in parenting practices and child behaviors and parental stress for Groups A and B

5
5.2
5.4
5.6
5.8
6
6.2
6.4
t1 t2 t3
Mean
Time
PPI Positive Verbal Discipline
Control
Intervention
4.3
4.4
4.5
4.6
4.7
4.8
4.9
5
5.1
t1 t2 t3
Mean
Time
PPI Appropriate Discipline
Control
Intervention
22

*
p < .05, Group A posttreatment Time II vs. Group B pretreatment Time II (ANCOV).

*
p < .05, Group A posttreatment Time II vs. Group B pretreatment Time II (ANCOV).
0
10
20
30
40
50
60
70
t1 t2 t3
Mean
Time
PSI Total Score
*

Control
Intervention
0
5
10
15
20
t1 t2 t3
Mean
Time
PSI Parent-Child Dysfunctional
Interaction
*
Control
Intervention
23

*
p < .05, Group A posttreatment Time II vs. Group B pretreatment Time II (ANCOV).

*
p < .05, Group A posttreatment Time II vs. Group B pretreatment Time II (ANCOV).

0
5
10
15
20
25
30
t1 t2 t3
Mean
Time
PSI Difficult Child*
Control
Intervention
0
0.5
1
1.5
2
t1 t2 t3
Mean
Time
PPI Physical Punishment*
Control
Intervention
24

0
1
2
3
4
5
6
t1 t2 t3
Mean
Time
CBCL Internal
Control
Intervention
0
1
2
3
4
5
6
7
8
t1 t2 t3
Mean
Time
CBCL External
Control
Intervention
0
5
10
15
20
25
30
t1 t2 t3
Mean
Time
CBCL Total Problems
Control
Intervention
25

4.5 Parent satisfaction with the program
Parents reported very high satisfaction with the content and format of the parenting program (means
ranged from 5.73 to 6.95 out of 7), and 81% of parents reported interest in continuing to meet as a group
after the intervention ended.
4.6 Process Evaluation
Focus groups after the groups were conducted and the methods and results are described in a separate
manuscript (Flores N et al., 2015). In summary, parents were very satisfied with the program and the new
parenting skills that they learned. Sample quotes from parents include: “I think this program is a must for
all parents”; “It helped me understand that praising, rewarding your kids does not necessarily mean that
you’re spoiling them. Positive reinforcement will help them later on”; and “It’s a whole different concept
of parenting, and with your Filipino background, you can incorporate your culture.”
5. Discussion
This pilot study demonstrates that the Incredible Years Parenting Program was effective in decreasing
use of physical punishment and decreasing parenting stress among the Filipino American parents who
participated. Intervention group parents continued to use less physical punishment and report decreased
parenting stress 4 months after completing the program. These results are consistent with previous studies.
There were no group differences in other study variables (i.e., appropriate discipline, positive verbal
discipline, internalizing behaviors, externalizing behaviors, and total problems). However, due to our small
sample size, strong conclusions cannot be reached concerning lack of treatment effect. In order to further
describe the treatment effect in this pilot study, pre-post paired t-tests of the outcomes were performed and
showed treatment effects in the predicted direction for the following variables: parenting stress (total),
positive verbal discipline, physical punishment, externalizing behaviors, and total problem behaviors. No
treatment effect was found for appropriate discipline. This may be due to the fact the appropriate discipline
strategies are novel, similar to studies with Korean American mothers (Kim E et al., 2008). The trend for
parental report of decreasing internalizing behaviors was in the right direction but not significant
26

(p=0.082). Speculatively, this may also be due to the fact that social and emotional coaching are new
strategies to Filipino American parents.
Interestingly both the control and intervention group parents reported less physical punishment. This
may be due to three factors. First, there may have been a Hawthorne effect as a result of taking part in the
pilot study. Parents may have taken more interest in their children’s behavior than previously as a result of
attention received from researchers during participation. Thus, they may have been more likely to seek
information about positive parenting widely available in the media/internet compared to before their
participation in the study. Second, this improvement may be related to a measurement issue. Given that
additional questions were asked if parents answered positively on items about physical punishment during
the baseline assessment, they may have been less likely to report use of physical punishment in subsequent
assessments. This may be related to the fact that the current study used self-report measurement as
opposed to home observation data. Future studies should examine how to minimize this measurement issue
in the future. Finally, our use of community engagement may have reduced the effect size in our ANOVA
analyses but given the effect of engagement should be the same for both groups, community engagement
should not affect the pre-/post- effect size reported in our pooled analyses.
The study results suggest that partnering with churches to offer a parenting program is a potentially
useful and acceptable intervention for Filipino immigrant parents to learn positive parenting techniques.
This is especially critical due to the high amounts of harsh discipline reported in the Philippines (Runyan
DK et al., 2010) and the need to prevent children’s behavior problems and promote positive parent-child
relationships.

