The Future of Parenting Programs I Design PDF

Parenting
Science and Practice
ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/hpar20
The Future of Parenting Programs: I Design
Marc H. Bornstein, Lucie Cluver, Kirby Deater-Deckard, Nancy E. Hill, Justin

Jager, Sonya Krutikova, Richard M. Lerner & Hirokazu Yoshikawa
To cite this article: Marc H. Bornstein, Lucie Cluver, Kirby Deater-Deckard, Nancy E. Hill, Justin
Jager, Sonya Krutikova, Richard M. Lerner & Hirokazu Yoshikawa (2022) The Future of Parenting
Programs: I Design, Parenting, 22:3, 201-234, DOI: 10.1080/15295192.2022.2087040
To link to this article: https://doi.org/10.1080/15295192.2022.2087040
© 2022 The Author(s). Published with

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Published online: 05 Aug 2022.
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PARENTING
2022, VOL. 22, NO. 3, 201–234
https://doi.org/10.1080/15295192.2022.2087040
The Future of Parenting Programs: I Design

Marc H. Bornstein , Lucie Cluver , Kirby Deater-Deckard , Nancy E. Hill ,
Justin Jager , Sonya Krutikova , Richard M. Lerner ,
and Hirokazu Yoshikawa
SYNOPSIS
Parenting programs worldwide (and especially in low- and mid
dle-income countries) support parents in their caregiving roles.
Parenting programs are popular and prolific, but many outright
fail to deliver meaningful effects or eventuate in only small
effects. Incomplete consideration and execution of many design
features of programs can account for these shortfalls. This article
delimits several critical criteria surrounding successful design
and evaluation of evidence-based parenting programs.
Specific factors include important preliminary questions con
cerning details of program design, such as whether the topic
of the parenting program specifies the aspect(s) of parenting to
be encouraged or discouraged and what theory of change
underlies the program; program design contents concern sub
ject matter development, sources, and messages; program
design components specify the delivery mode, effectiveness,
location, and alignment; program design targeting and sam
pling concern whom the program is addressing, why, and
whether the program is designed to be universal or targeted
to a specific population; ensuring reliable and valid program
measurement; and rigorous experimental standards that
encompass evaluating program effectiveness, including rando
mized control trial or quasi-experimental designs and the selec
tion of control and comparison conditions. Policy makers,
program leaders, investigators, and, of course, parents and chil
dren all benefit when parenting programs are well designed.
INTRODUCTION
Parenting programs are common globally and implemented by basic science
investigators, nongovernmental organizations, and governments to support
and improve caregiving and optimize the lives of children. Investigators in the
medical, social, and behavioral sciences have developed best practices of good
program design, but these principles are nowhere collected and codified for
parenting programs specifically and, in consequence, are not always fully
applied to the detriment of parenting program success. What should the
next generation of parenting program designers know to take advantage of
knowledge gained from past and extant parenting programs? What are “best
practices” in parenting program design? As the first of three companion
articles on the future of parenting programs, this article focuses on program
design. The complementary two articles focus on program implementation
© 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.
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cited.
202 BORNSTEIN ET AL.
and uptake/scaling. This article addresses seven key issues in parenting pro
gram design: design preliminary questions, design contents, design compo
nents, design targeting and sampling, measurement in design, and controls
and comparisons in evaluating design effectiveness. The main aims of this
article are to describe these key issues in the design of parenting programs and
best practices in determining whether parenting programs maximize effective
ness. Parenting program successes, and thereby optimal caregiving, child
development, and family life, will be improved through wider-spread recogni
tion and adherence to best practices in program design.
PROGRAM DESIGN PRELIMINARY QUESTIONS

When beginning to contemplate designing a parenting program, program
designers need to ask and answer several overarching preliminary questions.
The following nine having to do with the necessity of the program, objectives
and features, known knowledge relevant to the program, level addressed,
program theory of change, logic model and process of action, universal or
targeted nature, stand alone or integrated design, and program monitoring
and evaluation seem especially significant. The nine are not necessarily
ordered.
Necessity
Why is the parenting program necessary? What about the sample or popula
tion, community or locale requires support or prevention or intervention?
Who is determining the need for the program? Will the program design
resolve the requirement? How?
Objective and Feature
Is the objective of the parenting program to encourage or discourage a specific

feature of parenting? Is the specific feature an individual parenting cognition
or practice (e.g., to increase maternal knowledge of children’s cognitive devel
opment or maternal verbal responsiveness)? Is the feature a family-level
behavior (e.g., to change mutual expressions of warmth in a parent-child or
parent-parent relationship)? Is the feature some aspect of institutional func
tioning (e.g., to improve communication in a government agency’s informa
tion curriculum for parenting)? How salient is the objective for the population
that will take part in the parenting program? How is the feature manifest in
that population? What are appropriate measures to reach the program objec
tive, including cultural sensitivity and measurement equivalance?
PARENTING 203
Known Knowledge
Have other relevant parenting programs with comparable objectives directed to

comparable features been implemented? If so, what about those extant parenting
programs was effective, what is generalizable, and what gaps were left to fill? The
goal might be to identify core parental functions that impact multiple outcomes.
For example, if an existing program that promoted parental responsiveness to
child language fostered child language, could it be adapted to foster child
empathy through parental responsiveness? Are there design features that are
unique to specific parenting programs and therefore not generalizable? For
example, some parenting practices are deeply embedded in cultural beliefs and
goals or tied to the challenges and opportunities of a specific community (e.g.,
Harlem Children’s Zone). How and why did comparable parenting programs
fail or fall significantly short of having desired effects on their targeted outcomes,
and how can those pitfalls be avoided? Is there sufficient rigorous evidence from
similar parenting programs in similar contexts to provide a high degree of
confidence that the proposed parenting program design will be effective? If
there is, what key indicators of fidelity could be monitored to ensure that the
proposed parenting program will also be effective? If there is not, is a trial needed
to establish whether the proposed parenting program works?
Level
At what level is the parenting program targeted? At a psychological or beha
vioral level (e.g., change in parent cognitions or practices; Bornstein, 2015) or
in mental health and well-being (Dix & Moed, 2019; Nelson-Coffey & Stewart,
2019)? At a family systems level (e.g., change in parent-child responsive and
play interactions; Bornstein, 2012; Tamis-LeMonda, Kuchirko, Escobar, &
Bornstein, 2019) or the co-parenting relationship (McHale & Sirotkin,
2019)? At a macro-level (e.g., change in a parent-community relation)?
Theory of Change
What theory of change underlies the parenting program? A theory of change
explains the effective process by specifying causal linkages in the program design
that yield the desired outcome (Douglass, Halle, & Tout, 2019). For instance,
a theory of change might specify that, if a program promotes warm, engaged,
knowledgeable, and responsive parenting, then the child will thrive. Parenting
programs that aim to encourage positive outcome(s) or discourage negative
outcome(s) downstream operate upstream via changes and/or improvements in
implementation (e.g., text-based self-implemented media or staff cognitions or
practices where staff deliver programs). Thus, program design theories of change
rely on indirect or mediator models (Figure 1). Although mediational chains
Figure 1. A mediation model. An Independent variable (the parenting program materials)

