Evaluation of the Invest in Play Program - a New Parent Intervention for Children With Problem Behavior

Child problem behavior will be measured using the Eyberg Child Behavior Inventory (ECBI), where the change score from baseline to 12 weeks post intervention is the primary outcome. The measure consists of 36 items, which is scored on parents' notion about the intensity (1 = never to 7 = always), and whether child behavior is a problem (0 = no and 1 = yes, range 0-36). A total score is calculated, ranging from range 36-252. High intensity scores indicate more intense problems, and a high problem score indicate a higher frequency of problem behaviors. The ECBI has demonstrated strong internal consistency, test-retest reliability, and discriminant validity and has been shown to be a sensitive indicator of intervention efficacy for child behavior problems.

Social Competence Scale-Parent (SCS-P) is a 12-item measure for assessing two domains of children's social competence, namely prosocial skills ("Your child can give suggestions and opinions without being bossy") and emotion regulation (e.g., "Your child can calm down when excited or all wound up."). The items are rated on a scale from 0 = "Not at all" to 4 = "Very well". For this study, the emotion regulation skills subscale (6 items) will be used, and the subscale is scored as a mean of responses, where higher scores indicate better emotion regulation.

Kidscreen-10 index parent version measures children's health related global quality of life (HRQoL). The 10-item version is the short version of the KIDSCREEN-52 and KIDSCREEN-27 instrument and is rated on a scale from 1 = "Not at all" to 5 = "to a large extent". A total score is calculated, where higher scores indicates better HRQoL.

The Strength and Difficulties Questionnaire (SDQ) is a brief behavioral screening questionnaire consisting of 25 items, divided by on 5 subscales (prosocial, hyperactivity, emotional symptoms, conduct problems and peer problems), scored from 0 = not true, 1 = somewhat true and 2 = certainly true. The parent version will be used in this study. A total score from each subscale is calculated. In addition, the last four subscales are added together to generate a total difficulties score (based on 20 items), where a higher score indicate more difficulties.

Parenting and Family Adjustment Scales (PAFAS) is a 40-item measure assessing parent and family functioning through five domains (parenting practices, quality of parent-child relationship, parental emotional adjustment, positive family relationships, and parental teamwork), which are all considered to be important for child outcomes. The items are rated on a 4-point scale from 0 = not true for me at all to 3 = true of me very much. The scores are summed (some scores are reversed), where higher scores indicate a more dysfunctional family life.

The Parent Stress Scale (PSS) is an 18-item questionnaire assessing parents' feelings about their parenting role, exploring both positive aspects (e.g. emotional benefits, personal development) and negative aspects of parenthood (e.g. demands on resources, feelings of stress). The scale is rated on a 5-point scale from 1 = Strongly disagree to 5 = Strongly agree. Some of the scores are reversed, and a total score is calculated. A high score indicate high stress levels. We will use the subscale with six items addressing parent stress and the more negative aspects of parenthood in this study.

The Parent Cognition Scale (PCS) is a 16-item self-report measure of parental attributions of child behavior. The scale consists of two subscales, which assesses child-responsible attributions (e.g., "I'm not structured enough with my child") and parent-causal attribution (e.g., "I'm not structured enough with my child"). The items are rated on a scale from 0 = always true to 5 = never true, all being reverse scored. This means that higher scores indicate more negative attributions.

Me as parent - Short form (MaaPs-SF) is a four-item measure to assess parent self-efficacy. The scale is derived from the original 16-item version (Hamilton et al., 2014), developed to assess parenting self-regulation. The MaaPs-SF is rated on a 5-point scale from 1 = Strongly disagree to 5 = Strongly agree. The four items are added to provide a total score, where a higher score indicates better parenting self-efficacy.

The Parental Emotion Regulation Inventory (PERI-2) is a 23-item self-report measure to assess parents own self-regulation. The items consist of different emotion regulation strategies which are rated on a 7-point scale ranging from 1 (I never do this) to 7 (I very often do this), comprising four different subscales (Reappraisal, Suppression, Escape and Capitulation). A score for each subscale is calculated, where a high score indicate that the strategies within that factor are more used.

Investigators want to assess whether the scores changes in the Invest in Play intervention group three months post intervention.