Limitations
This study had several limitations. First, low sample size alone may explain the lack of significant
treatment effect for some outcomes. Second, this study relied on parent’s self-report which are less
objective assessments of parenting behavior as opposed to behavioral observations. Another limitation is
27

that the measure of acculturation used does not consider the orthogonal bicultural nature of acculturation
that newer measures are based on. Next, because volunteers from our study were recruited from Catholic
churches and schools, our findings may not be generalizable to the broader Filipino population in the U.S.
given that 35% of Filipinos in the U.S. are not Catholic. Another limitation is that the sample’s
demographic characteristics largely limit the generalizability of the findings to similar groups of parents
with high motivation. In our study, parents who participated in all data collection also attended at least 75%
of the sessions. Less motivated parents may not seek parenting programs and may not have parenting or
behavioral changes similar to this study once enrolled in the program. Nonetheless, the sample studied is
probably representative of the increasing numbers of motivated Filipino parents in the U.S. (69%) who feel
that being a good parent is one of the most important thing in their lives (Pew Research Center Social &
Demographic Trends, 2012). Finally, the effect size of our intervention may be over-estimated because we
only included participants who actually attended the program in our analyses. We did not conduct intent to
treat analyses because we did not have follow up data on parents who dropped out and because we could
not use the last observation carried forward method (LOCF) to predict outcome data among drop-outs.

6. Conclusion
This study contributes initial data about the efficacy, acceptability, and feasibility of the Incredible
Years School Age Program among Filipino American parents in a community-based setting. Despite the
promising nature of our results, these findings are preliminary. Future research should be conducted with a
larger sample size and observational data. Also, offering the program to Tagalog speakers would improve
the generalizability of our findings to the broader Filipino population. Although the project took place in a
real-world setting, several factors maximized the program’s success including a certified Incredible Years
trainer was on our study team, all of the preparation for the weekly group meetings was performed by
research staff, parents were offered light refreshments, incentives, and child care for participation in the
program. Future studies should examine the dissemination and implementation of Incredible Years without
28

such supports and instead with more Filipino community organizational involvement (i.e., community
behavioral health specialists as parent group leaders) in order to assess long-term sustainability of the
Incredible Years in community-based settings.

29

7. Appendix
Appendix 1

Parenting Practices Index & Parental Stress Index Reliabilities

Time 1 Time 2

Time 3
n=27 n=23 n=22
Appropriate discipline 0.71 0.70 0.75
Harsh & inconsistent discipline 0.74 0.71 0.61
Positive verbal discipline 0.72 0.69 0.76
Monitoring 0.59 0.41 0.40
Physical punishment 0.80 0.66 0.86
Praise & incentives 0.74 0.69 0.64
Clear expectations 0.60 0.63 0.72
Parental Stress Index 0.891 0.91 0.93
30

Appendix 2
Table II. Means & Standard Deviations for Child and Parenting Behaviors at Time I, II, & III (Excluding outlier for CBCL items)

Time I Time II Time III
Dependent
Measures
A
(n =14)
(not treated)
B
(n = 13)
(not treated)
A
(n = 12)
(treated)
B
(n = 11)
(not
treated)
A
(n = 12)
B
(n = 9)
(Both groups treated)
CBCL (Child
Behavior
Checklist)

Internalizing 3.64 ± 3.54 5.46 ± 5.68 2.17 ± 2.55 4.45 ± 4.32 1.83 ± 2.44 2.56 ± 2.07
Externalizing 2.36 ± 1.87 5.85 ± 4.90 1.25 ± 1.42 4.36 ± 3.17
a
1.50 ± 2.28 1.44 ± 1.51
Total Problems 13.21 ± 6.69 22.38 ± 17.11 8.00 ± 7.52 18.00 ± 12.17
a
7.08 ± 8.28 9.00 ± 5.57
Anxiety Dependent 1.79 ± 2.16 2.62 ± 3.12 1.42 ± 1.56

