There are challenges to implementing traditional face-to-face group-based parent training programs in real-world settings. The need for services to tackle childhood disruptive behavior is enormous, but only a minority of families receive them. Sufficiently strong evidence has been published on the efficacy of parent training to suggest that psychosocial services for children should include evidence-based parent training programs. These findings are of upmost importance to public health professionals because children who exhibit disruptive behavior face increased risks of adult psychiatric disorders, substance use, crime, suicide, and other adversities. There is mounting evidence from randomized controlled trials (RCTs) that parents can be trained to tackle and reduce children’s disruptive behavior and improve their parenting skills. The baseline measurements of each outcome were used as covariates. The estimated child and parent outcomes were adjusted for CBCL externalizing scores at baseline, maternal education, duration of the behavior problems, and paternal age. Parenting skills were measured using the 31-item Parenting Scale and the shorter 21-item Depression, Anxiety and Stress Scale (DASS-21). The child psychopathology and functioning level were measured using the Child Behavior Checklist (CBCL) version 1.5-5 for preschool children, the Inventory of Callous-Unemotional Traits (ICU), and a modified version of the Barkley Home Situations Questionnaire. The same demographic and child and parent measures were collected from both study groups and were compared using linear mixed-effect models for repeated measurements. The RCT intervention group comprised 232 families who were recruited between October 2011 and November 2013. The implementation group comprised 600 families who were recruited in the SFSW intervention between January 2015 and May 2017 in real-world implementation.
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