influences (via Path 1) some Mediator (parenting program implementation staff or support by
community members because of alignment with community values) which influences (via Path 2)
a Dependent variable (uptake of the parenting program message). As an example, maternal verbal
responsiveness training materials (the program independent variable) are used to train (Path 1)
staff in maternal responsiveness (the mediator), which enhances (Path 2) the proximal outcome of
increased maternal responsiveness (the dependent variable) and (presumably) a distal outcome,
such as, improved child language. In this way, parenting program design is intimately tied to
program implementation and program uptake/scaling (see Articles II and III).
underpin many program designs, moderated mediation – when a moderator

variable changes one or more links in the mediational chain – is often expectable
(Figure 2 Altafim, McCoy, & Linhares, 2021; Tein, Sandler, MacKinnon, &
Wolchik, 2004). For example, a Playing and Learning Strategies intervention (the
independent variable) identified mothers’ warm sensitivity and contingent respon
siveness (as mediators) of children’s cooperativeness (the dependent variable);
however, mothers differed in their “motivation to change” (the moderator)
which moderated the mediation (Landry, Smith, Swank, & Guttentag, 2008;
Shelleby & Shaw, 2014). In consequence, the resulting effect on children’s coopera
tiveness was stronger among mothers who were motivated to change than among
mothers who were not.
Logic Model and Process of Action
A logic model follows from the theory of change, with specific actions indexed
in specific ways at specific times with specific people to result in specific
outcomes. The logic model for the above-noted theory of change would
Figure 2. A moderated-mediation model. The strength of the Mediator effect varies across levels or
subgroups of the Moderator. The moderator alters path 1 and so changes the strength of the
independent variable → mediator link in the mediational chain (Path 3). An example is when
a program functions differently for different parents in a targeted group; concretely, maternal
verbal responsiveness training might proceed differently with more versus less verbal mothers. As
such, constructs that systematically impact program effectiveness (i.e., moderator effects) are
anticipated and should be identified.
PARENTING 205
specify operational definitions of parental warmth, engagement, knowledge,

and responsiveness that have to be inculcated in specific (e.g., first-time)
parents through specific actions (e.g., via instruction, modeling, reinforce
ment, peer support, promotion of emotional attachment, other means;
Dishion, Forgatch, Chamberlain, & Pelham, 2016) presented in specific
doses (e.g., specific numbers of repetitions lasting for specific lengths of
time). For example, an intervention informed by social learning theory is the
Participant Management Training-Oregon model (PMTO; Dishion et al.,
2016; Patterson, Chamberlain, & Reid, 1982). Similarly, specific outcomes
(e.g., cognition, emotion, behavior) would be specified for the target group
(e.g., parents, children).
Prevention/Intervention Scope
Is the program designed for all parents (i.e., universal) or parents with specific
needs or backgrounds (targeted)? Prevention/Intervention Scope refers to the
population for the intervention (e.g., Universal/Primary; Targeted/Secondary;
and Indicated/Tertiary). Programs designed for everyone are referred to as
“Universal” or “Primary” prevention programs. These include home-visiting
programs for new parents that all new parents receive. Targeted or Secondary
prevention/intervention programs are programs that are designed to support
parents and families who are at risk because of some identified factor (e.g.,
parenting in a high-crime neighborhood). Indicated/Tertiary programs are
deeper still and focused on parents, families, or children who are experiencing
adverse outcomes (Simeonsson, 1991).
For example, Brody et al. (2006) used quantitative studies of rural
African American families to develop a universal prevention known as
the Strong African American Families Program. Given the increasing
sophistication of machine learning and other adaptive computational
approaches, developing specific programs targeted to specific parents’
specific needs is becoming more feasible, fortuitously increasing program
designers’ ability to provide parents with “just-in-time” knowledge and
supports (Hill, 2021). A recurring challenge to parenting program uptake
is that programs do not meet parents where they are with the issues that
they confront at the moment (see Article III: Uptake and Scaling; Murry,
Berkel, & Liu, 2018).
Stand Alone versus Integrated

Is the parenting program intended to stand alone or to be integrated with
existing services or platforms? Parenting programs that are integrated with
existing community or government systems are likely more sustainable. As
such, designing the program (and conducting research) in collaboration
with community, NGO, and government leaders and agencies is essential to

program success and sustainability. The Harlem Children’s Zone exemplifies
an integrative program that includes parenting intervention programs. In
addition, NGOs such as ChildFund International, WorldVision, and Save
the Children embed parenting programs within integrative community
intervention programs that focus on education and economic outcomes.
Monitoring and Evaluation
What monitoring and evaluation need to be built into parenting program

design? Monitoring ensures that the parenting program is relevant to partici
pants and helps to keep the reality of program implementation in line with the
program design. Some successful program effects persist, others fade out, and
still others disappear only later to reappear (Bailey, Duncan, Odgers, & Yu,
2017). Monitoring tracks these time-dependent effects and may help to answer
why they occur.
PROGRAM DESIGN CONTENTS

Parenting program contents raise at least three significant issues for designers
of prevention, support, or intervention programs. They concern subject matter
development, sources, and messages.
Subject Matter Development

Developing parenting program contents usually follows one of three routes:
(1) Contents are invented de novo. (2) Contents are adopted, meaning the
subject matter comes whole cloth from some existing parenting program. (3)
Contents are adapted, meaning the subject matter is modified from an existing
parenting program on the same topic that was developed for some different
specific population. Adaptations may address surface and/or deep structural
change.
Surface structure adaptations translate language or substitute participant-
relevant situations or images for those in the existing parenting program.
Guidelines to translate and adapt instruments, and provisions to guard against
potential cultural bias and related validity threats, can be found in the extant
literature (Erkut, 2010; Peña, 2007; van de Vijver & Leung, 1997). In well-
specified program protocols, staff are expected to make small adjustments in
response to emergent needs (so long as they do not seriously drift from intent,
content, or goal of the program; Kitzman, Cole, Yoos, & Olds, 1997).
Deep structure adaptations transform program contents to relate to or
respect specific contextual factors of the target population. A long-standing
concern is that parenting programs originally developed and tested in one
PARENTING 207
location with one group (often middle-income North American or Western