2.27 ± 2.33 1.00 ± 1.04 1.44 ± 1.01
Withdrawal
Dependent
0.93 ± 1.33 1.38 ± 1.81 0.58 ± 1.17 1.27 ± 1.62 0.42 ± 0.669 0.56 ± 1.01
Somatic 0.93 ± 1.07 1.46 ± 1.85 0.17 ± 0.389 0.91 ± 1.04 0.42 ± 1.17 0.56 ± 1.33
Social 1.07 ±0.997 2.31 ± 2.06 1.00 ± 1.48 1.73 ± 1.27 0.58 ± 0.900 0.89 ± 1.17
Thought 1.00 ± 1.04 1.31 ± 1.38 0.75 ± 0.50 1.55 ± 1.92

0.42 ± 0.669 1.11 ± 1.05
Attention 2.29 ± 1.98 3.77 ± 4.23 1.33 ± 1.78

2.82 ± 4.33 1.17 ± 1.03 1.00 ± 1.58
Rule Break 0.86 ± 0.949 1.23 ± 1.17 0.58 ± 0.996 1.09 ± 0.831 0.42 ± 0.669 0.67 ± 1.00
Aggressive 1.50 ± 1.56 4.62 ± 4.17 0.67 ± 0.888 3.27 ± 2.57
a
1.08 ± 1.73 0.78 ± 0.833
Activities
Competence
9.32 ± 3.03 10.08 ± 1.78 10.0 ± 2.69 10.86 ± 1.36 10.25 ± 2.06 10.56 ± 1.89
Social Competence 7.64 ± 2.11 7.89 ± 2.14 7.83 ± 2.93 8.50 ± 2.01 7.29 ± 2.33 9.61 ± 1.58
Affective Disorder 0.43 ± 0.646 1.08 ± 1.19 0.33 ± 0.651 1.09 ± 1.04 0.58 ± 1.73 0.22 ± 0.441
Anxiety Disorder 1.14 ± 1.35 1.69 ± 1.89 0.92 ± 1.24 1.36 ± 1.29 0.58 ± 0.669 0.89 ± 0.782
Somatic Disorder 0.50 ± 0.519 0.85 ± 1.21 0.0 ± 0.0 0.45 ± 0.688 0.17 ± 0.577 0.44 ± 1.01
ADHD 2.21 ± 2.05 3.08 ± 3.15 1.33 ± 1.72 2.45 ± 2.77 1.33 ± 1.50 1.00 ± 1.32
Oppositional
Disorder
0.93 ± 1.21 2.46 ± 2.26 0.50 ± 0.674 1.91 ± 1.45
a
0.67 ± 0.778 0.56 ± 0.726
Conduct Disorder 0.64 ± 0.842 0.92 ± 1.12 0.42 ± 0.996 0.64 ± 0.674 0.17 ± 0.389 0.44 ± 1.01
SCT 0.50 ± 0.650 0.69 ± 1.32 0.17 ± 0.389 0.36 ± 0.924 0.08 ± 0.289 0.11 ± 0.333
Obsessive
Compulsive
0.93 ± 1.27 1.38 ± 1.66 0.67 ± 0.778 1.64 ± 1.75 0.50 ± 0.674 0.89 ± 1.05
PTSD 2.00 ±1.62 3.31 ± 3.25 1.58 ± 1.73 2.82 ± 2.27
a
1.42 ± 1.17 0.67 ± 1.00
a
p < .05 Group B posttreatment Time III vs. pretreatment Time II (paired t-tests)
b
p < .001, Group B posttreatment Time III vs. pretreatment Time II (paired t-tests)
c
p < .05, Group A posttreatment Time II vs. Group B pretreatment Time II (ANCOV).
d
p < .001 Group A posttreatment Time II vs Group B pretreatment Time II (ANCOV).
*Levene's Test of Equality of Error Variances

is significant for ANOVA/ANCOVA
ADHD, Attention deficit hyperactivity disorder; SCT, Sluggish Cognitive Tempo; PTSD, Post-traumatic stress disorder

