Parent Training of Toddlers in Day Care in Low-Income Urban Communities Deborah Gross and Louis Fogg Rush University College of Nursing Carolyn Webster-Stratton University of Washington School of Nursing Christine Garvey and Wrenetha Julion Rush University College of Nursing Jane Grady Rush-Presbyterian–St. Luke’s Medical Center The authors tested a 12-week parent training program with parents (n = 208) and teachers (n = 77) of 2–3-year-olds in day care centers serving low-income families of color in Chicago. Eleven centers were randomly assigned to 1 of 4 conditions: (a) parent and teacher training (PT + TT), (b) parent training (PT), (c) teacher training (TT), and (d) waiting list control (C). After controlling for parent stress, PT and PT + TT parents reported higher self-efficacy and less coercive discipline and were observed to have more positive behaviors than C and TT parents. Among toddlers in high-risk behavior problem groups, toddlers in the experimental conditions showed greater improvement than controls. Most effects were retained 1 year later. Benefits were greatest when parents directly received training. There is substantial evidence that improving parenting skills through parent training programs can significantly reduce the development and persistence of conduct problems and improve the quality of parent– child relationships (Kazdin, 1997; McMahon, 1999; Serketich & Dumas, 1996; Tucker & Gross, 1997). Specif- ically, when parents limit their use of coercive child management strategies (e.g., yelling, hitting, and verbal aggression) and in- crease their use of positive, supportive responses (e.g., encourage- ment, praise, and physically positive behaviors), child conduct problems and parenting self-efficacy significantly improve. These positive outcomes have mostly been achieved with early school- aged children and adolescents. However, those findings have led to increasing interest in providing training for parents when their children are toddlers and preschoolers, before child conduct prob- lems become firmly entrenched and more difficult to treat (Wak- schlag & Keenan, 2001; Yoshikawa, 1994). Conduct problems affect approximately 7%–35% of preschool- ers, with the higher rates occurring among children from low- income communities (Gross, Sambrook, & Fogg, 1999; Richman, Stevenson, & Graham, 1982; Webster-Stratton & Hammond, 1998). Persistent conduct problems originating during the pre- school years are particularly disconcerting because children with “early onset” problems are among the most resistant to mental health treatment when treatment is delayed until later childhood (Dodge, Bates, & Pettit, 1999; Loeber, 1991). Unfortunately, few preschool children with conduct problems ever receive treatment, and even fewer of those ever receive a treatment that has empirical validation (Brestan & Eyberg, 1998). Over 4,000,000 preschool children in the United States are enrolled in licensed child care facilities (Children’s Defense Fund, 1998). Thus, day care offers the potential of providing one of the most efficient and effective strategies for delivering parent training programs to large numbers of families before child conduct prob- lems develop into more serious problems. Within the context of day care, there are several ways parent training might be delivered. First, parent training may be offered on site directly to parents through weekly groups led by trained group leaders. A second option is to offer the same parent training program to parents and day care teachers. In this way, teachers can understand the behav- ior management strategies the parents are learning, model these behaviors in the classroom, and support the parents’ learning in situ. Such cross-setting consistency and support in child manage- ment strategies could strengthen children’s competencies and re- duce behavior problems. A third option is to train only the day care teachers but not the parents. Teachers would then be instructed to use the behavior management strategies in their classrooms and teach the parents what they were learning. This strategy is impor- tant to study given that many low-income parents are unable to Deborah Gross, Louis Fogg, and Christine Garvey, Department of Community and Mental Health Nursing, Rush University College of Nurs- ing; Carolyn Webster-Stratton, Department of Parent and Child Nursing, University of Washington School of Nursing; Wrenetha Julion, Depart- ment of Maternal–Child Nursing, Rush University College of Nursing; Jane Grady, Department of Human Resources, Rush-Presbyterian–St. Luke’s Medical Center. This study was supported by Grant R01 NRO4085 from the National Institute for Nursing Research and Grant K02 MH00988 from the National Institute for Mental Health. We gratefully acknowledge David Henry and Gina Barclay-McLaughlin for their consultation; Andrea Sambrook, Tamika Lee, Patricia Sistrunk, Irma Ordaz, Sol Maria Polo, Helga Mayr- grundter, Clariza Dominici, Betsy Lawson, Tonya Purnell, Martha Gonza- lez, and Wytress Richardson for assistance with data collection; Ada Gonzalez, Mary Johnson, Alice Gutierrez, Barbara Julion, Lenora Pizzello, Christine Herrmann, Nadine Wengroff, Jane Deuster, Karyn Wesley, Vir- ginia Julion, and Josie Murray for conducting parent and teacher training groups; and Kathy Rogers, Sarah Cook, Susan Reanier, Nat Houtz, Doris Harkness, and Kate Calhoun for assistance with coding videotapes. Correspondence concerning this article should be addressed to Deborah Gross, Rush University College of Nursing, 600 South Paulina Avenue, Suite 1080, Chicago, Illinois 60612. Journal of Consulting and Clinical Psychology Copyright 2003 by the American Psychological Association, Inc. 2003, Vol. 71, No. 2, 261–278 0022-006X/03/$12.00 DOI: 10.1037/0022-006X.71.2.261 261