{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T04:27:30Z","timestamp":1765600050948,"version":"3.48.0"},"reference-count":65,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01 HD108160"],"award-info":[{"award-number":["R01 HD108160"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,3,28]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Social, emotional and behavioural (SEB) problems are among the most common chronic disabilities affecting children growing up in poverty. They also have implications for children\u2019s school success as they affect essential social-emotional learning skills such as the ability to comply with rules, regulate emotions and get along with others. These skills are first learnt before kindergarten, in the context of a supportive, responsive and consistent parenting relationship. To date, school-based interventions to improve young children\u2019s SEB competence and learning have primarily targeted students and teachers. Yet, parents are central partners in promoting these skills. This study seeks to improve children\u2019s SEB competence and kindergarten readiness by strengthening parenting skills and parent engagement in early childhood education during prekindergarten (PreK). This hybrid type 2 effectiveness-implementation trial will rigorously evaluate the effects of an evidence-based parenting programme, the Chicago Parent Program (CPP), in PreK on children\u2019s SEB competence, kindergarten readiness, chronic school absenteeism and grade retention in urban and rural schools serving students from low-income families in Maryland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a cluster randomised design (n=30 schools, 840 parents; &gt;90% low-income), we will examine the effects of CPP offered universally to PreK parents on parenting skills and parent engagement in children\u2019s education; children\u2019s SEB competence and kindergarten readiness; and chronic absence and grade retention in kindergarten. Schools will be stratified by rural versus urban district, then randomised to CPP or usual practice conditions. Data will be analysed using mixed effects regression models. Using the reach, effectiveness-adoption, implementation, maintenance (RE-AIM) framework and a mixed methods approach, we will assess CPP reach, efficacy, acceptability, adoption, implementation, cost-effectiveness and sustainability when offered in different formats (virtual vs in-person CPP groups) and contexts (urban vs rural). Schools will participate for 2 years with experimental schools offering CPP twice, once in virtual group format and once in an in-person group format (format randomised and counterbalanced). Data will be collected using multiple informants (parents, teachers, district administrative data) and methods (quantitative and qualitative data). Knowledge gained will inform schools in under-resourced urban and rural communities on sustainable, cost-effective strategies for strengthening parent-school connections and improving young children\u2019s SEB competence and academic success.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethics approval has been granted by Johns Hopkins University School of Medicine (protocol number 00428221) and the Baltimore City Public Schools (protocol number 2024-013). At the conclusion of the study, results will be summarised and shared with parents, teachers, school principals and district leaders for their perspectives on the outcomes. Final reports will be published in scientific journals and presented at professional meetings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06197997\">NCT06197997<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-099204","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T16:56:23Z","timestamp":1744908983000},"page":"e099204","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Resilient, engaged and connected (REC) study: protocol for a type 2 cluster-randomised trial of the Chicago Parent Program in prekindergarten in low-income urban and rural communities"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct06197997","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5707-6132","authenticated-orcid":false,"given":"Deborah","family":"Gross","sequence":"first","affiliation":[{"name":"Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3081-5038","authenticated-orcid":false,"given":"Susan M","family":"Breitenstein","sequence":"additional","affiliation":[{"name":"College of Nursing, The Ohio State University, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2028-8358","authenticated-orcid":false,"given":"Lieny","family":"Jeon","sequence":"additional","affiliation":[{"name":"University of Virginia, Charlottesville, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Perrin","sequence":"additional","affiliation":[{"name":"School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Shen","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amie F","family":"Bettencourt","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"2025121220223691000_15.4.e099204.1","doi-asserted-by":"publisher","DOI":"10.1353\/foc.2012.0004"},{"key":"2025121220223691000_15.4.e099204.2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6609a1"},{"key":"2025121220223691000_15.4.e099204.3","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.ecresq.2015.04.005","article-title":"Early school readiness predictors of grade retention from kindergarten through eighth grade: A multilevel discrete-time survival analysis approach","volume":"32","author":"Davoudzadeh","year":"2015","journal-title":"Early Child Res Q"},{"key":"2025121220223691000_15.4.e099204.