Many parents experience elevated levels of stress, or the perceived inability to cope with one's situational demands. Parents of children with externalizing behavioral concerns tend to experience even higher levels of stress than parents of children without significant behavior concerns due to the transactional and bidirectional nature of child behavior and parent stress. The Family Adjustment and Adaptation Response (FAAR) model suggests that families work to balance demands with capabilities, which interact with family meanings, to achieve adjustment or adaptation. Thus, increasing capabilities is an important task for families experiencing stress. Mindfulness-based stress reduction (MBSR), rooted in mindfulness theory, is an increasingly popular framework for reducing stress, anxiety, and depression. MBSR has been successfully used in many populations including parents to reduce parent stress and even help to improve child outcomes. However, there is a dearth of research on MBSR for parents of children with externalizing behavior concerns. One accessible, research-supported, online-delivered MBSR program is called Be Mindful. Currently, there is no extant research on the effects of this program for parent stress and child behavior outcomes. This hybrid effectiveness-implementation intervention study sought to evaluate the effectiveness of this publicly accessible, online, self-mediated MBSR program (Be Mindful) for reducing parent stress and decreasing child externalizing behavior immediately following completion of the program and at one-month follow-up. Other major aims of the study were to determine whether the online-delivered MBSR intervention was acceptable to parents and to characterize how parents engaged with the MBSR program. Participants included a 38 mothers, fathers, and other primary caretakers of children ages two to ten years with behavioral concerns living across the United States. Children were a community sample presenting with externalizing behavior concerns at or above the at-risk range (raw score ⁹́Æ 115) based on the Eyberg Child Behavior Inventory whose parents had stress levels at or above the 60th percentile on any domain of the Parenting Stress Index, Fourth Edition. Parents engaged in the 4-module Be Mindful (MBSR) program for between 4 and 10 weeks and completed pre-, post-, and follow-up adult stress and child behavior measures. Parents also completed usage and satisfaction reports throughout the study. Results of the study provided promising support for the Be Mindful intervention within this particular population: there were robust, statistically significant and clinically meaningful reductions in both parent stress and externalizing child behavior problems following completion of the intervention that maintained through one-month follow-up. Additionally, participants generally found the intervention to be acceptable and practiced the skills a moderate amount during the intervention phase. Open-ended and quantitative feedback provides information regarding barriers and facilitators to intervention use. These results are important within the context of the global COVID-19 pandemic, provide further support for the increasingly popular MBSR framework in an online format, and uniquely examine effects on both parent stress and child behavior in a real-world sample. Limitations, directions for future research, and implications for practice are discussed.
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