Behavioral and subjective participant responsiveness to a manualized preventive intervention

The effects of preventive interventions are found to be related to participants' responsiveness to the program, or the degree to which participants attend sessions, engage in the material, and use the program skills. The current study proposes a multi-dimensional method for measuring responsiveness to the Family Bereavement Program (FBP), a parenting-focused program to prevent mental health problems for children who experienced the death of a parent. It examines the relations between individual-level risk-factors and responsiveness to the program, as well as the relations between responsiveness and program outcomes. The sample consists of 90 caregivers and 135 children assigned to the intervention condition of an efficacy trial of the FBP. Caregivers' responsiveness to the 12-week program was measured using a number of indicators, including attendance, completion of weekly "homework" assignments, overall program skill use, perceived helpfulness of the program and program skills, and perceived group environment. Three underlying dimensions of responsiveness were identified: Skill Use, Program Liking, and Perceived Group Environment. Positive parenting and child externalizing problems at baseline were found to predict caregiver Skill Use. Skill Use and Perceived Group Environment predicted changes in caregiver grief and reports of child behavior problems at posttest and 11-month follow-up. Caregivers with better Skill Use had better positive parenting outcomes. Skill use mediated the relation between baseline positive parenting and improvements in positive parenting at 11-month follow-up.