Prevention Science, Vol. 6, No. 4, December 2005 (
Parent Recruitment and Retention in a Universal Prevention
Program for Child Behavior and Emotional Problems:
Barriers to Research and Program Participation
and Kurt Hahlweg
Published online: 2 August 2005
Despite the potential of parent training as a prevention and behavioral family intervention
strategy, there are a number of important issues related to implementation (e.g., recruit-
ment and retention of families). This paper presents recruitment and retention data from
families enrolling in a randomized controlled universal prevention trial for child behavior
problems conducted in Germany. The recruitment rate averaged 31% (general project par-
ticipation), with families of lower socioeconomic status (SES) participating at a lower rate.
Project-declining families most often reported intrusion of privacy as their primary concern.
In contrast, once parents were enrolled in the project, participation among those random-
ized to the parent training group averaged 77% (program/intervention participation); non-
participation was mostly due to logistical issues. Parents accepting the offer of parent training
were more likely to report child behavior problems than did declining parents. Although par-
ents from more disadvantaged areas had a lower overall level of participation in the project
once recruited, parents with children having higher levels of behavior problems indeed were
more likely to participate in the intervention. Different recruitment methods may be required
to engage high-risk families from socioeconomically disadvantaged areas to further improve
community-level impact on child mental health.
KEY WORDS: implementation; recruitment; triple p; child behavior problems.
Increasing rates of serious youth violence in
recent years has led to a surge of research exploring
risk and protective factors in children that may
increase or decrease the likelihood of such a devel-
opmental pathway (Ingoldsby & Shaw, 2002; Loeber
et al., 2001; Rutter et al., 1998;Rutter,1999). Family
risk factors, such as poor parenting, family conﬂict
and marriage breakdown also strongly inﬂuence
children’s development (Forehand et al., 1997;Olson
et al., 2002).
Moreover, it has been repeatedly shown that
children at high-risk for emotional and behav-
Department of Clinical Psychology, Psychotherapy and Assess-
ment, Technical University of Braunschweig.
Correspondence should be directed to Nina Heinrichs, Depart-
ment of Clinical Psychology, Psychotherapy and Assessment,
Technical University of Braunschweig, Spielmannstr. 12a, 38106
Braunschweig, Germany; e-mail: firstname.lastname@example.org.
ioral problems, as well as academic difﬁculties
and social competence deﬁcits, often come from
economically disadvantaged homes (e.g., Bradley
& Corwyn, 2002; Hart & Risley, 1995; Leventhal &
Brooks-Gunn, 2000). Socioeconomic disadvantage
in the family (McLoyd, 1998) and neighborhood
(Boyle & Lipman, 2002) context, such as poverty,
unemployment, low education and single parent-
hood, impacts child development, and similar risk
factors (e.g., low income, social isolation, living in
remote areas or in inner city areas, marital problems,
parental depression, single parenthood and child
behavioral problems) also characterize families with
low access to mental health care (Snell-Johns et al.,
2004). Thus, these factors put families not only at
risk for child behavior problems, but also increase
barriers to accessing effective help. Additionally,
motivating families to participate in prevention
efforts has also been difﬁcult, particularly for
family-based interventions (e.g., Prinz et al., 2001).
2005 Society for Prevention Research