(PS6-64) Tele-group Parent Behavior Management Training for Disruptive Behavior: Comparison of Efficacy and Satisfaction Between White versus BIPOC caregivers

Abstract Text:

Background: Disruptive behavior and related disorders (e.g., ADHD, oppositional defiant disorder) constitute a top reason for referral of children to mental health agencies (Steiner et al., 2007) across racial/ethnic groups (Kaufman et al., 2010), indicating the need for culturally responsive, evidence-based psychosocial interventions. Parent Behavior Management Training (PBMT), both in person and teletherapy format, is effective in improving children’s disruptive behaviors (Bausback & Bunge, 2021; Mingebach et al., 2018). However, most PBMT research relies on predominantly White samples, and it is unclear if minoritized families benefit from PBMT to the same extent as white families (Pina et al., 2019). While teletherapy services have increased since the COVID-19 pandemic, evidence for the efficacy of telehealth PBMT for racial/ethnic minority families is limited (Willis et al., 2022). This study aims to (1) quantitatively compare clinical outcomes and satisfaction ratings of tele-group PBMT, and (2) qualitatively identify themes related to engagement and challenges among White and BIPOC caregivers.

Methods: A total of 196 caregivers (78% White; 22% BIPOC) of children aged 5 to 11 with disruptive behaviors participated in a nine-week one-hour tele-group PBMT and completed pre- and post-group questionnaires as part of routine clinical care. The questionnaires measured child externalizing behaviors, impairment, and parenting styles. Post-group, caregivers also reported their satisfaction with different components of the PBMT group and provided written suggestions to improve the group.

Results: Pre-post results indicated that tele-group PBMT was associated with significant improvement in child inattentive (p < 0.001, d = 0.87) and oppositional/defiant symptoms (p < 0.001, d = 0.87), overall functional impairment (p < 0.001, d = 0.72), and inconsistent parenting practices (p < 0.01, d = 0.69), and there was no difference in the degree of improvement for White versus BIPOC families. Hyperactivity symptoms decreased among White children (p < 0.001, d = 1.04), but not among BIPOC children. Overall, 86% of White and 95% of BIPOC caregivers were “satisfied” or “highly satisfied” with the tele-group PBMT (median = ‘5’ highly satisfied; possible range = ‘1’ highly dissatisfied to ‘5’ highly satisfied). Although overall satisfaction with the group did not differ, White caregivers were more likely to strongly agree that they can follow along during group, would recommend the group to others, and had seen improvement than BIPOC caregivers. Thematic analyses of open-ended questions identified families’ perceived helpful/least helpful aspects of the group and ways to make the group feel more inclusive.

Implications: Tele-group PBMT was associated with significant improvements in child and caregiver outcomes, and most of these improvements were not significantly different between White versus BIPOC families. Nevertheless, BIPOC caregivers noted more challenges in following along during group, were less likely to recommend the group to others, and were less likely to report observed improvements than White caregivers, indicating the need to improve the quality of care for BIPOC caregivers in this intervention.