Child-Adult Relationship Enhancement in Primary Care (PriCARE) / Criando Niños Con CARIÑO (CARIÑO)

The primary objective of this study is to evaluate the effectiveness of PriCARE/CARIÑO to reduce investigations of suspected Child Maltreatment (CM) by Child Protective Services (CPS), and CM risk as measured by the Brief Child Abuse Potential Inventory (BCAP).

The secondary objectives of this study are to measure the impact of PriCARE/CARIÑO on:

1. Parent-reported child behavior problems as assessed by the Eyberg Child Behavior Inventory (ECBI). 2. The quality of the parent-child relationship as measured by the Dyadic Parent-Child Interaction Coding System (DPICS). 3. Parenting stress as measured by the Parenting Stress Index-Short From (PSI). 4. Harsh parenting as measured by Conflict Tactics Scales, Parent-Child version (CTS) and the Parenting Scale (PS)

The investigators will perform a randomized controlled trial (RCT) of the effectiveness of the PriCARE/CARIÑO on objectives listed above among 2- to 6-year-old children and their parents at 3 Children's Hospital of Philadelphia (CHOP) Primary Care Centers and 10 pediatric clinics in North Carolina. The investigators intend to randomize 966 child-caregiver dyads (1932 subjects) to receive PriCARE/CARIÑO plus usual care (intervention group) and 966 child-parent dyads (1932 subjects) to receive usual care (control group). CM risk, parenting attitudes and skills, child behavior, and quality of the child-caregiver relationship will be measured at baseline and approximately 6-8 months after randomization for both the intervention and control groups. CPS investigations will be collected starting 4 months after randomization until the end of the study (up to 52 months).

• Change in the Eyberg Child Behavior Inventory (ECBI) intensity scale score from time 1 to time 4 [Срок оценки: Baseline, 0 months (time 1) to 6-8 months after baseline (time 4)]
• Change in the Eyberg Child Behavior Inventory (ECBI) problem scale score from time 1 to time 4 [Срок оценки: Baseline, 0 months (time 1) to 6-8 months after baseline (time 4)]
• Change in the number of child led play skills in the Dyadic Parent-Child Interaction Coding System (DPICS) from time 1 to time 4 [Срок оценки: Baseline, 0 months (time 1) to 6-8 months after baseline (time 4)]
• Change in the number of non-child led skill in Dyadic Parent-Child Interaction Coding System (DPICS) score from time 1 to time 4 [Срок оценки: Baseline, 0 months (time 1) to 6-8 months after baseline (time 4)]
• Change in the number of direct commands in Dyadic Parent-Child Interaction Coding System (DPICS) score from time 1 to time 4 [Срок оценки: Baseline, 0 months (time 1) to 6-8 months after baseline (time 4)]
• Change in the number child's compliance with commands in Dyadic Parent-Child Interaction Coding System (DPICS) score from time 1 to time 4 [Срок оценки: Baseline, 0 months (time 1) to 6-8 months after baseline (time 4)]
• Change in the Parenting Stress Index-Short Form (PSI) total score from time 1 to time 4 [Срок оценки: Baseline, 0 months (time 1) to 6-8 months after baseline (time 4)]
• Change in the Parenting Stress Index-Short Form (PSI) Parental Distress subscale score from time 1 to time 4 [Срок оценки: Baseline, 0 months (time 1) to 6-8 months after baseline (time 4)]
• Change in the Parenting Stress Index-Short Form (PSI) Parent-Child Dysfunctional Interaction subscale score from time 1 to time 4 [Срок оценки: Baseline, 0 months (time 1) to 6-8 months after baseline (time 4)]
• Change in the Parenting Stress Index-Short Form (PSI) Difficult Child subscale score from time 1 to time 4 [Срок оценки: Baseline, 0 months (time 1) to 6-8 months after baseline (time 4)]
• Change in the Conflict Tactics Scales Parent-Child (CTS-PC) Nonviolent Discipline score from time 1 to time 4 [Срок оценки: Baseline, 0 months (time 1) to 6-8 months after baseline (time 4)]
• Change in the Conflict Tactics Scales Parent-Child (CTS-PC) Psychological Aggression score from time 1 to time 4 [Срок оценки: Baseline, 0 months (time 1) to 6-8 months after baseline (time 4)]