Rewards as a behavior management strategy: acceptability among African-American parents

Given increasing cultural diversity, behavioral health professionals and researchers are paying greater attention to the need for cultural competence. Behavioral health treatment research has included predominantly individuals of European ancestry; research on parenting practices/interventions has been no exception. African-American parents are particularly underrepresented, raising questions of cross-cultural applicability and acceptability. Acceptability of interventions is crucial, predicting engagement in, adherence with, and premature withdrawal from treatment. In this study, acceptability of rewards, a frequently used intervention for changing children’s behavior, was examined among African-American parents. Children’s characteristics (gender, behavior problem type), culturally-linked variables (authoritarian parenting, promotion and prevention focus, Afrocentric worldview), and parenting beliefs (behavioral attributions, irrational parenting beliefs) were examined as predictors of reward acceptability. African-American parents (n=79) of children aged 4-12 read four vignettes (two with girls and two with boys) describing children’s behaviors (externalizing and internalizing symptoms). Parents rated the acceptability of rewards to improve the behavior. Authoritarian parenting and prevention focus were hypothesized to be negatively associated with reward acceptability. Acceptability was expected to be lower for externalizing males and additional variables were investigated as moderators and co-variates. Exploratory analyses examined differences between mothers and fathers and between low and high Afrocentric worldview. The main hypothesis was unsupported. Authoritarian parenting and prevention focus did not contribute to a model predicting acceptability, and gender differences were not found. Behavior type was associated with acceptability opposite the expected direction, with higher acceptability for externalizing symptoms. Acceptability on a general-attitude measure was predicted by efficacy expectations, internal behavioral attributions, and Afrocentric worldview. However, on a measure specific to the vignettes, few variables predicted acceptability; ratings were lower than on the general-attitude measure. This may suggest that parents viewed rewards as acceptable in circumstances different from those depicted in the vignettes. Individuals endorsing high Afrocentric worldviews had higher reward acceptability, were more likely to be older, were less driven by prevention goals, had lower authoritarian parenting styles, and had less rigid and more rational parenting beliefs. Fathers and mothers did not differ. Results underscored the importance of inquiring about specific situations rather than general attitudes in assessing intervention acceptability