In this study, parenting stress and its influence on children's behavioral outcomes (behavior problems and protective factors) were investigated following the implementation of the Child Care Expulsion Prevention (CCEP) program, an Early Childhood Mental Health Consultation (ECMHC) program. Participants included children and parents that participated in the CCEP program (n = 247) and a comparison group (n = 72) in the state of Michigan. Results of mediation analyses, moderated mediation analyses, and multiple regression indicated that parent-child dysfunctional interactions mediated the relation between ECMHC and children's behavior problems (CI = .001, .038) and protective factors (CI = -.061, -.001). Child gender and family SES did not impact the strength of the mediation (parenting stress). Parental distress (ΔR2 = .07, F(1, 75) = 6.82, p <.01) and family SES (ΔR2 = .06, F(1, 75) = 5.86, p <.05, ΔR2 = .05, F (1, 75) = 4.54, p <.05) predicted parent-rated behavior problems. Predictors of parent-rated protective factors included parental distress (ΔR2 = .06, F(1, 75) = 5.40, p <.01), main type of referral problem (ΔR2 = .04, F (1, 75) = 3.84, p <.05), and parent-child dysfunctional interaction (ΔR2 = .14, F (1, 75) = 13.82, p <.001). None of the variables examined predicted provider-rated child behavior. It is important to explore indirect influences that may contribute to the success of intervention programs in order better understand how the intervention achieved its effects.
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