A randomized controlled trial of technology-enhanced behavioral parent training: sustained parent skill use and child outcomes at follow-up

Justin Parent; Margaret T Anton; Raelyn Loiselle; April Highlander; Nicole Breslend; Rex Forehand; Megan Hare; Jennifer K Youngstrom; Deborah J Jones

doi:10.1111/jcpp.13554

A randomized controlled trial of technology-enhanced behavioral parent training: sustained parent skill use and child outcomes at follow-up

J Child Psychol Psychiatry. 2022 Sep;63(9):992-1001. doi: 10.1111/jcpp.13554. Epub 2021 Dec 9.

Authors

Justin Parent^{1

2

3}, Margaret T Anton⁴, Raelyn Loiselle⁵, April Highlander⁵, Nicole Breslend⁶, Rex Forehand⁶, Megan Hare³, Jennifer K Youngstrom⁵, Deborah J Jones⁵

Affiliations

¹ Warren Alpert Medical School, Brown University, Providence, RI, USA.
² Bradley/Hasbro Children's Research Center, E. P. Bradley Hospital, Providence, RI, USA.
³ Center for Children and Families, Florida International University, Miami, FL, USA.
⁴ AbleTo Inc., New York, NY, USA.
⁵ University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁶ University of Vermont, Burlington, VT, USA.

Abstract

Background: Early-onset (3-8 years old) disruptive behavior disorders (DBDs) have been linked to a range of psychosocial sequelae in adolescence and beyond, including delinquency, depression, and substance use. Given that low-income families are overrepresented in statistics on early-onset DBDs, prevention and early-intervention targeting this population is a public health imperative. The efficacy of Behavioral Parent Training (BPT) programs such as Helping the Noncompliant Child (HNC) has been called robust; however, given the additional societal and structural barriers faced by low-income families, family engagement and retention barriers can cause effects to wane with time. This study extends preliminary work by examining the potential for a Technology-Enhanced HNC (TE-HNC) program to improve and sustain parent skill proficiency and child outcomes among low-income families.

Methods: A randomized controlled trial with two parallel arms was the design for this study. A total of 101 children (3-8-years-old) with clinically significant problem behaviors from low-income households were randomized to HNC (n = 54) or TE-HNC (n = 47). Participants were assessed at pre-treatment, post-treatment, 3-month, and 6-month follow-ups. Primary outcomes were parent-reported and observed child behavior problems. Secondary outcomes included observed parenting skills use (ClinicalTrials.gov Identifier: NCT02191956).

Results: Primary analyses used latent curve modeling to examine treatment differences in the trajectory of change during treatment, maintenance of treatment gains, and levels of outcomes at the 6-month follow-up. Both programs yielded improvements in parenting skills and child problems at post-treatment. However, TE-HNC families evidenced greater maintenance of parent-reported and observed child behavior and observed positive parenting skills at the 6-month follow-up.

Conclusions: Our findings contribute to an ongoing line of work suggesting that technology-enhanced treatment models hold promise for increasing markers of engagement in BPT and sustaining long-term outcomes among low-income families.

Keywords: Behavioral parent training; child behavior disorders; low-income families; technology.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Attention Deficit and Disruptive Behavior Disorders / therapy
Child
Child Behavior Disorders* / psychology
Child Behavior Disorders* / therapy
Child, Preschool
Follow-Up Studies
Humans
Parent-Child Relations
Parenting / psychology
Parents* / education
Technology

Associated data

ClinicalTrials.gov/NCT02191956

Abstract

Publication types

MeSH terms

Associated data

Grants and funding