European samples) may be inappropriate and perhaps disempowering when
offered elsewhere (e.g., to lower-income or ethnically or culturally diverse
samples; Gardner et al., 2019; Jensen, Hoagwood, & Trickett, 1999; Laosa,
1983). Such applications typically require deep structure adaptations (Parra-
Cardona et al., 2017). For example, an adaptation of the PMTO-Oregon model
(originally developed for European American parents) changed and capita
lized on the concepts of respeto and family harmony to promote child disci
pline in low-income Latin American immigrants (Domenech-Rodríguez,
Baumann, & Schwartz, 2011). This adaptation maintained core content (e.g.,
the focus on reducing coercive interpersonal processes) of the PMTO-Oregon
model (Bernal & Adames, 2017). An adaptation method that increases cultural
sensitivity is to design parenting programs using community-based participa
tory research (CBPR). CBPR includes community members at each phase of
the prevention, support, or intervention (design, implementation, dissemina
tion, and scaling; Westfall, VanVorst, Main, & Herbert, 2006). CBPR pro
motes understanding and trust of program practices among different
communities, encourages participation, and allows input from community
members to guide and refine program efforts. CBPR practices help to ensure
that programs are culturally appropriate and sensitive to community norms
thereby enhancing program effectiveness. An alternative adaptation method is
to employ a deployment-focused model (Luthar & Eisenberg, 2017). This
method involves conducting randomized controlled trials (RCT; see below)
in naturalistic settings of the home or workplace in the target community.
Finally, it is especially important to understand whether the candidate
program theory of change is generalizable to the target parenting program
population before undertaking an adaptation. If the theory of change varies,
then even deep structural change is unlikely to yield an effective program.
In summary, community members should be included in discussions of
program design. Ultimately, a parenting program is designed to empower
parents, and community-based participation determines parenting program
contents and methods. That is, a participatory approach builds on existing
cultural and participant strengths. To promote uptake, ownership, and sus
tainability of a parenting program, it is important to consult the participants
and use the local context to determine program contents. Parents tend to be
more receptive when they are acknowledged as an important source of infor
mation for a parenting program.
In addition, community parents should be engaged in a sensitive and respect
ful manner from the inception of the program and going forward. For example,
the Chicago Parent Program was developed in collaboration with African
American and Latin American parents to ensure cultural appropriateness
(Gross et al., 2009; Murry, Berkel, Simons, Simons, & Gibbons, 2014a, 2014b).
Content Sources
Program content information usually comes from one or the other of

two sources: (1) Content information is developed top-down, as when
program contents are developed and delivered without participation or
input from the target population. (2) Content information is developed
bottom-up, as when program contents are developed and delivered with
participation and input from the target population. Top-down develop
ment is less than ideal as the goals and sensitivities of the target
population are likely to be missed resulting in program content that is
neither on target, welcoming, nor applicable to the participants. With
bottom-up development, program contents and methods build on exist
ing cultural and participant strengths, community-based participatory
research determines contents and methods, and programs are designed
to empower participants and to promote up-take ownership and sustain
ability (Gutiérrez & Jurow, 2016). Participants tend to be more receptive
to program contents when they are included as important sources of
information in program design. For example, designers of a framework
for one parent education component of the Even Start Family Literacy
Program learned that local program leaders typically wanted to convey
unambiguous messages to parents about their actions (e.g., “If you read
to your child every day, your child will become a strong reader.”), and
local program leaders expressed frustration with more nuanced and
qualified statements of the original parenting program designers
(Powell, 2005).
Content Messages
Program content messages may be specific and prescriptive (e.g., when
a parenting program directs what specifically to do to encourage some cogni
tion or practice in a parent), or program content messages may be general and
based on broad principles (e.g., when a parenting program offers generic rules
for encouraging some cognition or practice in a parent). Whichever, content
messages should be erected on a faithful understanding of parents’ strengths
and needs.
PROGRAM DESIGN COMPONENTS

Parenting program designs must specify constituent components. Four such
elements include the delivery mode, quantitative characteristics and contribu
tions of individual components to parenting program effectiveness, location,
and alignment. Content that articulates with the theory of change is essential.
PARENTING 209
Program Delivery Mode
The delivery mode (aka modality or platform) of the parenting program needs
to be specified as (1) interpersonal in a one-to-one, group, or combined format
or (2) not interpersonal in a format as self-instructional or based on technology
or media. Each mode has advantages and disadvantages. For example, groups
are useful to incorporate peer support for parent well-being when peer support
and community building are explicitly targeted in the theory of change. With the
increase in machine learning and individualized adaptive computer algorithms,
individualized, and targeted programs are both possible and feasible. Moreover,
some modes lend themselves to specific outcomes: Lectures, brochures, and
videos might prove more effective when delivered using active rather than
passive learning techniques, such as role-playing or actual interactions with
participants. In the face of the COVID-19 pandemic, parenting programs were
designed to accommodate to physical distancing using a variety of remote
platforms (e.g., digital/internet, telephone, text messaging, radio, and others)
to reach parents during lockdown periods (Hackett, Proulx, & Omoeva, 2021).
Internet programs can mitigate challenges to in-person attendance, including
transportation and childcare, but modes that rely on technology/remote pro
gramming can still pose technical difficulties related to access and connectivity
depending on the context. Moreover, internet-based programs inhibit the crea
tion of social support networks that are ancillary to program content but some
times integral to program success. Social supports and friendships that arise
from being in a program together often constitute significant program benefits
(Task Force for Child Survival and Development, 2003).
Quantitative Characteristics and Contributions of Individual Components to

Parenting Program Effectiveness
Quantitative characteristics of the program need to be specified. “Dose” some
times serves as an umbrella term for intensity (e.g., number of messages
per session, sum, frequency, and duration of program sessions, overall duration
of the program, attendance, and so forth; Sanders, 2008). Dose data can be
analyzed to understand program impact (e.g., by addressing questions such as
how many sessions lead to specific levels of impact; Grindal et al., 2016; Sweet &
Appelbaum, 2004). The Positive Parent Program (Triple P; Sanders, 2008) defined
five degrees of intensity: At the mildest degree of intensity, a public health
approach uses mass media to increase community awareness of risk and protec
tive factors in child development and available participant resources. The second
degree offers brief advice on common developmental issues (e.g., toilet training)
through short-term phone calls or face-to-face sessions. The third degree targets
parents of children who have mild to moderate behavioral challenges through
three to four one-to-one face-to-face or telephone sessions. The fourth and fifth
degrees offer parents still more intensive training in how to manage a range of
child behavioral problems through eight to 10 face-to-face or self-directed sessions
(degree four) or actual practice sessions with parents (degree five). A meta-analysis
of 70 studies of parenting interventions focused on maternal sensitivity and
attachment found that fewer than five sessions were equally effective to five to
16 sessions and more effective than more than 16 sessions (Bakermans-
Kranenburg, van IJzendoorn, & Juffer, 2003). Booster sessions that extend pro
gram duration are helpful to reinforce and remind parents about program content
after programs conclude (Breiner, Miller, & Hormes, 2021; Buchanan-Pascall,
Melvin, Gordon, & Gray, 2021; Zhang et al., 2021).
Program Location
Parenting programs are commonly delivered in different settings (e.g., home,

center, school, or other) and may vary in their entry points (e.g., health,
nutrition, education, social protection), so delivery mode might not bear the
same results in different settings or for different entry points. In consequence,
both program settings and entry points need to be specified.
Program Alignment
Program components should align with the needs and characteristics of the
participants and adjust appropriately to available human, technical, and
financial resources. Also, outcome variables are strongest when closely aligned
with program content (Pinquart & Teubert, 2010); but see the discussion of
indirect effects below.
Trade-offs
Adjudicating among these several criteria entails trade-offs. Parenting pro
grams with small doses with concise messaging might reach large numbers of
parents and achieve successful outcomes around more targeted knowledge and
information. Trade-offs are always an empirical question. In program design
generally, to design is to choose.
PROGRAM DESIGN TARGETING AND SAMPLING

