Family engagement in a behavioral parenting intervention: A randomized comparison of telehealth versus office-based treatment formats.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL Journal of consulting and clinical psychology Pub Date : 2024-04-15 DOI:10.1037/ccp0000887

Amanda L. Sanchez, Natalie Javadi, Jonathan S Comer

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Abstract

OBJECTIVE Despite effective treatment options, many families-especially those from marginalized backgrounds-lack access to quality care for their children's behavioral difficulties. Since the COVID-19 pandemic, telehealth has become a prominent format for the delivery of outpatient services, with potential to increase access to quality care. Although telehealth-delivered parenting interventions are associated with positive clinical outcomes, limited research has examined whether telehealth formats improve treatment engagement relative to office-based care. The present study is the first controlled comparison of engagement across office-based parent-child interaction therapy (PCIT) and internet-delivered PCIT (iPCIT). METHOD Children ages 3-5 years, and their caregiver(s) (N = 40) participated in a randomized trial comparing iPCIT to office-based PCIT in the treatment of behavioral problems. Analyses examined the effects of treatment format on engagement (i.e., missed sessions, premature treatment discontinuation, homework completion, therapeutic alliance, and treatment satisfaction). Logistic and linear regressions further explored whether treatment format moderated the effects of common predictors of treatment engagement (i.e., family economic means, racial/ethnic background, caregiver stress). RESULTS iPCIT improved attendance rates relative to office-based PCIT, especially for families from minoritized racial/ethnic backgrounds. At the same time, among families with relatively higher levels of caregiver stress, office-based PCIT was associated with lower dropout rates and improved treatment alliance and satisfaction, relative to iPCIT. CONCLUSIONS This study provides the first experimental support that telehealth formats can improve treatment attendance in behavioral parenting interventions. Findings highlight nuances in treatment engagement across treatment formats that reveal limits to the extent telehealth transcends engagement concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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家庭参与行为养育干预：远程医疗与办公室治疗形式的随机比较。

目的：尽管有有效的治疗方案，但许多家庭（尤其是那些来自边缘化背景的家庭）仍然无法获得高质量的医疗服务来治疗其子女的行为障碍。自 COVID-19 大流行以来，远程保健已成为提供门诊服务的一种重要形式，并有可能增加获得优质护理的机会。虽然远程医疗提供的育儿干预与积极的临床结果有关，但对远程医疗形式是否能提高治疗参与度的研究还很有限。本研究首次对基于诊室的亲子互动疗法（PCIT）和基于互联网的亲子互动疗法（iPCIT）的参与度进行了对照比较。方法 3-5 岁的儿童及其照顾者（N = 40）参加了一项随机试验，该试验比较了 iPCIT 和基于诊室的 PCIT 对行为问题的治疗效果。研究分析了治疗形式对参与度的影响（即错过疗程、过早中断治疗、作业完成情况、治疗联盟和治疗满意度）。逻辑回归和线性回归进一步探讨了治疗形式是否调节了参与治疗的常见预测因素（即家庭经济状况、种族/民族背景、照顾者压力）的影响。结果相对于办公室 PCIT，iPCIT 提高了出勤率，尤其是对于来自少数种族/民族背景的家庭。同时，在照顾者压力相对较高的家庭中，相对于 iPCIT，办公室 PCIT 与较低的辍学率以及较好的治疗联盟和满意度相关。研究结果凸显了不同治疗形式在治疗参与度上的细微差别，揭示了远程医疗在超越参与度问题上的局限性。(PsycInfo Database Record (c) 2024 APA, 版权所有）。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.