(PS6-19) Meta-analysis of Parent & Family Training Targeting Externalizing Behaviors in Asian Youth

Despite being the fastest-growing ethnic minority population in the United States (Budiman & Ruiz, 2021), Asians remain largely underrepresented in clinical samples. Pina and coauthors’ (2019) most recent update on evidenced-based treatments for minority youth identified only one randomized control trial (RCT) targeting Asian Americans: behavioral parent training (BPT) for Chinese immigrants. While there are individual clinical trials examining BPT-arguably the most well studied evidence-based intervention for children with behavior disorders (e.g. ODD or ADHD) with Asian samples-the transnational and pan-ethnic nature of the Asian diaspora increases the uncertainty of whether these limited research findings are generalizable. The current study aimed to explore the main effects of BPT on child externalizing and internalizing behaviors, child mental health, and parent mental health in Asian populations. The authors followed PRISMA guidelines to conduct a literature search. Studies were divided into three categories: RCTs, non-randomized comparison trials (NCT), and single-group trials (SGT). The researchers calculated a Hedge’s g correction as some studies reported small sample sizes. 
23 studies were included in the final analysis. There was a moderate, significant effect for RCTs (g = 0.54, CI 95% [0.31, 0.78], p < 0.001)  and SG (g = 0.52, 95% CI [0.24, 0.80], p = 0.001) interventions on childhood ADHD symptoms. On measures of opposition and conduct behaviors, there was a small effect for studies using NCTs (g = 0.38, 95% CI [0.08, 0.68]; p = 0.013). RCTs (g = 0.43, 95% CI [0.21, 0.64], p < 0.001); and SGTs (g = 0.67, 95% CI [0.26, 1.09]; p = 0.001) demonstrated a moderate effect. Some studies measured broadband externalizing behaviors; for these studies, RCTs and NCTs (g = 1.00, 95% CI [0.32, 1.69]; p = 0.004) and SGTs produced a large effect (g = 1.08 95% CI [0.73, 1.44]; p < 0.001). Studies on negative parenting behaviors showed overall large effect sizes for  NCTs (g = 1.60, 95% CI [1.11, 2.10]; p < 0.001) and RCT studies had an overall large effect size (g = 0.89, 95% CI [0.55, 1.22]; p < 0.001). Parent reports of the child’s anxiety and depression were categorized as internalizing symptoms; RCT studies showed a small effect (g = 0.41, 95% CI [0.12, 0.70]; p = 0.005). Finally, RCT studies (g = 0.55,  95% CI [0.35, 0.74], p < 0.001) and SGTs demonstrated moderate improvements in caregiver mental health (g = 0.69, 95% CI [0.04 1.34], p = 0.037). Compared to other findings, the child externalizing behaviors tend to fall within similar small to medium range as meta-analysis of BPT with other ethnicities (Coates et al., 2014; Mingebach et al., 2018). These initial findings are promising, though the effect sizes should be interpreted conservatively given the wide confidence interval and high heterogentiy. Over half of the studies (65%) were conducted in an East Asian country and no Southeast Asian samples were included in the study. While China's historical development and ethnic groups are quite diverse, our limited sample highlights the absence of research with both South and Southeast Asian groups; particularly, minimal funding for studies in developing countries contributes to this gap and negatively impacts the field’s development of parenting interventions.