Caring for the Caregivers: A Community-Developed Program to Prevent Substance Use for Children with Incarcerated Parents

About This Grant

Project Summary/Abstract National estimates suggest more than five million children in the United States have experienced parental incarceration. Rates of parental incarceration have increased dramatically over the past four decades. Children with an incarcerated parent (CIP) are seven times more likely to have a diagnosed substance use disorder due to multiple stressors, including separation from parents, exposure to traumatic events, parental substance use, and poverty. Caregivers of CIP experience high levels of stress, and many have their own history of trauma and adverse childhood experiences (ACEs). These experiences can impede their use of effective parenting strategies, which have been shown to prevent substance use and associated behavioral health problems among children in a range of stressful circumstances. Evidence-based parenting programs (EBPPs) have been shown to prevent adolescent substance use by enhancing positive parenting in other populations experiencing stress and major life transitions. However, no EBPP has been designed to address the unique circumstances of caregivers who bear the day-to-day responsibility for raising CIP. Moreover, most EBPPs were developed without focusing on scalability, resulting in limited dissemination or public health impact. Over the past 3 years, we have worked with a community-based Steering Committee (SC) to develop a conceptual model of contextually specific risk and protective mechanisms, adapt candidate components from existing parenting programs, and pilot the components with CIP caregivers. Qualitative data from caregivers and providers suggest high acceptability for program components, but challenges related to feasibility. The proposed R34 includes a partnership across three states, each with a high rate of incarceration and variability by race/ethnicity (i.e., Arizona, Florida, and Texas). In Aim 1, we will leverage our existing community partnerships and form a Design Workgroup to refine the program in ways that promote adaptability and potential adoption by agencies serving families affected by incarceration. In Aim 2, we will conduct a pilot trial using a randomized waitlist-controlled design (n=48) Caregivers and their CIP (aged 9-15 years) will provide assessment data at baseline (T1), 3 months (T2), and 6 months (T3). Caregivers will be randomized to participate in the intervention after T1 (Cohort 1) or after T2 (Cohort 2). Study aims focus on recruitment (Aim 2a), data collection for CIP and caregiver assessment batteries (Aim 2b), and implementation batteries (Aim 2c) in preparation for a future multisite Hybrid Type 2 Effectiveness Implementation trial. Moreover, results will provide important information for addressing the implementation gap for EBPPs more broadly.