Discussion
depression, anxiety
This study examined the short-term impact of a novel adaptation of the FCU-O, designed to support adaptive parenting in response to stressors such as those associated with the COVID-19 pandemic. In particular, a new module, “healthy behaviors for stressful times,” was developed with input from parents and community providers, to support parental self-care as well as youth coping with stress, including stressors due to the pandemic.Results of the current study showed that the enhanced FCU-O predicted consistent improvements in important aspects of parent functioning at 2-month follow-up. Parents in the FCU-O condition reported significant reductions in perceived stress, improvements in emotion regulation (including impulse control and access to emotion regulation strategies), and reductions in symptoms of anxiety and depression, with effect sizes ranging from small-to-moderate to moderate-to-large in magnitude. Parents also reported significant improvements in crucial parenting skills, including reductions in negative parenting behaviors (e.g. hostile criticism, yelling at child), increases in positive parenting strategies (e.g. use of praise and spending positive time together), and improvements proactive parenting behaviors (e.g. giving reasons for requests, breaking tasks into smaller steps), with effect sizes also ranging from small-to-moderate to moderate-to-large. Improvements in parental perceptions of family-togetherness and the quality of the co-parenting relationship were also observed.There were, however, several areas of parenting and family relationships for which significant intervention effects were not observed, including parental limit-setting, monitoring, and family conflict. It is possible that these behaviors may take a longer time to change. As we follow families through 4- and 6-month follow-up assessments, we will examine longer-term impacts on these aspects of parenting.Nevertheless, the overarching pattern of results show that significant improvements in parental mental health, adaptive parenting, and family relationship functioning can be achieved with a relatively brief program incorporating app-based intervention material and coaching support for parents, in order to support effective parenting during stressful times. Parents spent nearly 5 h of intervention time across app-based materials and parent-coaching sessions. While this is relatively brief compared to many parenting interventions, it is comparable to the original school-based trials of the FCU. For instance, in the first large scale RCT of the FCU in with children aged 10–14, families received an average of 8.9 h of in-person intervention, while families received an average of 5.62 h of in-person intervention between grades 7 and 9 in a subsequent school-based trial. This study also builds upon work with the FCU-O prior to the COVID-19 pandemic (Stormshak et al., In line with this possibility, analyses of factors associated with greater engagement with the FCU-O generally showed that greater parental challenges were associated with greater engagement with elements of the intervention, although results differed somewhat for engagement with app-based materials and with coaching sessions. Parents who were unemployed or reported receiving financial assistance (e.g. unemployment insurance, social security benefits, etc.) generally spent more time engaging with app-based intervention materials. A broader range of baseline factors were associated with engagement with coaching sessions, however. Parental unemployment and receipt of financial assistance were associated with spending more time in coaching sessions, as were single-parenthood and greater baseline levels of parenting difficulties (including greater perceived stress, emotion regulation difficulties, symptoms of anxiety and depression, negative parenting behaviors, and lower levels of positive parenting behaviors and parental monitoring of family routines).Our results regarding engagement-related factors are in contrast to the broader emerging literature on predictors of engagement with online mental health interventions, which has yielded few consistent predictors of adherence across a range of demographic, treatment-target, or programmatic factors (Beatty & Binnion, 