Parenting program design needs to address questions about whom the pro
gram is targeting, why, and whether the program is designed to be universal or
targeted to a specific population (that has, for example, experienced some
specified risk factor). Program design is concerned with four dictates about
targeting and sample specification: The first addresses program design, and
the second through fourth address program evaluation.
PARENTING 211
Target Sample and Population
Parenting program designs need to specify the target sample, keeping in mind
that the sample is meant to represent a specific population. Results of a sample
are meaningful, not because they apply to the specific sample, but because the
sample represents, and hence generalize to, a larger population (which is the
reason for sampling in the first place; Bornstein, Jager, & Putnick, 2013; Jager,
Putnick, & Bornstein, 2017). Specify the sociodemographic characteristics of
the target sample (e.g., sample size, gender; Bornstein, 2013; Brown & Tam,
2019), ethnicity (Bornstein, 2019), socioeconomic status (Hoff & Laursen,
2019; Magnuson & Duncan, 2019) as well the presence and sizes of any
subsamples (e.g., the disadvantaged or at-risk; Bornstein, 2013, 2019; Brown
& Tam, 2019; Hoff & Laursen, 2019; Magnuson & Duncan, 2019). The target
sample of parenting programs is usually adult parents (both mothers and
fathers are children’s significant caregivers) or co-parents (McHale &
Sirotkin, 2019) but may be someone else in or outside the family in
a parenting role (e.g., grandparents, other members of the extended family,
non-parental caregivers, et al.; Kramer & Hamilton, 2019; Raikes et al., 2019;
Smith & Wild, 2019). The target sample could also be children or adolescents,
in which case the sample age or stage needs to be identified (Sandler, Ingram,
Wolchik, Tein, & Winslow, 2015). Every program must tailor its contents and
its methodology to the cognitive and social-emotional developmental levels of
the target sample. Samples should also be comprehensive; UNICEF Standards
for ECD Parenting Programs note: “Parenting programmes should involve all
parents and caregivers so that messaging about the function of parenting is
cohesive and coherent within the household” (UNICEF, 2017, p. 16).
Unit of Randomization
Parenting program designs need to specify the unit of randomization (if the
sample is a probability sample). (1) The unit of randomization might be an
individual parent or child, adolescent, family, or community (e.g., neighbor
hood, municipality, state, or province). (2) The unit of randomization might be
embedded in a cluster (e.g., families in a neighborhood, parent groups in village,
schools in a community). Clustering minimizes contamination effects from one
participant or group to another (Song & Herman, 2010a, 2010b). If clusters are
randomized, moreover, confounds are less an issue (Lachman et al., 2020).
However, randomizing at the cluster level can lead to “design effects” which
artificially deflate standard errors, but can be appropriately adjusted (Davis-
Kean, Jager, & Maslowsky, 2015). If clusters are not randomized, analyses need
to ensure balance across clusters and consider variation due to clustering in
examining effects (Raudenbush, Martinez, & Spybrook, 2007).
Sample Recruitment, Enrollment, and Adherence
Parenting program designs need to specify sample recruitment and document

participation enrollment and adherence. Enrollment and adherence are asso
ciated with characteristics of the parents, the providers, the program, and the
broader community. Strategies have been identified to encourage prospective
participants to enroll in a program (Yaremych & Persky, 2022; Salari & Filus,
2017). Program features that encourage enrollment include sufficient staffing,
defraying participant costs in regard to time, energy, and stress, amount of
compensation, and whether the parenting program addresses a need viewed as
beneficial and relevant to participant parents’ daily routines and culture
(Gross, Julion, & Fogg, 2001; Gul & Ali, 2009; McCurdy & Daro, 2001). In
addition, characteristics of the program’s providers (e.g., cultural competence
and communication style) are related to successful enrollment (see Article II:
Implementation). Inviting all participants into a program reduces stigma and
augments attendance relative to limiting enrollment to participants screened
according to specific criteria (Webster-Stratton, Reid, & Hammond, 2001). For
example, a program might involve all parents (and include family members
and parents of children’s schoolmates) to ensure that messaging is cohesive
and coherent across situations, across family members, and across peer groups
of parents, thereby increasing the probability of a positive outcome. Moreover,
an intergenerational approach, where parents and children attend program
sessions together (if appropriate), may similarly enhance program effective
ness in certain contexts and cultures (Yousafzai & Aboud, 2014).
Sample Attendance, Engagement, and Attrition

Parenting program designs need to specify sample attendance, engage
ment, and attrition. Parenting program evaluations show a wide range of
participant completion rates – from less than 50% to more than 99%
(Breitenstein, Gross, & Christophersen, 2014). Standards of study inclu
sion from the U.S. Institute for Education Sciences “What Works
Clearinghouse” specify that, to be deemed efficacious, a program should
lose fewer than 25% of the original participants (Song & Herman, 2010a).
Moreover, the percentage of attritted participants as well as their socio
demographic characteristics should be approximately the same for all
groups in a randomized control trial or quasi-experimental design (see
below). If participants who leave a program differ from those who remain,
then it is only appropriate to generalize findings to individuals who are
like those who remained in the program (e.g., if only parents from intact
families remained in the program, then it would be appropriate to gen
eralize findings to parents from intact families and not appropriate to
generalize findings to parents from non-intact families). For this reason, it
PARENTING 213
is important to maximize participant retention whenever possible

(Graham, 2009; Zhou et al., 2014). Like enrollment, successful retention
in parenting programs is associated with characteristics of the participants
(e.g., satisfaction with the experience), the providers (e.g., competency,
professionalism), the program (e.g., incentives, sufficient staff), and the
broader community (e.g., cultural barriers, community cohesion). To
account for differences in parents who remain and those who attrit,
many prevention scientists consider all those who participated in one
session should be included in the program group for purposes of evalua
tion. Finally, it is important to document the reasons and predictors of
attrition (Mauricio et al., 2018).
MEASUREMENT IN PROGRAM DESIGN

Parenting programs with good designs for evaluating efficacy and impact
incorporate reliable and valid measures into all phases (Card, 2017; Rioux &
Little, 2020). Two sets of measurement issues concern measuring specific
features of a program and overall measurement standards.
Measurement Features of a Program

Two measurement issues are especially noteworthy: measures of direct
and indirect effects and measures of fidelity. (It is inevitably the case that
this measurement concern of program design spills over into measure
ment standards; the two are separated here and re-visited in Article II:
Implementation.)
Measures of Direct and Indirect Effects. Measures of direct effects of

a parenting program are requisite, and measures of (related) indirect
effects are desirable. (1) Measures of program direct effects ideally
match program contents and outcomes. Outcome variables are strongest
when measured in ways that closely align to program focus. (2) Measures
of indirect effects that stand adjacent to program content can yield addi
tional benefits. For example, a relationship/marriage education program
was developed to improve interparental relationships with parenting.
A sample of low-income minority mothers with a child attending
a Head Start program showed increases in maternal reports of coparenting
agreement but also positive “spillover effects” in decreases in maternal
reports of punitive parenting behaviors toward children (this program also
showed spillover effects to increases in children’s social competence over
time; Adler-Baeder et al., 2018). Thus, outcome measures that extend
beyond measures directly related to program focus can yield value
added results. For example, the Family Checkup intervention (developed
to improve positive behavior in children) recorded positive spillover

effects on children’s school readiness (Lunkenheimer et al., 2008). (3)
Measures of potential drivers (intermediate outcomes) and relevant mod
erators in line with the program theory of change are also important. Such
measures explore whether the program has an effect and why, and they
are critical to monitoring program design and identifying key ingredients
for future programs (Attanasio, Cattan, Fitzsimons, Meghir, & Rubio-
Codina, 2020).
Fidelity. Parenting program designs need to build in measures of fidelity.