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsp.2012.09.005"},{"key":"2025121220223691000_15.4.e099204.5","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.ecresq.2018.02.012","article-title":"Pre-kindergarten attendance matters: Early chronic absence patterns and relationships to learning outcomes","volume":"44","author":"Ehrlich","year":"2018","journal-title":"Early Child Res Q"},{"key":"2025121220223691000_15.4.e099204.6","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2004.061424"},{"key":"2025121220223691000_15.4.e099204.7","first-page":"10","article-title":"Vital Signs for Pediatric Health: School Readiness","volume":"2023","author":"Kaminski","year":"2023","journal-title":"NAM Perspect"},{"key":"2025121220223691000_15.4.e099204.8","first-page":"10","article-title":"Vital Signs for Pediatric Health: Chronic Absenteeism","volume":"2023","author":"Johnson","year":"2023","journal-title":"NAM Perspect"},{"key":"2025121220223691000_15.4.e099204.9","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1111\/sode.12112","article-title":"Dimensions of Parenting Associated with Child Prekindergarten Emotion Regulation and Attention Control in Low-income Families","volume":"24","author":"Mathis","year":"2015","journal-title":"Soc Dev"},{"key":"2025121220223691000_15.4.e099204.10","unstructured":"National Academies of Sciences, Engineering, and Medicine . Parenting matters: supporting parents of children ages 0-8. Washington, DC: The National Academies Press, 2016."},{"key":"2025121220223691000_15.4.e099204.11","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2018.5727","article-title":"Social and Emotional Learning Associated With Universal Curriculum-Based Interventions in Early Childhood Education and Care Centers: A Systematic Review and Meta-analysis","volume":"1","author":"Blewitt","year":"2018","journal-title":"JAMA Netw Open"},{"key":"2025121220223691000_15.4.e099204.12","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1353\/foc.2017.0000","article-title":"Social and Emotional Learning: Introducing the Issue","volume":"27","author":"Jones","year":"2017","journal-title":"Future Child"},{"key":"2025121220223691000_15.4.e099204.13","doi-asserted-by":"crossref","unstructured":"Sanders MR , Turner KMT . The importance of parenting in influencing the lives of children. In: Sanders MR , Morawska A , eds. Handbook of parenting and child development across the lifespan. Cham: Springer International Publishing, 2018: 3\u201326.","DOI":"10.1007\/978-3-319-94598-9_1"},{"key":"2025121220223691000_15.4.e099204.14","unstructured":"Perera RM , Hashim AK , Weddle HR . Family engagement is critical for schools COVID-19 recovery efforts. Brookings Institution, 2022."},{"key":"2025121220223691000_15.4.e099204.15","doi-asserted-by":"crossref","unstructured":"Breitenstein S , Gross D , Bettencourt AF . The chicago parent program. In: Gershoff E , Lee S , eds. Effective approaches to reducing physical punishment and teaching discipline. American Psychological Association, 2019: 109\u201319.","DOI":"10.1037\/0000162-012"},{"key":"2025121220223691000_15.4.e099204.16","unstructured":"Gross D , Garvey C , Julion WA , et al . Preventive parent training with low-income, ethnic minority families of preschoolers. In: Briesmeister J , Schaefer C , eds. Handbook of parent training: helping parents prevent and solve problem behaviors. 3rd edn. Hoboken, NJ, US: John Wiley & Sons, Inc, 2007: 5\u201324."},{"key":"2025121220223691000_15.4.e099204.17","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1002\/nur.21489","article-title":"The Chicago Parent Program: comparing 1-year outcomes for African American and Latino parents of young children","volume":"35","author":"Breitenstein","year":"2012","journal-title":"Res Nurs Health"},{"key":"2025121220223691000_15.4.e099204.18","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.jaac.2018.08.013","article-title":"Reducing Preschool Behavior Problems in an Urban Mental Health Clinic: A Pragmatic, Non-Inferiority Trial","volume":"58","author":"Gross","year":"2019","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"2025121220223691000_15.4.e099204.19","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s11121-008-0116-7","article-title":"Efficacy of the Chicago parent program with low-income African American and Latino parents of young children","volume":"10","author":"Gross","year":"2009","journal-title":"Prev Sci"},{"key":"2025121220223691000_15.4.e099204.20","unstructured":"Bandura A . Self-efficacy: The exercise of control. New York, NY, US: W H Freeman\/Times Books\/ Henry Holt & Co, 1997:604."