Legacy for Children™

The Parenting Research Projects

University of Miami Research Site | University of California at Los Angeles Research Site

The early years of life (birth to age 5) are crucial for cognitive and social/emotional development. Parents play a critical role in their children’s development and are responsible for their children’s environment. Children develop within the context of their family and their development is affected by the nature of the relationship with their parents. Previous early intervention efforts have typically included early education for children in child care centers and social or mental health services for the parents in their role as adults, with only marginal attention devoted to parenting behavior. The interventions initiated by the Centers for Disease Control and Prevention (CDC) focus on parenting behaviors and the relationship of the parent with his or her own child.

Through its Child Development Studies Section, CDC has initiated Legacy for Children™, a set of randomized, controlled, longitudinal research projects. Legacy for Children™ will examine the potential for improvement in child developmental outcomes through programs designed to influence parenting behavior. The first two research sites are located at the University of Miami and the University of California at Los Angeles.

Research Questions: The primary research question for Legacy for Children™ is: Do children in the intervention groups achieve better developmental outcomes than do the children in the comparison groups? There are five related research questions:

(1) Do parents become engaged in the intervention program? (2) Do parents adopt parenting behaviors that are more likely to foster child development? (3) Does one project have a greater effect than the other project. (4) Do parents in the intervention program develop a greater sense of community? (5) What are the costs of delivering the intervention and do the potential benefits outweigh the costs?

Target Population: The participating families are those whose children, on average, would be expected to fall below national norms on a range of developmental variables. Each project will enroll 120 children in the intervention group and 120 children in the comparison group.

The Intervention: A variety of intervention activities in multiple settings will be offered to parents in the intervention group for a period of 3 to 5 years beginning at their children’s birth. The activities will be intense and sustained. They will include parent and parent/child group meetings, visits to the home, and participation in community events and activities.

The intervention program aims to promote parents’ belief that their behavior towards their child can make a difference in short- and long-term developmental outcomes. We hypothesize that parents will do a better job of adopting and maintaining preferred parenting behaviors if they receive support for these behaviors from a peer group and have a sense of belonging to a community larger than themselves.

The CDC Legacy for Children™ Projects will emphasize the following:

• Parental responsibility, parental investment in the child, parental commitment of time and energy

• Parent-child interaction style

• Parent as guide of child’s socialization (behavioral guidance and regulation)

• Parent as guide of child’s verbal and cognitive development

Measurement:
Process, cost, and outcome data will be collected. Process data will allow the researchers to understand and interpret the outcomes achieved by study participants. Cost data will estimate the costs and benefits of delivering the intervention. In order to determine if there are lasting effects on parenting behavior, family functioning, and child development, outcome data will be collected periodically during the project and will continue until the target children reach adulthood.

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The Miami Legacy for Children™ is a randomized, controlled, longitudinal research project designed to examine the potential for improvement in child developmental outcomes. The intervention program will begin at birth and continue until the child is 5 years of age. One hundred and twenty families will be enrolled in the intervention group, and one hundred and twenty will be enrolled in the control group.

Goals: The primary goal of the intervention is to enhance child development outcomes by influencing parenting behaviors through group meetings and building a sense of community. The specific goals for Miami are to: a) promote responsive and nurturing relationships between the mother and child, b) encourage verbal and cognitive development and appropriate behavioral guidance, c) encourage parents to be responsible and committed, and d) provide mothers with a broader view of and participation in communities.

Target Population: The target population for the Miami project is mothers who have zip codes in areas that correspond to the catchment area of critically low-performing schools. To participate, mothers must live within 50 minutes of the three community intervention sites and have the additional risk factor of less than 12 years education. The project will exclude mothers with very low birth weight babies or children with disabilities; mothers who do not speak English; and mothers who have a diagnosis of mental illness, drug dependency, alcoholism, or more than two other children. Mothers will be recruited in the hospital or within one week after discharge.

The Intervention: There will be three primary components of the intervention: 10 parenting group sessions, 2) visits to the home, and 3) activities to build a sense of community.

Parenting groups will meet weekly for approximately 1.5 hours and will consist of 10 mother/infant dyads. Topics, which will be repeated as children grow, include: basic care, health and safety, parent issues, behavioral guidance, social skills, play and toy making, language and literacy, and individual differences. Separate fathers' groups will meet less frequently.

There will be four home visits per year to follow up on the parenting sessions and to reinforce the curriculum. During these visits the group leader will observe how the family home serves as a nurturing environment.

There will be two field trips per year to community sites. Celebrations and trips will be planned by parents during the group sessions. The Miami project plans to build a sense of community by promoting group cohesion among peers and encouraging parental involvement in the community.

Measurement: Process, cost, and outcome data will be collected by the Project Coordinating Center and the Research Triangle Institute of North Carolina and analyzed by the Centers for Disease Control and Prevention.

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The UCLA Legacy for Children™ is a randomized, controlled, longitudinal research project designed to examine the potential for improvement in child developmental outcomes. The intervention program will begin prenatally and continue until the child is 36 months of age. one hundred and twenty  families will be enrolled in the intervention group and one hundred and twenty will be enrolled in the control group.

Goals: The primary goal of the intervention is to enhance child development outcomes by influencing parenting behaviors through group meetings and by building a sense of community. The specific goals for UCLA are to 1) promote warm, responsive, and nurturing relationships between mother and child, 2) enhance the mother's ability to help her child regulate his or her emotions and behaviors, 3) foster nonintrusive maternal verbal and object stimulation appropriate to the child's developmental level, 4) increase the mother's self-awareness of her effectiveness in promoting her child's development through her own parenting practices, and 5) build a sense of community by promoting group cohesion among mothers of children of similar ages.

Target Population: The target population for the UCLA project includes women who are Medi-Cal eligible, are English speaking, live within 10 miles of UCLA, and are 18 years of age or older. UCLA will exclude mothers who have more than two children (including the target child), are known substance abusers, or have a serious mental disorder such as schizophrenia. Mothers who receive their care from the pre-natal and well-baby UCLA Medi-Cal HMO will be recruited prior to their last trimester of pregnancy (by 28 weeks).

The Intervention: There will be three primary components of the intervention: 1) parenting group sessions, 2) visits to the home, and 3) activities to build a sense of community.

Parenting groups will begin prenatally. UCLA will offer 10-12 weekly 1-hour meetings, approximately half of which will occur before the birth of the baby. Starting when the babies reach 2 months of age, a group leader will lead 3 blocks of 10 weekly, 2-hour meetings, separated by 4-6 week breaks. Topics covered during the group sessions will include family health and safety, communication skills, behavioral regulation skills, emotional development, temperament, attachment and autonomy, how to play with a child, helping children learn, using praise and encouragement, limit setting, and problem solving. These topics will be centered around significant changes in child development or touchpoints. Children will participate in every other group meeting.

A nurse will make two or three visits to the home during the prenatal period and early infancy. Between each block of group sessions, the intervention specialist will conduct two visits to the home to provide an expanded and individualized focus on the topics that were discussed in the previous group sessions.

UCLA will offer opportunities for the mothers and children to join together in holiday and birthday celebrations to provide further opportunities to build a sense of community. One field trip per phase will be planned.

Measurement: Process, cost, and outcome data will be collected by the Project Coordinating Center and the Research Triangle Institute of North Carolina and analyzed by the Centers for Disease Control and Prevention.

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