The Eyberg Child Behavioral Inventory (ECBI) is a well-validated measure for evaluating child problem behavior. The measure consists of 36 items, which is scored on parents' notion about the intensity (1 = never to 7 = always), and whether child behavior is a problem (0 = no and 1 = yes, range 0-36). A total score is calculated, ranging from range 36-252. High intensity scores indicate more intense problems, and a high problem score indicate a higher frequency of problem behaviors.

Investigators want to assess whether the scores changes in the Invest in Play intervention group three months post intervention.

The Social Competence Scale-Parent (SCS-P) is a 12-item measure for assessing two domains of children's social competence, namely prosocial skills ("Your child can give suggestions and opinions without being bossy") and emotion regulation (e.g., "Your child can calm down when excited or all wound up."). The items are rated on a scale from 0 = "Not at all" to 4 = "Very well". For this study, the emotion regulation skills subscale (6 items) will be used, and the subscale is scored as a mean of responses, where higher scores indicate better emotion regulation.

Investigators want to assess whether the scores changes in the Invest in Play intervention group three months post intervention.

Kidscreen-10 index parent version measures children's health related global quality of life (HRQoL). The 10-item version is the short version of the KIDSCREEN-52 and KIDSCREEN-27 instrument and is rated on a scale from 1 = "Not at all" to 5 = "to a large extent". A total score is calculated, where higher scores indicates better HRQoL.

Investigators want to assess whether the scores changes in the Invest in Play intervention group three months post intervention.

The Strength and Difficulties Questionnaire (SDQ) is a brief behavioral screening questionnaire consisting of 25 items, divided by on 5 subscales (prosocial, hyperactivity, emotional symptoms, conduct problems and peer problems), scored from 0 = not true, 1 = somewhat true and 2 = certainly true. The parent version will be used in this study. A total score from each subscale is calculated. In addition, the last four subscales are added together to generate a total difficulties score (based on 20 items), where a higher score indicate more difficulties.

Investigators want to assess whether the scores changes in the Invest in Play intervention group three months post intervention.

Parenting and Family Adjustment Scales (PAFAS) is a 40-item measure assessing parent and family functioning through five domains (parenting practices, quality of parent-child relationship, parental emotional adjustment, positive family relationships, and parental teamwork), which are all considered to be important for child outcomes. The items are rated on a 4-point scale from 0 = not true for me at all to 3 = true of me very much. The scores are summed (some scores are reversed), where higher scores indicate a more dysfunctional family life

Investigators want to assess whether the scores changes in the Invest in Play intervention group three months post intervention.

The Parent Stress Scale (PSS) is an 18-item questionnaire assessing parents' feelings about their parenting role, exploring both positive aspects (e.g. emotional benefits, personal development) and negative aspects of parenthood (e.g. demands on resources, feelings of stress). The scale is rated on a 5-point scale from 1 = Strongly disagree to 5 = Strongly agree. Some of the scores are reversed, and a total score is calculated. A high score indicate high stress levels. We will use the subscale with six items addressing parent stress and the more negative aspects of parenthood in this study.

Investigators want to assess whether the scores changes in the Invest in Play intervention group three months post intervention.

The Parent Cognition Scale (PCS) is a 16-item self-report measure of parental attributions of child behavior. The scale consists of two subscales, which assesses child-responsible attributions (e.g., "I'm not structured enough with my child") and parent-causal attribution (e.g., "I'm not structured enough with my child"). The items are rated on a scale from 0 = always true to 5 = never true, all being reverse scored. This means that higher scores indicate more negative attributions.

Investigators want to assess whether the scores changes in the Invest in Play intervention group three months post intervention.

Me as parent - Short form (MaaPs-SF; Matthews, et al., 2022) is a four-item measure to assess parent self-efficacy. The scale is derived from the original 16-item version (Hamilton et al., 2014), developed to assess parenting self-regulation. The MaaPs-SF is rated on a 5-point scale from 1 = Strongly disagree to 5 = Strongly agree. The four items are added to provide a total score, where a higher score indicates better parenting self-efficacy.

Investigators want to assess whether the scores changes in the Invest in Play intervention group three months post intervention.

The Parental Emotion Regulation Inventory (PERI-2) is a 23-item self-report measure to assess parents own self-regulation. The items consist of different emotion regulation strategies which are rated on a 7-point scale ranging from 1 (I never do this) to 7 (I very often do this), comprising four subscales (Reappraisal, Suppression, Escape and Capitulation). A score for each subscale is calculated, where a high score indicate that the strategies within that factor are more used.