After deployment, adaptive parenting tools: 1-year outcomes of an evidence-based parenting program for military families following deployment
Open accessAbstract
Despite significant stressors facing military families over the past 15 years of wars in Iraq and Afghanistan, no parenting programs adapted or developed for military families with school-aged children have been rigorously tested. We present outcome data from the first randomized controlled trial of a behavioral parent training program for families with a parent deployed to Iraq or Afghanistan. In the present study, 336 primarily National Guard and Reserve families with 4-12-year-old children were recruited from a Midwestern state. At least one parent in each family had deployed to the recent conflicts: Operations Iraqi or Enduring Freedom, or New Dawn (OIF/OEF/OND). Families were randomized to a group-based parenting program (After Deployment, Adaptive Parenting Tools (ADAPT)) or web and print resources-as-usual. Using a social interaction learning framework, we hypothesized an indirect effects model: that the intervention would improve parenting, which, in turn, would be associated with improvements in child outcomes. Applying intent-to-treat analyses, we examined the program's effect on observed parenting, and children's adjustment at 12-months post baseline. Controlling for demographic (marital status, length, child gender), deployment variables (number of deployments), and baseline values, families randomized to the ADAPT intervention showed significantly improved observed parenting compared to those in the comparison group. Observed parenting, in turn, was associated with significant improvements in child adjustment. These findings present the first evidence for the effectiveness of a parenting program for deployed military families with school-aged children.
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In Gewirtz 2018, the attrition rate was approximately 15%.
“There was a reasonably high attrition rate, approximately 15%.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Gewirtz 2018
The Method section (page unavailable) reports that 81% of mothers and 76.8% of fathers completed the T3 assessment. Those figures imply attrition of 19% and 23.2%, respectively, rather than approximately 15%. (LLM, conf=0.85)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredIn Gewirtz 2018, the methods used for the intention-to-treat analysis were not reported.
“An intent-totreat analysis was undertaken, but the methods used to do this were not reported in the study.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Gewirtz 2018
The Method > Measures section explicitly reports how the intent-to-treat analysis was conducted: assignment to ADAPT was coded 1 and control assignment 0, and the hypotheses were tested using structural equation path modeling in Mplus 7.4. It also describes full-information maximum likelihood for handling missing data. Thus, the paper does report analysis methods, contrary to the claim. (LLM, conf=0.94)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredOne study assessed parenting skills using both a self-report measure and a separate observational measure.
“One study assessed parenting skills using a self-report measure and a separate observational measure (Gewirtz 2018).”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Gewirtz 2018
The Method > Measures section says parenting practices were scored from direct observations of parent–child interactions. It describes self-report measures of child adjustment, but not a separate self-report measure of parenting skills; the Discussion’s comparison with parent-report measures does not establish that one was used in this study. Page numbers are unavailable in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThree studies included multiple respondents for child emotional and behavioural adjustment, parenting skills, and parent mindfulness outcomes.
“Three studies included multiple respondents for child emotional and behavioural adjustment, parenting skills, and parent mindfulness outcomes, including mother, father and/or child reports (Coatsworth 2010; Coatsworth 2015; Gewirtz 2018).”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Gewirtz 2018
The Method > Measures section describes child adjustment using child, parent and teacher reports, including available mother and father reports. It measures parenting skills through coded observations of parent–child interactions, not mother, father or child reports, and does not describe parent mindfulness as a measured outcome. The citation therefore supports the multiple-respondent claim for child adjustment, but not all the outcomes listed. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn Gewirtz 2018, an intention-to-treat analysis was undertaken.
“An intent-totreat analysis was undertaken, but the methods used to do this were not reported in the study.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Gewirtz 2018
The Effectiveness Hypotheses section identifies intent-to-treat analyses, and Results > Hypothesis 1 reports an ADAPT ITT contrast. The sentence’s further assertion that the methods were not reported is not supported: Method > Measures describes the missing-data approach (FIML), and the Results describe the ITT contrast in the effectiveness model. Page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measured
For Gewirtz 2018, the risk of selection bias from random sequence generation was judged unclear because information on how randomisation was carried out was insufficient.
“Unclear risk There was insufficient information provided about how randomisation was carried out.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Gewirtz 2018
The Method > Measures section (page unavailable) describes assignment to the ADAPT and control conditions, but the passages found do not explain how the random sequence was generated. The paper also does not itself judge selection-bias risk as unclear; that is the citing authors’ assessment. (LLM, conf=0.76)
Experimental — accuracy not yet measuredFor Gewirtz 2018, the risk of attrition bias was judged unclear.