},{"key":"2025121220223691000_15.4.e099204.21","unstructured":"Biglan A . The nurture effect: how the science of human behavior can improve our lives and our world. Oakland, CA, US: New Harbinger Publications, 2015:253."},{"key":"2025121220223691000_15.4.e099204.22","unstructured":"Gross D , Garvey D , Julion W , et al . Preventive parent training with low-income ethnic minority parents of preschoolers. In: Briesmeister JM , Schaefer CE , eds. Handbook of parent training: helping parents prevent and solve problem behaviors. John Wiley & Sons, 2007: 5\u201324."},{"key":"2025121220223691000_15.4.e099204.23","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1080\/10409289.2023.2247954","article-title":"Embedding a Parenting Skills Program in Public PreK: Outcomes of a Quasi-experimental Mixed Methods Study","volume":"35","author":"Bettencourt","year":"2024","journal-title":"Early Educ Dev"},{"key":"2025121220223691000_15.4.e099204.24","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1007\/s10826-019-01680-6","article-title":"What is Parent Engagement in Early Learning? Depends Who You Ask","volume":"29","author":"Gross","year":"2020","journal-title":"J Child Fam Stud"},{"key":"2025121220223691000_15.4.e099204.25","unstructured":"Christenson SL , Sheridan SM . Schools and families: creating essential connections for learning. New York: Guilford Press, 2001."},{"key":"2025121220223691000_15.4.e099204.26","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jsp.2016.12.002","article-title":"A randomized trial examining the effects of Conjoint Behavioral Consultation in rural schools: Student outcomes and the mediating role of the teacher\u2013parent relationship","volume":"61","author":"Sheridan","year":"2017","journal-title":"J Sch Psychol"},{"key":"2025121220223691000_15.4.e099204.27","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1177\/1059840518786995","article-title":"Evaluating Implementation Fidelity of a School-Based Parenting Program for Low-Income Families","volume":"35","author":"Bettencourt","year":"2019","journal-title":"J Sch Nurs"},{"key":"2025121220223691000_15.4.e099204.28","unstructured":"Bierman K , Morris PA , Abenavoli RM . Parent engagement practices improve outcomes for preschool children. University Park, PA: Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, 2017."},{"key":"2025121220223691000_15.4.e099204.29","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.3102\/0002831218772274","article-title":"Reducing Student Absenteeism in the Early Grades by Targeting Parental Beliefs","volume":"55","author":"Robinson","year":"2018","journal-title":"Am Educ Res J"},{"key":"2025121220223691000_15.4.e099204.30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1037\/ort0000695","article-title":"A mixed-methods study of parents\u2019 social connectedness in a group-based parenting program in low-income communities","volume":"94","author":"Plesko","year":"2024","journal-title":"Am J Orthopsychiatry"},{"key":"2025121220223691000_15.4.e099204.31","unstructured":"Camero E . Broadband connection in rural communities. ChangeLab Solutions; 2023."},{"key":"2025121220223691000_15.4.e099204.32","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.89.9.1322"},{"key":"2025121220223691000_15.4.e099204.33","doi-asserted-by":"crossref","DOI":"10.5888\/pcd15.170271","article-title":"Pragmatic Applications of RE-AIM for Health Care Initiatives in Community and Clinical Settings","volume":"15","author":"Glasgow","year":"2018","journal-title":"Prev Chronic Dis"},{"key":"2025121220223691000_15.4.e099204.34","doi-asserted-by":"publisher","DOI":"10.2307\/2673185"},{"key":"2025121220223691000_15.4.e099204.35","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1111\/cdev.12741","article-title":"Promoting Strengths and Resilience in Single-Mother Families","volume":"88","author":"Taylor","year":"2017","journal-title":"Child Dev"},{"key":"2025121220223691000_15.4.e099204.36","doi-asserted-by":"publisher","DOI":"10.1007\/s11121-010-0187-0"},{"key":"2025121220223691000_15.4.e099204.37","doi-asserted-by":"publisher","DOI":"10.1002\/nur.20127"},{"key":"2025121220223691000_15.4.e099204.38","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s10935-011-0255-7","article-title":"Cost-effectiveness of childcare discounts on parent participation in preventive parent training in low-income communities","volume":"32","author":"Gross","year":"2011","journal-title":"J Prim Prev"},{"key":"2025121220223691000_15.4.e099204.39","doi-asserted-by":"publisher","DOI":"10.1037\/dev0000185"},{"key":"2025121220223691000_15.4.e099204.40","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1007\/s11121-019-0977-y","article-title":"Financial Incentives for Promoting Participation in a School-Based Parenting Program in Low-Income Communities","volume":"20","author":"Gross","year":"2019","journal-title":"Prev Sci"},{"key":"2025121220223691000_15.4.e099204.41","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-8624.2007.00986.x"},{"key":"2025121220223691000_15.4.e099204.42","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-8624.2007.00987.x"},{"key":"2025121220223691000_15.4.e099204.43","first-page":"732","article-title":"Promoting Parents\u2019 Social Capital to Increase Children\u2019s Attendance in Head Start: Evidence From an Experimental Intervention","volume":"10","author":"Sommer","year":"2017","journal-title":"J Res Educ Eff"},{"key":"2025121220223691000_15.4.e099204.