Assessments of program fidelity give attention to the delivery and receipt of
program elements as actually implemented versus intended. Delivery pertains
to the provision of key program features, including content and method.
Receipt focuses on the extent to which parents participated in a delivered
program component.
Demonstrating fidelity has many advantages. Fidelity ensures to consumers
that the program is meaningful and valid (Powell & Carey, 2012). Data that
reliably demonstrate that a program was implemented with a high degree of
fidelity to the intended model bolster confidence in positive program out
comes. Fidelity monitoring also allows for timely course corrections and
identification of variations in enactment that appear to be irrelevant to pro
gram outcomes so that aspects of a program that do not work can be omitted
in favor of those that do work (as in MOST/SMART designs elaborated
below). If a program did not work, knowing whether it was implemented
with fidelity is vitally informative. For example, a study showing mostly null
results for one home visiting program (Wagner & Clayton, 1999) was
informed by a companion fidelity study that found that the actions of home
visitors (the implementation staff) only minimally aligned with the original
intended intervention design (Hebbeler & Gerlach-Downie, 2002).
Strategies to measure fidelity vary from implementation staff logging and
counting delivery and receipt to recording and coding videos of staff imple
menting the program to staff demonstrations of knowledge of and proficiency
in program content (Forgatch & DeGarmo, 1999; Rubio-Codina, Dormal, &
Araujo, 2019). Strategies that rely exclusively on self-reports of fidelity are
discouraged. All that said, program designers should anticipate less than 100%
fidelity (Durlak & DuPre, 2008). For example, mothers complete about one-
half of the intended number of home visits in the Olds nurse home visitation
program (Korfmacher, O’Brien, Hiatt, & Olds, 1999). Fidelity is too often
a neglected design feature of parenting programs. A 2014 analysis of 22 home
visiting programs selected for a U.S. federal Home Visiting Evidence of
Effectiveness project found that a majority did not report implementation
fidelity data, and those that offered some implementation fidelity data did not
identify the data source (Paulsell, Del Grosso, & Supplee, 2014).
PARENTING 215
General Measurement Standards
In considering appropriate measurement of program effects and fidelity, three

measurement standards are noteworthy: measurement sources, measurement
psychometric adequacy, and multiple measurement.
Measurement Sources. Measures may be developed de novo, adopted, or

adapted (the pros and cons of each approach are discussed above with respect
to Design Contents). In evaluating prevention and intervention programs,
assessments from multiple sources are ideal, including the perspectives of
multiple relevant individuals, such as parents and other family members,
children and siblings, along with teachers and counselors. In addition, other
data sources including school and health record data and administrative data
are desirable. Convergence among reporters on similar outcomes and pro
cesses might be ideal, but it is important to remember that diverging perspec
tives are equally important. Indeed, parents’ and children’s reports on parents
only correlate on average at about r = 30 (Tein, Roosa, & Michaels, 1994),
Measurement Psychometric Adequacy. All program measures should be

psychometrically sound, sensitive to bias and reliability and validity threats,
developmentally appropriate (especially as the manifestations of constructs
can be expected to change with child development), and sensitive to change
(so that actual effects of the program on outcomes can be detected). Where
called for, measurement invariance across demographic groups should also be
ensured (Putnick & Bornstein, 2016). Parenting is moderated by many factors,
prominently gender, socioeconomic status, ethnicity, and culture (e.g., even
common parenting constructs, such as warmth and behavioral control, are
manifested differently across sociodemographic groups; Bornstein, 1995; Hill,
2021; Knight & Hill, 1998).
Multiple Measurement. The use of multiple measures and multiple sources

of those measures is recommended. Program evaluations that employ one
measurement method or one source risk yielding limited, biased, or inflated
results due to common variances (Okagaki & Bingham, 2005). Self-reports can
be contaminated by social desirability or other biases as well (Bornstein et al.,
2015). Different measures and sources can yield convergent or different
results, so employing multiple measures and sources can make stronger or
more nuanced contributions than assessments of one measure or one source.
A multi-method multi-informant approach ideally includes reports, observa
tions, interviews, questionnaires, and standardized measures completed by
parents, teachers or coaches, trained assessors, and (when appropriate) com
plemented with administrative data and public records (Drake & Ginsburg,
2011; Fredrick & Luebbe, 2022; Lachman et al., 2020).
PROGRAM DESIGN AND EFFECTIVENESS

Evaluating parenting program effectiveness calls for rigorous experimental
standards. Key considerations include the design approach as a randomized
control trial or the use of a quasi-experimental design and the selection of
control and comparison conditions.
Randomized Control Trials, Quasi-Experimental Designs, and Follow-ups
Randomized Control Trials. A randomized control trial (RCT) is widely

regarded as a superior program evaluation design. Parenting program parti
cipants (who on average are like each other on demographic characteristics
and background variables that are believed to be associated with the program
goal or outcome) are randomly assigned to participating groups. The logic is
that the observed program outcome can be attributed to the parenting pro
gram, and not to differences between characteristics of the participants (such
as mothers’ verbosity as in the Figure 2 “moderated-mediation” example) that
exist between the groups at the start (Cook, Campbell, & Shadish, 2002).
An innovation in RCT methodology is the adaptive design framework
where preliminary evidence regarding program implementation fidelity and
potential efficacy are used to modify a design based on prespecified guidelines.
Examples of such frameworks include the sequential, multiple assignment,
randomized trial (SMART; https://ies.ed.gov/ncser/pubs/2020001/; https://
www.methodology.psu.edu/ra/adap-inter/research/) and the multiphase opti
mization strategy (MOST; https://www.methodology.psu.edu/ra/most/
research/). When implemented effectively, adaptive designs improve the effi
ciency and feasibility of RCTs.
RCTs have known limitations concerning logic, validity, and inconsisten
cies in evaluating the probabilities of risks and rewards (Cartwright & Munro,
2010; Conaway & Goldhaber, 2020; McCall & Green, 2004). For example, in
traditional RCTs with pretest-posttest analyses, pretests are susceptible to
a response shift bias which occurs when participants’ frame of reference
regarding a question changes between the pretest and the posttest, rendering
it difficult to compare pretest and posttest. Such bias threatens the internal
validity of the evaluation design (Geldhof et al., 2018; Rioux & Little, 2020). On
account of such limitations, alternatives to RCTs have been developed.
COVID-19 restrictions also challenged delivery of RCTs. These challenges
sparked several innovations including online training and delivery of parent
ing programs and online trial methods (Cluver et al., 2020).
Quasi-Experimental Designs. Quasi-experimental designs include regres

