It’s a familiar paradox: those who most need help may be the least likely to seek it. Poverty, depression, violence, and other problems that plague families lead to chaos and stress, which in turn make showing up for classes or other types of therapeutic programs difficult. And attendance matters: research shows that families who participate consistently in parenting programs reap the most benefits.

A recent article in Prevention Science throws some light on this problem. Gene H. Brody and his colleagues at the University of Georgia examined 172 families from poor rural communities in their home state who took part in a parenting initiative called Strong African American Families Program (SAAF).

They collected information from the families before and after seven sessions and investigated a number of reasons why some might have attended more than others. (see Effects of Family Risk Factors on Dosage and Efficacy of a Family-centered Preventive Intervention for Rural African Americans)

They found two types of families who were unlikely to be regulars at the sessions: families with children with risky behaviors (ie. children who said they were likely to have sex without protection and to use drugs or alcohol with friends), and families with fewer adults and more children.

The study did not pursue why these types of families tended to miss sessions, although the authors suggest that parents of children with risky behaviors might have difficulty exerting any influence over their attendance in a parenting program. Additionally, families with fewer adults and more children might lack the time and other resources (like childcare) required for attendance.

The authors also found consistent attendance to be a stronger predictor of parenting improvements among families who had more problems at the beginning of the study than among families with fewer problems. They conclude that such an outcome suggests that regular participation is ‘crucial’ for these high risk families.

However, it remains unclear whether what families learned in SAAF helped them to improve their parenting or whether high risk families who attended the program consistently had some other helpful quality (perhaps determination to change).

Practitioners know that even programs that work well under ideal circumstances often fail in the real world. And one of the most basic challenges is getting children and families to show up. Brody and his colleagues’ research points to the types of families who might need extra support to benefit from parenting or other types of programs.