“Unclear risk There was a reasonably high attrition rate, approximately 15%.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Gewirtz 2018
The Method section reports one-year follow-up for 81% of mothers and 76.8% of fathers, establishing attrition but implying rates of 19% and 23.2%, rather than approximately 15%. The paper discusses missing-data handling but does not itself judge the risk of attrition bias as unclear; that is the citing authors’ assessment. (LLM, conf=0.83)
Experimental — accuracy not yet measuredFor Gewirtz 2018, the risk of other bias was judged unclear because an attentional control group received a minimum intervention labelled standard care, potentially introducing performance bias.
“Unclear risk There was an attentional control group who received a minimum intervention, also labelled 'standard care'.There is a potential that this may have introduced performance bias.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Gewirtz 2018
The Effectiveness Hypotheses and Results (Hypothesis 1: Proximal Impact; pages unavailable) confirm that ADAPT was compared with a control group. The cited paper passages do not establish that this was an attentional control receiving a minimum intervention labelled “standard care,” or assess whether that arrangement introduced performance bias. The unclear-risk judgment is the citing authors’ assessment, not a finding reported by the source. (LLM, conf=0.78)
Experimental — accuracy not yet measuredFor Gewirtz 2018, the risk of detection bias was judged high because measures to blind outcome assessment were not reported and most measures were self-report.
“High risk Any measures used to blind outcome assessment from knowledge of which intervention a participant received were not reported in the study.Aside from an observational parenting measure, all measures were self-report.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Gewirtz 2018
The Method > Measures section (page unavailable) describes observational parenting ratings by trained coders and child, parent, and teacher reports of child adjustment. It does not describe blinding of outcome assessment, but it does not itself assign a high detection-bias rating. The claim that every non-observational measure was self-report is imprecise: parent and teacher ratings of children are informant reports, not child self-reports. (LLM, conf=0.83)
Experimental — accuracy not yet measuredFor Gewirtz 2018, the risk of performance bias was judged high because information on blinding was insufficient and blinding is generally unfeasible in this type of study.
“High risk There was no insufficient information provided about measures undertaken to blind participants and/or researchers.However, given that blinding is generally unfeasible for this type of study, the risk of bias has been assessed as high.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Gewirtz 2018
For Gewirtz 2018, the risk of reporting bias was judged high because the study reported that an immediate post-test data point involved only adult self-report data and was not included in the report, with no further information.
“High risk The study reports that:”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Gewirtz 2018
For Gewirtz 2018, the risk of selection bias from allocation concealment was judged unclear because information on concealment measures was insufficient.
“Unclear risk There was insufficient information provided about measures undertaken to conceal allocation.”
From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Gewirtz 2018
The Method section describes the study participants, and Method > Measures identifies intervention and control assignments, but neither passage assesses allocation concealment or states that information about it was insufficient. Searches for allocation concealment, randomization procedures, and concealment measures did not find a passage supporting the quoted risk-of-bias judgment. (LLM, conf=0.72)
Experimental — accuracy not yet measured
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Self-citation
- Authors
- Gewirtz, A. H., DeGarmo, D. S., & Zamir, O.
- Affiliations
- University of Minnesota (US)
- University of Oregon (US)
- Hebrew University of Jerusalem (IL)
- Corresponding author
- Gewirtz, Abigail H.
- Venue
- Prevention Science
- Published
- 2017-09-15
- Volume
- 19
- Issue
- 4
- Pages
- 589-599
- ISSN
- 1389-4986 (ISSN-L)
- 1573-6695
- PMC
- PMC5854502
- OpenAlex
- W2754746759
- Cited by
- 97
- References
- 47
- Citations by year
- 2026: 11 · 2025: 9 · 2024: 14 · 2023: 10 · 2022: 10 · 2021: 11 · 2020: 12 · 2019: 7 · 2018: 9 · 2017: 2 · 2016: 1
- FWCI
- 10.15
- Type
- journal article
- Language
- en
- Update notices
- correction (2017-11-02)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Prevention Science (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (R01 DA 030114; 2010-2015)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Social Sciences › Education › Education and Military Integration
- Keywords
- military families, parental deployment, parent training, behavioral parent training, child adjustment, school-aged children, indirect effects, Iraq and Afghanistan wars, online intervention
- MeSH terms
- Adaptation, Psychological, Adult, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Military Personnel, Program Evaluation, Parenting, Outcome Assessment, Health Care, Evidence-Based Practice, Young Adult, Military Family
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