sion discontinuity designs, instrumental variable analysis, interrupted time
series, and observational studies with propensity score matching methods
PARENTING 217
(Cook, 2014; Heckman, Urzua, & Vytlacil, 2006; Heckman & Vytlacil, 1999;
Murnane & Willett, 2010). An alternative to the traditional pretest–posttest
design involving participant self-reports is the retrospective pretest–posttest
design (Geldhof et al., 2018). When, as in most instances, prior or preliminary
evidence for the main pathways and processes in the theory of change are
based on correlational evidence, it is important to evaluate that background
correlational evidence to ensure that the evidence is based on rigorous mea
surement and sampling methods.
Follow-ups. Whether an RCT or quasi-experimental design, contempor

ary parenting program designs almost always include follow-ups (e.g.,
Olds et al., 2002, to 15 years). Here several temporal considerations
come into play. Programs may have immediate (direct or indirect) short-
term effects; program short-term effects may or may not endure as long-
term effects; effects may not become evident until the long-term (aka
“sleeper effects”); program effects may emerge in the short-term, attenu
ate, and then re-appear; etc. Most program designs are limited to measur
ing short-term effects, but distinct advantages may be reaped by
determining whether a program has a long-term or delayed effects
(Grantham-McGregor & Smith, 2016; Heckman, Moon, Pinto, Savelyev,
& Yavitz, 2010). Current standards call for programs to have at least one
long-term follow-up (where follow-up data are collected on all program
participants; Gottfredson et al., 2015). In support of this point, a review of
46 RCTs identified positive effects up to 20 years after the conclusion of
a prevention, support, or intervention (Grantham-McGregor & Smith,
2016; Olds et al., 1997; Sandler, Schoenfelder, Wolchik, & MacKinnon,
2011). Follow-up investigative designs disambiguate the duration of pro
gram effects and strengthen claims to program value (Sandler et al., 2011).
Control and Comparison Conditions
How does a parenting program designer know that the design will be
effective? Just because an “effect” is detected at the conclusion of the
program does not prove the program had efficacy (in the case of an
efficacy trial) or was effective (in the case of an effectiveness study; for
discussions of standards of evidence see Flay et al., 2005; Gottfredson
et al., 2015). An efficacy trial is an experiment or proof-of-concept study
to test whether a program works under researcher-controlled circum
stances. Program design therefore includes evaluation to ensure success
and meaningfulness. Three evaluation questions are: (1) when and how
to evaluate; (2) what measures to use in evaluation; and (3) how to judge
success and meaningfulness. (For a discussion of general standards of
evidence in evaluation, see Crowley et al., 2018.)
With respect to the first evaluation question of when and how, multi-phase
optimization models prior to finalization or adaptation of a model have been
advanced (Collins, 2018; Collins, Murphy, & Strecher, 2007). Evaluation data
collectors and analysts should be blind to all research conditions, and assess
ments should be made by researchers who are independent of the parenting
program developer (Flay et al., 2005). Although some independent program
evaluations have produced findings like those reported by program developers
(Baker-Henningham, Scott, Jones, & Walker, 2012), other evaluations of
programs have indicated that studies led by evaluators who had a higher
degree of influence on the design and implementation report substantially
larger effects than studies in which the evaluators have a lesser degree of
influence on the design and implementation (Petrosino & Soydan, 2005).
Measurement (and the corresponding measurement model) represents the
selections made by program personnel and stakeholders (e.g., families, com
munity leaders) of specific indicators (surveys, interviews, standardized tests,
observations, behavioral/performance tests, or biomarkers) that are used to
quantitatively and/or qualitatively measure or index each facet of the logic
model (Lerner, 2018).
Program effectiveness is usually judged with respect to program treatment
versus control and comparison conditions, and meaningfulness is usually
judged with respect to effect size of the difference between treatment and
control or comparison conditions (Cohen, 1988). (Large effect sizes are nor
mally sought, but even small to moderate effect sizes may still have practical
meaning, and small early effects can aggregate to later large effects; Bornstein,
2014; Dishion et al., 2008). Alongside the treatment group, five types of control
or comparison conditions test and defeat specific potential criticisms or
weaknesses in parenting program design regarding causal inference.
Replication is an additional evaluation consideration.
(1) The no-treatment condition. Parents in this group are not offered
program resources, but they are free to make use of other available
(even related) resources on their own. A mathematics intervention
program with Head Start families provided eight biweekly classes
for mother–child dyads plus access to a library of mathematics kits
for use at home (Starkey & Klein, 2000). Participants assigned to
the no-treatment (aka business-as-usual) condition in this study
received neither the classes nor access to the mathematics kits. But
the no-treatment condition participants could find or continue to
use other resources to promote their child’s mathematics knowl
edge (e.g., borrow mathematics-related materials from their local
library). Some researchers contend that a business-as-usual condi
tion is ethically problematic and opt to offer a nominal level
(Condition 2) program for all participants as a comparison
PARENTING 219
condition. A no-treatment condition is generally deemed to be

especially ethically problematic in studies involving vulnerable
populations that may be at risk without receipt of pertinent pro
gram services (Sieber & Tolich, 2012). (In the Remdesiver COVID
trial, the NIH suspended the no treatment comparison group
because the treatment group went from 15 days in the ICU to
11; Beigel et al., 2020.)
(2) The nominal support condition. Parents in this group are offered
a modest level of assistance related to, but not part of, the actual
program.
(3) The component condition. Parents in this group are offered an element
or lower dosage of the program. Olds et al. (1998) systematically varied
the intensity and components of a Nurse Home Visiting Program by
randomly assigning participants to one of four different degrees of
intervention: (i) sensory and developmental screening for the child,
with referral for further evaluation and treatment when needed; (ii)
screening services offered to participants in the first condition plus free
transportation to prenatal and well-child care visits through the
child’s second birthday; (iii) screening and transportation services
offered in the first two conditions plus home visits from a nurse during
pregnancy; and (iv) services offered in the third group plus nurse home
visits through the child’s second birthday. The internal validity of
a study that compares two or more variants of an intervention is
stronger when there are controls for possible intervention staff con
founds (e.g., ensure intervention staff deliver more than one variant of
the intervention).
(4) The placebo condition. Questions about whether the active ingredient of
an intervention is simply the amount of attention participants receive
from intervention staff, rather than the substance of the intervention
per se, has led to the use an attention placebo condition. Parents in this
group receive supports that mirror the amount of contact (e.g., fre
quency and length of program) offered in the program to determine
whether program effects are the result of the program or simply the
result of offering program group participants the regular attention of
providers of the program. Parents therefore receive similar levels of
attention from program staff, but not the aspect of the program that is
deemed most effective (i.e., the program “active ingredient”). This
condition disentangles actual parenting program effects from general
social support or attention (sometimes called the “Hawthorne effect”;
Adair, 1984). For example, a study of responsive parenting offered
mothers randomly assigned to the attention placebo condition the
support of a “development assessment screening facilitator” who
made the same number of home visits that staff in the program made
to mothers assigned to the actual intervention condition. The develop

