Table 1.

Description of mentor parent contributions to the study at each stage

Stage in CER Process	Mentor parent recommendations and resulting changes in the Padres project
Proposal development	Timing: Parents suggested that the intervention be delivered at the start of their child's treatment because it would help build a sense of support and lessen their feelings of isolation early on. They also recommended a length of four sessions. Study arm structure: Parents explained that having a group intervention was preferable because they valued the support of other parents experiencing similar situations. Intervention content: Parents suggested focusing on improving communication between parents and children. Each of these recommendations was incorporated in the study.
Implementation of study protocols	Recruitment and retention: Mentor parents told us that participants felt they could not continue participating if they missed a group session or their child stopped coming to the clinic. In turn, we have emphasized to parents that they are welcome to continue in the study even in the case of these events. As a result, among the first 16 cohorts, 72% of participants attended at least three of four group sessions, and there has been a 3% dropout rate after an individual has been assigned a parent group.
Analysis plan	Measures: (i) The mentor parents explained that school success is an important factor motivating parents to seek mental health services for their child. We added two measures to capture confidence in and quality of parent interactions with school personnel, (ii) the mentor parents expressed concern that parents who are new to the health‐care system are very different in terms of their confidence and skills when interacting with providers compared to parents with previous contacts. As a result, we added two measures to assess if a participant had previous experience with the mental health system and where, (iii) mentor parents discussed how it would be easy to convey a high level of activation out of enthusiasm without actually having the skills to accomplish the visit goals. This discussion underscored the appropriateness of the study's use of alternative measures of parent activation: self‐report, clinical encounter and archival record review. Data analysis: Mentor parents emphasized the need to account for differences in the level of confidence that parents have at the beginning of the project during the data analysis process and as a way to contextualize the data. This feedback underscored the importance of our planned statistical analyses.
Dissemination of Results	The results of the Padres Efectivos study have been disseminated in the following ways: Written report to the partner clinic: A one‐page written report with mentor parent comments on the services provided by the clinic and on their experiences as members of the study mentor parent group that was shared with the clinic director and clinical manager. The report included direct quotes from parents, and this information was shared with therapists and staff at the clinic as well and uploaded to the clinic's website. Dissemination of findings to outside audiences: Mentor parents expressed how important it was to help other parents and community members understand the information gathered by the researchers as well as with researchers. They particularly mentioned the importance of implementing findings in school settings. Dissemination efforts are on‐going, including piloting the intervention in schools.