31

Appendix 3
Table III. Means & Standard Deviations for Child and Parenting Behaviors at Time I, II, & III
Time I Time II Time III
Dependent
Measures
A
(n = 14)
(not
treated)
B
(n = 14)
(not
treated)
A
(n = 12)
(treated)
B
(n = 12)
(not
treated)
A
(n = 12)
B
(n = 10)
(Both groups treated)
PSI (Parenting
Stress Index)

PSI total score 60.0 ± 14.27 60.64 ± 21.50 48.6 ± 10.00
c
60.58 ± 16.27 47.92 ± 13.65 54.20 ± 12.58
PSI parental
distress
19.71 ± 5.47 20.07 ± 7.14 18.42 ± 7.14 19.67 ± 7.60 14.58 ± 3.63 18.0 ± 6.50
PSI parent-child
dysfunctional
interaction
18.43 ± 4.09 17.79 ± 6.0 14.50 ± 3.26
c
17.67 ± 4.42 15.83 ± 4.68 17.40 ± 5.38
PSI difficult child 21.86 ± 6.89 24.54 ± 9.97 15.67 ± 3.45
c
*

23.25 ± 7.71 17.50 ± 5.89 18.80 ± 4.66
PPI (Parenting
Practice Index)

Appropriate
discipline
4.65 ± 0.899 4.56 ± 0.802 4.92 ± 0.744 4.70 ± 0.889 4.92 ± 1.07 4.98 ± 0.664
Positive verbal
discipline
5.59 ± 0.650 5.44 ± 0.798 6.04 ± 0.600 5.50 ± 0.771
a
6.18 ± 0.565 5.89 ± 0.831
Physical
punishment
1.37 ± 0.409 1.69 ± 0.736 1.08 ± 0.087
c
*

1.43 ± 0.446 1.10 ± 0.241 1.27 ± 0.630
CBCL (Child
Behavior
Checklist)

Internalizing 3.64 ± 3.54 5.50 ± 5.46 2.17 ± 2.55 4.33 ± 4.14 1.83 ± 2.44 3.80 ± 4.39
Externalizing 2.36 ± 1.87 6.86 ± 6.04 1.25 ± 1.42
c
* 5.08 ± 3.92 1.50 ± 2.28 3.50 ± 6.65
Total Problems 13.21 ± 6.69 24.71 ± 18.60 8.00 ± 7.52
c
* 19.50 ± 12.71 7.08 ± 8.28 15.40 ± 20.91
Anxiety
Dependent
1.79 ± 2.16 2.79 ± 3.07 1.42 ± 1.56 2.25 ± 2.22 1.00 ± 1.04 2.10 ± 2.28
Withdrawal
Dependent
0.93 ± 1.33 1.36 ± 1.74 0.58 ± 1.17 1.25 ± 1.55 0.42 ± 0.669 1.00 ± 1.70
Somatic 0.93 ± 1.07 1.36 ± 1.82 0.17 ± 0.39
c
* 0.83 ± 1.03 0.42 ± 1.17 0.70 ± 1.34
Social 1.07 ±0.997 2.71 ± 2.49 1.00 ± 1.48 1.92 ± 1.38 0.58 ± 0.900 1.80 ± 3.08
Thought 1.0 ± 1.04 1.50 ± 1.51 0.75 ± 0.50 1.75 ± 1.96 0.42 ± 0.669 1.50 ± 1.58
Attention 2.29 ± 1.98 4.29 ±4.50 1.33 ± 1.78 3.08 ± 4.23 1.17 ± 1.03 2.10 ± 3.78
Rule Break 0.86 ± 0.949 1.57 ± 1.70 0.58 ± 0.996 1.25 ± 0.965 0.42 ± 0.669 1.30 ± 2.21
Aggressive 1.50 ± 1.56 5.29 ± 4.73 0.67 ± 0.89
c
* 3.83 ± 3.18 1.08 ± 1.73 2.20 ± 4.57
Activities
Competence
9.32 ± 3.03 10.04 ± 1.71 10.0 ± 2.69 10.67 ± 1.47 10.25 ± 2.06 10.40 ± 1.85
Social
Competence
7.64 ± 2.11 7.96 ±2.08 7.83 ± 2.93 8.54 ± 1.92 7.29 ± 2.33 9.55 ± 1.50
Affective
Disorder
0.43 ± 0.646 1.07 ± 1.14 0.33 ± 0.651
c
1.08 ± 0.996 0.58 ± 1.73 0.80 ± 1.87
Anxiety Disorder 1.14 ± 1.35 1.79 ± 1.85 0.92 ± 1.24 1.33 ± 1.23 0.58 ± 0.669 1.30 ± 1.49
Somatic Disorder 0.50 ± 0.519 0.79 ± 1.19 0.0 ± 0.0
c
* 0.42 ± 0.669 0.17 ± 0.577 0.40 ± 0.966
ADHD 2.21 ± 2.05 3.50 ± 3.41 1.33 ± 1.72 2.75 ± 2.83 1.33 ± 1.50 2.00 ± 3.40
Oppositional
Disorder
0.93 ± 1.21 2.64 ± 2.27 0.50 ± 0.67
c
* 2.17 ± 1.64
a
0.67 ± 0.778 1.00 ± 1.56