mental assessment screening facilitators responded to mothers’ ques
tions about infant skill levels and provided handouts on common infant
development issues (e.g., pacifiers) but did not respond to questions
about how to facilitate infant development or offer supports that were
central to the intervention condition, particularly feedback on mothers’
responsive behaviors promoted by the intervention (Landry et al., 2008,
2012). Here, assessments of the fidelity of implementation are especially
important to ensure that participants assigned to the attention placebo
condition do not receive the active ingredient of the intervention
(Landry, Smith, & Swank, 2006).
(5) The waitlist condition. Parents in this group are offered the parent
ing program but at a later time than the treatment condition. The
waitlist condition offers the program to other parents who may be
interested and is relevant when authorities (e.g., schools, govern
ments) decide that all members of a community should receive
a beneficial program (Hulley, Cummings, Browner, Grady, &
Newman, 2013). (Using a control group that does not receive
a proven intervention may not be considered ethical, whereas
assignment or randomization for later program participation may
be acceptable.) A wait-list condition also investigates immediate
effects of a program with a no-treatment comparison group that
receives the program at a later point. Nonetheless, the waitlist
condition may be problematic for longer-term programs because
the prospect of participating in a program later than a treatment
may suppress study enrollment or contribute to attrition among
participants assigned to the waitlist condition. Another limitation
of a wait-list condition is the lack of opportunity to examine follow-
up effects in a contrast of treatment and comparison groups once
the comparison group participates in a program. For example, in
a study of a behavioral family program, families randomly assigned
to the wait-list condition completed post-program assessments at
a later time, participated in a variant of the program of their choice,
and did not contribute any further to the study, including follow-up
data collection sessions at 1 year and at 3 years out that were
conducted with families who participated in the program condition
(Sanders, Bor, & Morawska, 2007; Sanders, Markie-Dadds, Tully, &
Bor, 2000). Wait-list participants may be useful to examine program
implementation questions, but this condition contributes only
weakly to outcome analyses in the absence of an appropriate com
parison group. In addition, the optimal timing of the program to
participants’ developmental issues may have passed by the time
PARENTING 221
wait-list parents participate in the program, and, further, repeated

exposure to outcome measures in a relatively short time period may
affect performance on post-program assessments.
Replication
Replication studies are essential in science to rule out chance findings and the
potential influences of specific times and unique contextual factors, which is
also applicable to parenting program evaluation (Duncan, Engel, Claessens, &
Dowsett, 2014). Current best practices to exclude chance findings include
preregistration of design (including sample, hypotheses, measures, and analy
tic approach) and open-access data (Naudet et al., 2018; Nosek, Ebersole,
DeHaven, & Mellor, 2018). As for replication across contexts, in practice, it
is often impractical to run a trial every time a change is made to a program, or
a program is implemented in a new context. Replication studies are unfortu
nately rare in the design of parenting programs (Pashler & Harris, 2012). An
exception is systematic program research as in Olds’s Nurse-Family
Partnership (NFP) which investigated replication in a series of sequential
efficacy trials, each conducted with a different population in a different com
munity. The first trial was implemented with a small European American
sample of women in a semi-rural community (Elmira, NY) that was followed
up 15 years after the intervention (Olds et al., 1997, 1998). A second efficacy
trial was conducted with a larger sample of African American women
(Memphis, TN) and followed up 9 years post-intervention (Olds et al.,
2007a, 2007b). A third RCT was conducted (Denver, CO) with a Mexican
American sample and followed up 4 years post-intervention (Olds et al., 2004).
Each follow-up study replicated generally positive parenting program effects
(e.g., reductions in child abuse, neglect, and injuries), although some differ
ences were evident across the three sites and populations in types of impacts.
Alongside replication, where possible, systematic research on drivers of
impacts is key because knowing the drivers of impacts fortifies an assumption
that those drivers will be robust to variation in time and context. Rather than
running full trials through replication exercises at different times and in
different contexts, it is often more feasible to measure and document key
drivers.
Contamination and Diffusion

Related to considerations of control and comparison conditions are issues of
contamination and diffusion, that is when non-program participants in
a control or comparison condition find out about the program and take
advantage of it in some way, as might happen when treatment and control
conditions are offered in the same location. For example, as part of a parenting
program to promote children’s reading Klaus and Gray (1968) had home
visitors school mothers in a program versus a comparison with a popular
children’s magazine. When they got no program effect, the investigators
discovered that local merchants in the community sold unusually large quan
tities of the same children’s magazine. They then graphed overlapping family
and friendship networks of participants to understand the flow of information
(“horizontal diffusion”) between their program and comparison groups. With
the advent of modern social media, it is also feasible that experiences with
a parenting program even at great distances can contaminate or diffuse.
Another benefit of fidelity monitoring is assurance that control and compar
ison participants are not exposed to or participate in program services
(Gottfredson et al., 2015). Contamination and diffusion are non-trivial in
that both undermine the possibility to detect effects between program versus
control and comparison conditions.
The Four-Group Design
To account for the benefits of each of the possible comparison condi

tions, a four-group design is recommended (Lessac & Solomon, 1969;
Solomon & Lessac, 1968). Figure 3 shows the four-group design plan.
Notably, this omnibus design addresses the potential of pretest priming
effects and therefore underestimation of the true impact of the proposed
parenting program.
(1) Condition 1 follows the traditional three-phase design of pretest

followed by parenting program administration followed by posttest.
The comparison of pretest scores between the treatment and the no-
treatment group determines the level of parents’ cognitions or prac
tices before the program. The comparison of posttest with pretest
purports to demonstrate the (improvement) effect of the parenting
program.
(2) Normally the pretest and posttest are substantively related to the
program, and so the pretest incorporates some experience relevant
to the program (e.g., in the case of parenting program evaluations,
including play-based activities between parent and child that are part
of a parenting assessment). The posttest is often highly overlapping
with the pretest, so it is feasible that the pretest or the pretest-plus-
program is the “active ingredient” and not the program per se.
Condition 2 omits the pretest and includes only the program and
the posttest. A Condition 1 versus 2 posttest comparison eliminates
effects of pretesting versus the program.
PARENTING 223
Figure 3. The Solomon-Lessac four-group design. Condition 1 presents a parenting program

