(PS12-22) Examining How Parental Engagement in a Brief, Group-based Behavioral Parent Training Program Delivered via Telehealth Predicts Change in Child Behavioral Concerns

Behavioral Parent Training (BPT) is an effective intervention that improves child and parent mental health outcomes (Reyno & McGrath, 2008; Lundahl et al. 2006). However, BPT has substantial engagement issues (Chacko et al., 2016). Evidence indicates that poor engagement during BPT can reduce its effectiveness (Chacko et al., 2012). We developed a BPT intervention intended to address engagement barriers by being brief (i.e., 6, 1-hour sessions), group-based, and delivered through telehealth. However, it is unclear if engagement predicts the effectiveness of this intervention at addressing child behavioral concerns. This study will test if engagement indicators predict how much child behavioral concerns improve. We expect to find that higher levels of engagement will relate to more improvement in child behavioral concerns. 

Thirty-four caregivers of children between 3 and 7 years old were recruited from a large children’s hospital behavioral health clinic. Caregivers enrolled in the BPT intervention as a part of standard care and were recruited into this pilot study. Engagement indicators included parents’ attendance, weekly skill use, and satisfaction with the intervention. Attendance was determined by how many group sessions the primary caregiver joined. Weekly skills use was measured by weekly surveys asking how many days parents practiced each strategy. Caregivers completed the Client Satisfaction Questionnaire to assess satisfaction with the intervention. Caregivers completed the Eyberg Child Behavior Inventory and the Pediatric Symptom Checklist (PSC) to assess child behavioral concerns before and after the group. Change in child behavioral concerns was computed by subtracting post-group scores from pre-group scores; higher scores reflect more improvement in child behavioral concerns. 

We ran preliminary analyses to test the link between engagement indicators and change in child behavioral concerns after the BPT intervention. Attendance was significantly related to improvement in the frequency of child behavioral concerns (r = .42, p = .03); yet, unrelated to change in child problem intensity (r = -.11, p = .58) or conduct concerns measured on the PSC (r = -.09, p = .63). Interestingly, caregiver’s weekly skill use was not related to improvement in child behavioral concerns (r range = -.25 to .18, p’s > .25). Satisfaction was significantly related to improvement in the frequency of child behavioral concerns (r = .50, p = .01); however, unrelated to change in child problem intensity (r = .21, p = .31) or conduct concerns measured on the PSC (r = .27, p = .19). 

Findings indicated that attendance and satisfaction related to improvement in the frequency of child behavioral concerns, while skill practice was not related. These results highlight that engagement in BPT, even when adapted, is related to effectively reducing the frequency of child behavioral concerns. Future research will evaluate if engagement also predicts change in parent outcomes. We will continue to collect data as families enroll in this BPT program at two community partnerships, including several Head Start sites. We will recruit 20 more families before ABCT and present findings that hold implications for disseminating BPT among community partnered settings.