Centering Parenting:
Meeting the needs of parents
J. Cyne Johnston, PhD and Cheryl MacLeod, RN MEd
Outline
• Group Parenting Programs
• Centering Parenting
• Centering Parenting within AHS
– Development
– Implementation
– Evaluation
• Future Plans
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Transitions
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Traditional One-to-One Support
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Group Care
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Key Concepts for Group Care
Client and
Provider
Satisfaction
Facilitative
Peer
Support
Family
Centered
Care
Empowerment
Capacity
Building
6
Group Parenting Interventions
• Short-term improvement
in parental depression,
stress, confidence and
anxiety (Barlow, et al. 2012)
• Early support for
improvement of child
emotional and behavioural
adjustment (Barlow et al. 2012)
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Other Supporting Work
• Peer Support for improving
breastfeeding duration
(Jolly et al. 2012, Renfrew et al. 2012)
• Early evaluation work from
other Centering Parenting
programs shows some signs
of improved maternal BMI
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Centering Parenting
A model of group care for well-woman and well-baby
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Health assessment
Education
Peer and Professional Support
Immunization
9
Each 2 hour session
30- 45 minutes
Check-in and individual
assessments with the provider
45-60 minutes
Formal “circle-up” or facilitated
discussion time
Vaccinations and informal
socialization
30-45 minutes
Closing and follow-up as needed
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Maternal and Infant Self-Assessment
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Provider Assessment
• Each dyad has an
individual
assessment with
the health provider
• Normal triage
done
• Questions are
saved for the
group session
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Group Session
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Key Elements of Centering Parenting
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8 parent/infant dyads and 2 PHN facilitators
All activities occur within the group space
The group is conducted in a circle
Each session has an overall plan with core content;
emphasis may vary depending upon the needs of the
group
• Group members are involved in self-care activities,
weighing, examining, assessing infants and selves.
• Opportunity for socializing within the group is provided
• There is on-going evaluation of outcomes
14
Paradigm Shift
Traditional Care
• Directive
• Expert-led
• Education random
and provider
dependent
• Few opportunities for
socialization with
others
Group Care
• Facilitative
• Shared ownership of health
• More time for education,
shared with all
• Opportunity for
socialization, peer-to-peer
support
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Centering Parenting in
Calgary Public Health Clinics
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Centering Parenting Project within AHS
Stage 1
– Received a $10K grant from the Alberta Centre for
Child, Family, and Community Research
– Development of the universal program and content
– Focus groups with parents, PHNs, parenting
experts
– Adaptation and integration of U.S. Centering
Parenting curriculum
– Development of research proposal
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Adapting to local context
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Curriculum
Vaccination delivery system
Public health nursing led
Visit time points: 1,2,4,6,9,12
months
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What have we learned so far…
Parents:
“I didn’t have a support
network: other
mothers who were
feeling the same
things I was feeling.”
“The most valuable
component is
connecting with other
parents.”
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What have we learned so far…
PHNs were
excited about a
new model of
providing care
and having
additional
opportunities
for professional
growth.
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Parenting Experts
There was considerable support from local parenting and
child development experts
“[The program] has really good adult learning principles
and parenting education practices as well… It’s
fabulous.”
“I really think that it’s only getting them there once.
Once you get them to [the group] they’re hooked. I truly
believe that.”
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Centering Parenting Calgary Zone
Stage 2- Current Work
– Received grant from the Alberta
Centre for Child, Family, and
Community Research
– Funding for: Staff training and a
feasibility study of Centering
Parenting for 32 parent/infants in 2
locations
– Recruiting now!!! Intervention to
begin November 2013
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Research Questions for the Feasibility Study
Is it feasible to implement a Centering Parenting group
intervention In the Alberta context?
How do the pilot results compare to pre-intervention
measures, available local data, and/or established
norms?
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Centering Parenting Calgary Zone
Research Methodology
– 2 communities selected for pilot – 1 urban (East
Community Health Centre) and 1 suburban/rural
(Airdrie)
– Two groups will be run concurrently at each site
– 7-8 mother/infant dyads recruited in each group (2832 in total)
– Families will attend 6 X 2 hour sessions
(@1,2,4,6,9,12 months)
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Centering Parenting Calgary Zone
Data Collection Tools, Measures, Health Indicators
Maternal BMI
Program costs
Child growth
Qualitative interviews
Social support
Postpartum depression
Parenting moral index
Parent and clinician satisfaction
Parenting stress
Breastfeeding initiation/duration
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Centering Parenting Calgary Zone
Stage 3 – Future Work
– Randomized Trial
– Additional external
funding will be sought
if the pilot is
acceptable to PHNs,
parents, AHS.
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Challenges
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Shift in Practice
• Moving from directive
to facilitative
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Logistical Issues
• Physical space for a group
that’s appropriate for groups
of parents and infants
• Scheduling and shift
changes
• Recruitment of parents
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Stakeholder Support
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Provincial and International Interest
Considerable interest from:
• Alberta Health
• Centering Healthcare Institute
• Other Alberta Health Services Zones
• Primary Care Networks
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Key Points
• Early parenthood is a time of great transitions
• Group parenting programs have the potential to provide
an effective intervention to improve the health of
children, parents, and families
• There is demand for a group well-child visit among
parents, PHNs, and parenting experts
• Centering Parenting Pilot is ready for implementation in
2 Calgary-area sites
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Special Thanks to Project Team
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Cheryl MacLeod
Donna Wallace
Shelly Philly
Deborah A. McNeil
Germaeline van der Lee
Kaitlyn Hill
Joanne Coldham
Sandy Phillips
Lynn Headley
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Special Thanks
• Alberta Centre for Child, Family and Community
Research
• Alberta Health Services
• University of Calgary
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Contact Information
Cyne Johnston
Cyne.johnston@albertahealthservices.ca
Cheryl MacLeod
Cheryl.macleod@albertahealthservices.ca
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