Collections > UNC Chapel Hill Undergraduate Honors Theses Collection > A Cumulative Risk Model of Low-Income Families in a Behavioral Parent Training Pilot Study

Cumulative risk or the presence of multiple risk factors that can lead to negative life outcomes is linked to the development of early onset behavior problems (e.g. noncompliance, oppositionality, aggression) in young children (Conger et al., 1999; Reno et al., 2006; Shelleby et al., 2014). This study extends this work by examining the link between cumulative risk and treatment outcome in low-income families with a child with clinically significant behavior problems, as well as the extent to which increasing family’s support, competence, and, in turn, autonomy via technology between sessions mitigates risk. Low-income families (N = 22) enrolled in a pilot study that compared a standard treatment program, Helping the Noncompliant Child (HNC; McMahon & Forehand, 2003) with a technology-enhanced version (TE-HNC), which yielded higher levels of treatment engagement and, in turn, boosted treatment outcome (Jones et al., 2014). Contrary to study hypotheses, a relatively high number of barriers did not predict families dropping out of treatment, the effect size of a relatively high number of barriers compared to a relatively low number of barriers on treatment outcomes was small, and families with more barriers took fewer, rather than more, sessions to complete treatment. Consistent with hypotheses, however, families with low (rather than high) barriers randomized to the TE-HNC (rather than HNC) had the lowest ECBI intensity and problems scores at post-treatment. Findings and future directions are discussed.