Conduct
Disorder
0.64 ± 0.842 1.36 ± 1.95 0.42 ± 0.996 0.92 ± 1.17 0.17 ± 0.389 1.10 ± 2.28
SCT 0.50 ± 0.650 0.86 ± 1.41 0.17 ± 0.389 0.33 ± 0.888 0.08 ± 0.289 0.50 ± 1.27
Obsessive
Compulsive
0.93 ± 1.27 1.50 ± 1.65 0.67 ± 0.778 1.58 ± 1.68 0.50 ± 0.674 1.20 ± 1.40
PTSD 2.00 ±1.62 3.57 ± 3.28 1.58 ± 1.73 2.92 ± 2.19 1.42 ± 1.17 1.60 ± 3.10
a
p < .05 Group B posttreatment Time III vs. pretreatment Time II (paired t-tests)
b
p < .001, Group B posttreatment Time III vs. pretreatment Time II (paired t-tests)
c
p < .05, Group A posttreatment Time II vs. Group B pretreatment Time II (ANOV).
d
p < .001 Group A posttreatment Time II vs Group B pretreatment Time II (ANOV).
* Levene's Test of Equality of Error Variances

is significant for ANOVA/ANCOVA
ADHD, Attention deficit hyperactivity disorder; SCT, Sluggish Cognitive Tempo; PTSD, Post-traumatic stress disorder
32

Appendix 4
Table IV. Means & Standard Deviations for Child and Parenting Behaviors at Time I, II, & III (Excluding outlier for CBCL items)
Time I Time II Time III
Dependent
Measures
A
(n = 14)
(not treated)
B
(n = 13)
(not treated)
A
(n = 12)
(treated)
B
(n = 11)
(not treated)
A
(n = 12)
B
(n = 9)
(Both groups treated)
CBCL (Child
Behavior
Checklist)

Internalizing 3.64 ± 3.54 5.46 ± 5.68 2.17 ± 2.55 4.45 ± 4.32 1.83 ± 2.44 2.56 ± 2.07
Externalizing 2.36 ± 1.87 5.85 ± 4.90 1.25 ± 1.42
c
* 4.36 ± 3.17
a
1.50 ± 2.28 1.44 ± 1.51
Total Problems 13.21 ± 6.69 22.38 ± 17.11 8.00 ± 7.52
c
* 18.00 ± 12.17
a
7.08 ± 8.28 9.00 ± 5.57
Anxiety Dependent 1.79 ± 2.16 2.62 ± 3.12 1.42 ± 1.56

2.27 ± 2.33 1.00 ± 1.04 1.44 ± 1.01
Withdrawal
Dependent
0.93 ± 1.33 1.38 ± 1.81 0.58 ± 1.17 1.27 ± 1.62 0.42 ± 0.669 0.56 ± 1.01
Somatic 0.93 ± 1.07 1.46 ± 1.85 0.17 ± 0.389
c
* 0.91 ± 1.04 0.42 ± 1.17 0.56 ± 1.33
Social 1.07 ±0.997 2.31 ± 2.06 1.00 ± 1.48 1.73 ± 1.27 0.58 ± 0.900 0.89 ± 1.17
Thought 1.00 ± 1.04 1.31 ± 1.38 0.75 ± 0.50 1.55 ± 1.92

