Family Engagement in an Early Childhood Preventive Parenting Program: Innovative Methods for Examining Sociodemographic, Psychosocial, and Contextual Predictors.

Despite well-studied benefits of preventive parenting programs for early child development, various real-world barriers may impede families from engaging in those programs. The current study aims to provide new insights into family engagement by examining enrollment, retention, and involvement and their predictors in an evidence-based universal pediatric primary care parenting program for families with young children. Data (n = 204) were from an ongoing longitudinal randomized controlled trial of PlayReadVIP in Flint, MI. Families (66% Black, 35% White, low socioeconomic status) had high enrollment and retention in the program. As exploratory analyses, random forest models, a machine learning method, identified a multitude of sociodemographic, psychosocial, and contextual predictors of retention and involvement in PlayReadVIP across the first 9 months. As confirmatory analyses, multiple regressions showed that COVID-19 significantly hindered retention (odds ratio = .04; b =  - .30) and involvement (b =  - .31) and that higher parenting self-efficacy was associated with lower retention (odds ratio = .76). Furthermore, the association between COVID-19 and family engagement was moderated by household income, suggesting that families with the highest economic risks were less likely to attend and be actively involved in sessions during the pandemic. This study addresses important research gaps by focusing on multiple aspects of family engagement in a pediatric program during infancy, assessing whether experiencing contextual adversity hinders or motivates engagement, and employing a machine learning method. These findings have crucial implications for designing and implementing early childhood prevention parenting programs to more effectively engage families with higher needs.