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2019.112513"},{"key":"2025121220223691000_15.4.e099204.45","unstructured":"CDC . Social vulnerability index - place and health - geospatial research, analysis, and services program (GRASP). 2024."},{"key":"2025121220223691000_15.4.e099204.46","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.appdev.2018.02.002","article-title":"Early childhood teachers\u2019 stress and children\u2019s social, emotional, and behavioral functioning","volume":"61","author":"Jeon","year":"2019","journal-title":"J Appl Dev Psychol"},{"key":"2025121220223691000_15.4.e099204.47","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(01)00097-3"},{"key":"2025121220223691000_15.4.e099204.48","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.8.4.369"},{"key":"2025121220223691000_15.4.e099204.49","unstructured":"Eyberg S , Pincus D . Eyberg child behavior inventory: professional manual: psychological assessment resources. 1991."},{"key":"2025121220223691000_15.4.e099204.50","doi-asserted-by":"crossref","first-page":"106613","DOI":"10.1016\/j.childyouth.2022.106613","article-title":"Developing an equitable measure of parent engagement in early childhood education for urban schools","volume":"141","author":"Gross","year":"2022","journal-title":"Child Youth Serv Rev"},{"key":"2025121220223691000_15.4.e099204.51","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-4405(00)00050-9"},{"key":"2025121220223691000_15.4.e099204.52","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1037\/dev0000369","article-title":"How do parent expectations promote child academic achievement in early elementary school? A test of three mediators","volume":"53","author":"Loughlin-Presnal","year":"2017","journal-title":"Dev Psychol"},{"key":"2025121220223691000_15.4.e099204.53","unstructured":"WestEd . Ready for kindergarten: kindergarten readiness assessment technical report: fall 2014. 2014."},{"key":"2025121220223691000_15.4.e099204.54","unstructured":"Maryland State Department of Education . 2018 kindergarten readiness assessment results. Maryland State Department of Education; 2019."},{"key":"2025121220223691000_15.4.e099204.55","unstructured":"Jeon L , Dewey N , Zhao X , et al . Kindergarten success fact book 2022. Baltimore city kindergarten classes of 2016-17 and 2021-22. Baltimore MD: Baltimore Education Research Consortium, 2023."},{"key":"2025121220223691000_15.4.e099204.56","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2017.01.007"},{"key":"2025121220223691000_15.4.e099204.57","doi-asserted-by":"publisher","DOI":"10.1126\/science.277.5328.918"},{"key":"2025121220223691000_15.4.e099204.58","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2019.00064"},{"key":"2025121220223691000_15.4.e099204.59","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1002\/jcop.20193","article-title":"Scale development of a measure to assess community-based and clinical intervention group environments","volume":"36","author":"Wilson","year":"2008","journal-title":"J Community Psychol"},{"key":"2025121220223691000_15.4.e099204.60","doi-asserted-by":"publisher","DOI":"10.1097\/NNR.0b013e3181dbb2e2"},{"key":"2025121220223691000_15.4.e099204.61","doi-asserted-by":"publisher","DOI":"10.1080\/03637750903310360"},{"key":"2025121220223691000_15.4.e099204.62","doi-asserted-by":"publisher","DOI":"10.1207\/s15327906mbr3901_4"},{"key":"2025121220223691000_15.4.e099204.63","unstructured":"ICMJE . International committee of medical journal editors: defining the role of authors and contributors. 2025."},{"key":"2025121220223691000_15.4.e099204.64","doi-asserted-by":"crossref","first-page":"746289","DOI":"10.3389\/fpsyg.2021.746289","article-title":"Effects of COVID-19-Related School Closures on Student Achievement-A Systematic Review","volume":"12","author":"Hammerstein","year":"2021","journal-title":"Front Psychol"},{"key":"2025121220223691000_15.4.e099204.65","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jsp.2019.03.001","article-title":"A state-wide quasi-experimental effectiveness study of the scale-up of school-wide Positive Behavioral Interventions and Supports","volume":"73","author":"Pas","year":"2019","journal-title":"J Sch Psychol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-099204","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T04:22:48Z","timestamp":1765599768000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-099204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":65,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,17]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bmjopen-2025-099204"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-099204","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}