0.42 ± 0.669 1.11 ± 1.05
Attention 2.29 ± 1.98 3.77 ± 4.23 1.33 ± 1.78

2.82 ± 4.33 1.17 ± 1.03 1.00 ± 1.58
Rule Break 0.86 ± 0.949 1.23 ± 1.17 0.58 ± 0.996 1.09 ± 0.831 0.42 ± 0.669 0.67 ± 1.00
Aggressive 1.50 ± 1.56 4.62 ± 4.17 0.67 ± 0.888
c
* 3.27 ± 2.57
a
1.08 ± 1.73 0.78 ± 0.833
Activities
Competence
9.32 ± 3.03 10.08 ± 1.78 10.0 ± 2.69 10.86 ± 1.36 10.25 ± 2.06 10.56 ± 1.89
Social Competence 7.64 ± 2.11 7.89 ± 2.14 7.83 ± 2.93 8.50 ± 2.01 7.29 ± 2.33 9.61 ± 1.58
Affective Disorder 0.43 ± 0.646 1.08 ± 1.19 0.33 ± 0.651
c
1.09 ± 1.04 0.58 ± 1.73 0.22 ± 0.441
Anxiety Disorder 1.14 ± 1.35 1.69 ± 1.89 0.92 ± 1.24 1.36 ± 1.29 0.58 ± 0.669 0.89 ± 0.782
Somatic Disorder 0.50 ± 0.519 0.85 ± 1.21 0.0 ± 0.0
c
* 0.45 ± 0.688 0.17 ± 0.577 0.44 ± 1.01
ADHD 2.21 ± 2.05 3.08 ± 3.15 1.33 ± 1.72 2.45 ± 2.77 1.33 ± 1.50 1.00 ± 1.32
Oppositional
Disorder
0.93 ± 1.21 2.46 ± 2.26 0.50 ± 0.674
c
* 1.91 ± 1.45
a
0.67 ± 0.778 0.56 ± 0.726
Conduct Disorder 0.64 ± 0.842 0.92 ± 1.12 0.42 ± 0.996 0.64 ± 0.674 0.17 ± 0.389 0.44 ± 1.01
SCT 0.50 ± 0.650 0.69 ± 1.32 0.17 ± 0.389 0.36 ± 0.924 0.08 ± 0.289 0.11 ± 0.333
Obsessive
Compulsive
0.93 ± 1.27 1.38 ± 1.66 0.67 ± 0.778 1.64 ± 1.75 0.50 ± 0.674 0.89 ± 1.05
PTSD 2.00 ±1.62 3.31 ± 3.25 1.58 ± 1.73 2.82 ± 2.27
a
1.42 ± 1.17 0.67 ± 1.00
a
p < .01 Group B posttreatment Time III vs. pretreatment Time II (paired t-tests)
b
p < .001, Group B posttreatment Time III vs. pretreatment Time II (paired t-tests)
c
p < .05, Group A posttreatment Time II vs. Group B pretreatment Time II (ANOV).
d
p < .001 Group A posttreatment Time II vs Group B pretreatment Time II (ANOV).
* Levene's Test of Equality of Error Variances

is significant for ANOVA/ANCOVA
ADHD, Attention deficit hyperactivity disorder; SCT, Sluggish Cognitive Tempo; PTSD, Post-traumatic stress disorder
33

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Asset Metadata

Creator Javier, Joyce Rivera (author)

Core Title The Filipino family initiative: preliminary effects of an evidence-based parenting intervention offered in churches on parent and child outcomes

School Keck School of Medicine

Degree Master of Science

Degree Program Clinical, Biomedical and Translational Investigations

Publication Date 07/21/2017

Defense Date 07/21/2015

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag evidence‐based medicine,Filipino‐American,health disparities,OAI-PMH Harvest,Parenting

Format application/pdf (imt)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Kipke, Michele D. (committee chair), Azen, Stanley P. (committee member), Palinkas, Lawrence A. (committee member)

Creator Email jojavier@chla.usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c3-601374

Unique identifier UC11298841

Identifier etd-JavierJoyc-3666.pdf (filename),usctheses-c3-601374 (legacy record id)

Legacy Identifier etd-JavierJoyc-3666.pdf

Dmrecord 601374

Document Type Thesis

Format application/pdf (imt)

Rights Javier, Joyce Rivera

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA