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Summary of Parent-Child Connectedness (PCC):
Findings from an On-line Survey with Practitioners

by Lori A. Rolleri, MSW, MPH
and Steve Bean, MAT

January 2004

This paper summarizing the findings of an on-line survey on parent-child connectedness includes the following sections:

Background

Emerging research from the fields of public health, psychology, education and others demonstrates that the condition of "parent-child connectedness" (PCC) serves as an important protective factor for a variety of adolescent health outcomes, including the prevention of adolescent pregnancy, STI and HIV.

Program developers at ETR Associates found the prevalence of parent-child connectedness in the research literature to be compelling. Yet after program developers revisited the literature and spoke with several experts in the field, they found little information about the factors that determine PCC, and even less information about how to design interventions to strengthen it.

ETR program development staff saw this gap in the field as an interesting and important opportunity to shed light on this protective factor that appears to have such a strong and widespread impact on adolescent health.

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ETR's PCC BRIDGE Project

In January 2003, ETR Associates was awarded funding from the Annie E. Casey Foundation to study the construct of "parent-child connectedness." The objectives of ETR's project titled "Parent-Child Connectedness: Bridging Research and Intervention Design" (PCC BRIDGE) were:

At the completion of Year One, the PCC BRIDGE Project will:

  • Increase awareness and understanding of how parent-child connectedness serves as a protective factor in adolescent reproductive health;
  • Increase awareness and understanding of the factors that determine or influence parent-child connectedness; and
  • Identify characteristics of interventions that have the potential to increase parent-child connectedness.

In support of these objectives, four activities were completed during Year One of this project. These activities included:

  • A comprehensive literature reviewthat: 1) establishes the protective influence of PCC on a variety of adolescent health outcomes; 2) describes close to 100 possible determinants of PCC; 3) propose a new logic model that describes how PCC is established; and 4) reviews existing interventions that have had an affect on PCC.
  • A two-day think tank meeting held in July 2003 in Baltimore, MD and attended by researchers and practitioners with expertise in parent-child connectedness.
  • An on-line survey examining how parent-child connectedness is understood by users of the Resource Center for Adolescent Pregnancy Prevention (ReCAPP) web site (the focus of this article).
  • A variety of dissemination activities including a ReCAPP edition dedicated to PCC, presentations at conferences and other meetings, and an on-line forum discussion.

In future years, the PCC BRIDGE Project plans to develop and/adapt interventions specifically designed to increase PCC, pilot and evaluate these interventions, and lastly disseminate interventions through written products, training and technical assistance.

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Purpose of the On-line Survey

ETR's overall strategy to understand parent-child connectedness more fully involved three methods:

  1. a review of more than 600 documents related to PCC gathered from information databases (e.g. Medline, PsychInfo, etc.), the world wide web, and colleagues;
  2. discussions with national experts (researchers and practitioners) through phone calls, email and a two-day think tank meeting; and
  3. an on-line survey of practitioners in the field of adolescent reproductive health.

The opinions and perspectives of practitioners in the field were particularly important to the PCC BRIDGE project team for two major reasons:

  1. Since practitioners will ultimately be the people who will implement the PCC interventions developed by ETR, their insights should be reflected in the products we produce; and
  2. given the incompleteness of the research of PCC found in the literature, practitioner opinions and experiences help to shed further light on understanding what comprises PCC and how it functions.

The purpose of the on-line survey was three-fold:

  1. Assess practitioners' current understanding of PCC: How do practitioners define PCC, and what do they think are the most important factors that strengthen and weaken it?
  2. Assess practitioners' current experience in working on PCC: What type of intervention activities are practitioners developing and/or implementing to support parent-child connectedness with the families they serve, if any?
  3. Assess practitioners' interest in learning more about PCC: Are practitioners interested in PCC? How are they most likely to learn about it?

Findings from this survey have helped the PCC BRIDGE Project team define and operationalize PCC as well as shed light about how to engage practitioners to incorporate PCC into their work. These findings will be described later on in this article.

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Description of Survey

The 17-question survey on parent-child connectedness was posted on ReCAPP from May 1 - May 27, 2003. The survey included 11 close-ended questions (Likert scale, yes/no, check all that apply) and six open-ended questions.

The survey was formatted and posted on ReCAPP using SurveyMonkey. (SurveyMonkey is an on-line service that enables subscribers to create, collect, and analyze online surveys quickly and easily. Since on-line surveys are easy to use — there is nothing to download, print or mail — the response rate is typically high.)

To review a full copy of the survey, click here.

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Data Analysis

Survey respondents were recruited through ReCAPP's mailing list, recappnotes (more than 2,500 members at the time of the survey), and other listservs such as the National Organization on Adolescent Pregnancy, Parenting & Prevention (NOAPPP), the Comprehensive Health Education Network (CHEN), the Office of Adolescent Pregnancy Programs (OAPP), and others. Over a period of 27 days, the survey was completed by 599 people representing Program Administrators, Health Educators, Social Workers and other professionals (for a graphic overview, click on question #2).

Overall, survey takers were an experienced group with 56% of them (n=584) having five or more years in the field (question #3). It is important to note that the sample of professionals completing this survey were not randomly chosen and therefore cannot be described as truly representative of the field as a whole.

Frequencies were calculated for the responses to 10 close-ended questions. (The first question asking for the respondent's email address was not analyzed). Frequencies were relatively easy to calculate as SurveyMonkey automatically keeps count of responses. These frequencies were then made into graphs on Power Point slides. Below find a list of these slides and their links.

Question #2: Occupation (top five responses only)

Question #3: Years Working in the Field

Question #4: Age of Clients Served

Question #5: Heard of PCC before Survey

Question #10: PCC Relevant to Work I Do

Question #11: Program Experience (Implementation of PCC Activities)

Question #12: Program Experience (Development of PCC Activities)

Question #14: Protective Factors Associated with PCC

Question #15: Risk Factors Associated with PCC

Question #16: Interest in Learning More about PCC and Interest in Incorporating PCC into Work

Qualitative data from the six open-ended questions were hand-coded for themes, and the most common themes found for five of the open-ended questions are presented below. The responses to question #17 ("Is there anything else you would like to tell us?") (n=175) are not represented in the slides below. However, responses can be summarized by requests for additional information, validation on the importance of PCC, and professional accounts of work being done in the field (some accounts related to PCC and others not related).

Question #6: How You Heard of PCC (top five only)

Question #7: What PCC Means to You (top five only)

Question #8: Factors that Strengthen PCC (top five only)

Question #9: Factors that Break Down PCC (top five only)

Question #13: Program Activities that Strengthen PCC (top five only)

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Discussion

Analysis of the survey data suggests four key points regarding practitioners and parent-child connectedness: 1) PCC in not clearly understood by the majority of the practitioners who completed the survey; 2) Communication and connectedness may be understood to mean the same thing; 3) Survey respondents expressed some common themes in the factors related to PCC as compared to the literature and national experts; and 4) There is clearly interest on the part of survey respondents to learn more about PCC.


PCC is Not Clearly Understood
The majority of survey respondents (58%, n = 532) reported not hearing of parent-child connectedness before taking the ReCAPP survey (question #5). However, a larger percentage later on in the survey (question #11) reported having implemented activities explicitly addressing parent-child connectedness (68%, n =491). There may be a couple of explanations for these apparently contradictory data. First, question #5 "Had you heard of the term 'parent-child connectedness' before taking this survey?" is placed early in the survey.

As respondents completed the survey, they answered questions about factors that lead to parent-child connectedness (questions #7-9). When they reached questions #11 and #12 (about program experience), they may have realized that they actually did know about parent-child connectedness from answering questions about factors that lead to it. An alternate explanation is that given the frequency of "communication" in responses to questions, survey responders may have confused parent-child connectedness with parent-child communication toward the end of the survey.


"Communication" and "Connectedness"
"Communication" is a key theme presented by survey respondents in defining PCC. Some of the responses to question #7 "What does PCC mean to you?" included:
  • "It means parents and their children being able to communicate effectively…"
  • "…continuing parent-child relationship through dialogue."
  • "…that there is an open line of two-way communication between parent and child."
  • "…open communication; being a good listener when it comes to your children; being an askable parent…"

Although communication is certainly part of parent-child connectedness, it is clear from ETR's literature review that is only one determinant of PCC, and that communication alone does not result in a state of high parent-child connectedness. Moreover, the construct of communication needs to be broken down to better understand the essential skills (e.g. active listening, assertive communication, non-verbal cues, etc.) that could be taught to achieve "good parent-child communication."

The frequent mention of "communication" by survey respondents is an important perspective for ETR's project team to consider in developing interventions. Effective marketing of parent-child connectedness as a unique and separate construct must be part of the intervention dissemination plan.


Echoing Common Themes
"Communication," "Encouragement and Support," "Shared Experiences" and "Consistency and Structure" were frequently mentioned as factors that help strengthen PCC by respondents of the on-line survey. These determinants were also found in the literature, as well as prioritized as most important and most amenable to change by the panel of national experts during our think tank meeting. Survey responses describing important determinants of parent-child connectedness helped to triangulate data obtained from the literature and the educated opinions of our experienced experts.

"Communication," "Encouragement and Support," "Shared Experiences" and "Consistency and Structure" are represented in the quotes found below.

  • "That the parent and child do things together where they appreciate the time spent together and feel connected to each other…"
  • "…being present to your children on a daily basis, listening, eating meals together, knowing what's happening in their lives, communicating."
  • "Clear boundaries with a caring, loving structure."
  • "Consistency in relationship/clarity of roles."
  • "Parental responsiveness of child cues."

These determinants have become central pieces of ETR's operational definition and theory behind the establishment parent-child connectedness.


High Interest in Learning More
The majority of survey respondents stated that PCC is relevant to what they do and that they have implemented and/or developed programs addressing PCC. About 70% of respondents expressed "high" interest in learning more about, and/or incorporating PCC into their work. This data was encouraging to ETR's PCC BRIDGE Project team — as the next phase of the project is to disseminate findings about PCC and to develop targeted interventions.

Written products have so far been a good way to get the word out on parent-child connectedness with 30% (n=227) reporting having heard of PCC through reading.

    "I remember reading about it in literature we receive at our office."
  • "Research I was reading for a grant."
  • "Read about the research in professional articles, as well as the newspaper.
  • "Parenting books, magazines and psychology textbooks.

ETR will continue to use ReCAPP as a vehicle to share information on PCC as well as through trainings, conference/meeting presentations, on-line discussion forums, and articles written for peer reviewed journals.


For More Information
For more information about this survey and its findings, contact Lori Rolleri at lorir@etr.org.

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Data Analysis Charts

Question #2: Occupation (top five responses only)


Question #3: Years Working in the Field


Question #4: Age of Clients Served


Question #5: Heard of PCC Before Survey


Question #6: How You Heard of PCC (top five only)


Question #7: What PCC Means to You (top five only)


Question #8: Factors that Strengthen PCC (top five only)


Question #9: Factors that Break Down PCC (top five only)


Question #10: PCC Relevant to Work I Do


Questions #11 and #12: Program Experience
(Implementation and Development of PCC Activities)


Question #13: Program Activities that Strengthen PCC (top five only)


Question #14: Protective Factors Associated with PCC


Question #15: Risk Factors Associated with PCC


Question #16: Interest in Learning More about PCC and Interest in Incorporating PCC into Work

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