preceded by a pretest and followed by a posttest to evaluate change in the targeted outcome.
Because the pretest gives Condition 1 participants some relevant exposure to the outcome,
pretest-posttest change might be due to the pretest and not the program. Condition 2 offers
just the parenting program and a posttest, not the pretest. Then, Condition 1 versus 2 comparison
of posttests eliminates the priming effect of pretesting versus the program. Condition 2-Condition
1 similarity on the posttest suggests that the pretest was not the active ingredient on the posttest,
but rather the program was or contained the active ingredient. Condition 3 offers just the pretest
and posttest, not the parenting program, and so has no effects of pretest priming or the program
active ingredient. Comparing Conditions 1 and 3 on the pretest-posttest difference reveals the
unique (or non) effect of the program. Between the time of a pretest and the time of a posttest (as
in Condition 1), participants develop (grow and change), and they are exposed to different
experiences (including contamination or diffusion). Some growth, change, or experience may be
incidentally related to the program. Condition 4 offers just a posttest, not the pretest or parenting
program. Comparing Conditions 1 and 4 reveals parenting program effects with development
solely and permits an evaluation of contamination and diffusion (see the text).
(3) Condition 3 deletes the program and tests the effects of pretest priming on
the posttest. A comparison of Conditions 1 versus 3 on the pretest-posttest
difference reveals the unique effect (or non-effect) of the program.
(4) Condition 4 deletes the pretest and the program, retaining only the
posttest. Between the times of the pretest and the posttest in Condition
1, participants grow and change (possibly also affected by contamina
tion or diffusion). A comparison of Conditions 1 and versus 4 reveals
the effects of development or other non-program influences (such as the
“Hawthorne Effect” or contamination and diffusion).
CONCLUSIONS
Designing parenting programs calls for a wide array of upstream decisions that
have implications for downstream outcomes. Parenting programs are multi-
dimensional and dynamic but always occur with specific aims involving
specific populations and in specific contexts. Specific designs therefore differ
by contents, participants, and situations, but still share many common over
arching meta-principles described here. Evidence-based research and scientific
rigor constitute the core of quality parenting program design. Article I focuses
on a broad range of design considerations for parenting program preventions,
supports, and interventions. It is not thought that all parenting programs,
especially those undertaken in challenging contexts of low- and middle-
income countries, can implement all of the design considerations detailed in
this article. However, it is best for parenting program designers to be fully
cognizant of all these considerations of program design so that priorities
among them can be adjudicated thoughtfully and trade-offs clearly understood
in advance of any parenting program field implementation. Building and
disseminating knowledge about good program design is vital to ensuring
future parenting programs that enhance caregiving, child development, and
family life. Design challenges span a wide range of decisions about how to
devise, implement, evaluate, and scale up parenting programs. This article on
Design is accompanied by companion articles on parenting program imple
mentation and parenting program up-take and scaling.
AFFILIATIONS AND ADDRESSES

Marc H. Bornstein, Eunice Kennedy Shriver National Institute of Child Health
and Human Development, 8404 Irvington Avenue, Bethesda MD 20817-3838
U.S.A. Email: marc.h.bornstein@gmail.com. Lucie Cluver is at the University
of Oxford and University of Cape Town, Kirby Deater-Deckard is at the
University of Massachusetts - Amherst, Nancy E. Hill is at Harvard
University, Justin Jager is at Arizona State University, Sonya Krutikova is at
the Institute for Fiscal Studies, Richard M. Lerner is at Tufts University, and
Hirokazu Yoshikawa is at New York University.
ARTICLE INFORMATION
Conflict of Interest Disclosures
Each author signed a form for disclosure of potential conflicts of interest. No
authors reported any financial or other conflicts of interest in relation to the
work described.
Ethical Principles
The authors affirm having followed professional ethical guidelines in prepar

ing this work. This ms. did not have any patient involvement or require ethics
approval.
PARENTING 225
Funding
MHB was supported by the Intramural Research Program of the NIH/NICHD, UNICEF, and
an International Research Fellowship at the Institute for Fiscal Studies, funded by the European
Research Council under the Horizon 2020 research and innovation programme. LC was
supported by the UKRI Global Challenges Research Fund, the European Research Council,
the LEGO Foundation, and the Oak Foundation. RML was supported by the Templeton World
Charity Foundation, the Chan Zuckerberg Initiative, Compassion International, and the
National 4-H Council. HY was supported by funding from the NYU Abu Dhabi Research
Institute to the Global TIES for Children Center.
Role of the Funders/Sponsors

None of the funders or sponsors of this research had any role in the design and
conduct of the study; collection, management, analysis, and interpretation of
data; preparation, review, or approval of the manuscript; or decision to submit
the manuscript for publication.
Acknowledgements
The ideas and opinions expressed herein are those of the authors alone, and endorsement by
the authors’ Institutions or funding agencies is not intended and should not be inferred. We
thank L. Henry for keen assistance.
ORCID
Marc H. Bornstein http://orcid.org/0000-0002-6810-8427
Lucie Cluver http://orcid.org/0000-0002-0418-835X
Kirby Deater-Deckard http://orcid.org/0000-0003-4151-2152
Nancy E. Hill http://orcid.org/0000-0002-2489-3582
Justin Jager http://orcid.org/0000-0003-0067-0920
Sonya Krutikova http://orcid.org/0000-0003-2488-7489
Richard M. Lerner http://orcid.org/0000-0002-0429-8719
Hirokazu Yoshikawa http://orcid.org/0000-0001-5607-8526
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The Future of Parenting Programs: I Design

Marc H. Bornstein, Lucie Cluver, Kirby Deater-Deckard, Nancy E. Hill, Justin

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The Future of Parenting Programs: I Design

PROGRAM DESIGN PRELIMINARY QUESTIONS

Objective and Feature

Is the objective of the parenting program to encourage or discourage a specific

Have other relevant parenting programs with comparable objectives directed to

Figure 1. A mediation model. An Independent variable (the parenting program materials)

underpin many program designs, moderated mediation – when a moderator

Logic Model and Process of Action

specify operational definitions of parental warmth, engagement, knowledge,

Stand Alone versus Integrated

with community, NGO, and government leaders and agencies is essential to

Monitoring and Evaluation

What monitoring and evaluation need to be built into parenting program

PROGRAM DESIGN CONTENTS

Subject Matter Development

location with one group (often middle-income North American or Western

Program content information usually comes from one or the other of

PROGRAM DESIGN COMPONENTS

Program Delivery Mode

Quantitative Characteristics and Contributions of Individual Components to

Parenting programs are commonly delivered in different settings (e.g., home,

PROGRAM DESIGN TARGETING AND SAMPLING

Target Sample and Population

Sample Recruitment, Enrollment, and Adherence

Parenting program designs need to specify sample recruitment and document

Sample Attendance, Engagement, and Attrition

is important to maximize participant retention whenever possible

MEASUREMENT IN PROGRAM DESIGN

Measurement Features of a Program

Measures of Direct and Indirect Effects. Measures of direct effects of

to improve positive behavior in children) recorded positive spillover

Fidelity. Parenting program designs need to build in measures of fidelity.

General Measurement Standards

In considering appropriate measurement of program effects and fidelity, three

Measurement Sources. Measures may be developed de novo, adopted, or

Measurement Psychometric Adequacy. All program measures should be

Multiple Measurement. The use of multiple measures and multiple sources

PROGRAM DESIGN AND EFFECTIVENESS

Randomized Control Trials, Quasi-Experimental Designs, and Follow-ups

Randomized Control Trials. A randomized control trial (RCT) is widely

Quasi-Experimental Designs. Quasi-experimental designs include regres­

Follow-ups. Whether an RCT or quasi-experimental design, contempor­

Control and Comparison Conditions

condition. A no-treatment condition is generally deemed to be

to mothers assigned to the actual intervention condition. The develop­

Quasi-Experimental Designs. Quasi-experimental designs include regres

Follow-ups. Whether an RCT or quasi-experimental design, contempor

to mothers assigned to the actual intervention condition. The develop

To account for the benefits of each of the possible comparison condi

The authors affirm having followed professional ethical guidelines in prepar