(PS13-B49) Is Brief Telehealth Behavioral Parent Training Acceptable to Parents? A Mixed Methods Acceptability and Feasibility Trial

Introduction: Behavioral parent trainings (BPTs) are highly efficacious treatments for children with disruptive behaviors. However, BPTs can be challenging to access, particularly for disadvantaged families, thereby limiting their impact on population health. Efforts to deliver BPTs in brief format or over telehealth are promising alternatives to traditional care, and recent studies suggest that these modifications do not reduce efficacy and can ease the burden of care for families (Comer & Myers, 2016). Few studies have combined brief treatments with telehealth delivery. This study assessed the feasibility and acceptability of a four-session telehealth BPT, adapted from a manualized program. We used a mixed methods approach to assess the acceptability and feasibility of the intervention and the study method.

Method: Families with children ages 2-8 with concerns about disruptive behaviors were recruited from a large pediatric practice to participate in an open trial. Twenty-seven families and 3 clinicians (1 PhD-, 1 Master’s-, 1 Bachelor’s-level) enrolled in the study, 22 families attended the first session, and 13 families completed all four sessions.  Participating parents and clinicians were assessed post-treatment. We collected standardized measures of treatment acceptability, standard NIH quantitative benchmarks for program feasibility (NCCIH, n.d.), and qualitative interviews. We synthesized Quantitative data with qualitative insights to draw conclusions.

Results: We found that 100% of participating families rated the intervention to be at least moderately acceptable, with most reporting a strongly positive experience. Clinicians found the intervention feasible, especially when they had dedicated time to deliver the program and strong supervisory support. Analyses revealed meaningful diversity in how caregivers experienced the brief telehealth intervention. Some caregivers found the program to be convenient and flexible, while other families struggled with finding reliable wifi or technology, felt distracted during telehealth visits, and disliked the lack of in-person contact. When examining the acceptability of program content with a simultaneous mixed-methods approach, we found that caregivers rated attending, praising, and giving clear instructions as easy to learn and voiced that they found these components most helpful. Some caregivers rated time-out skills as useful but difficult to learn and talked about not yet feeling confident using these skills on their own. Similarly, clinicians voiced concern about having sufficient time to teach time-out within the time constraints.

Discussion: Overall, we found that a brief telehealth-delivered BPT program was highly acceptable to families and feasible to deliver for clinicians. Mixed methods analyses suggested that certain skills were easier than others to teach and learn in the brief telehealth format. Despite telehealth's flexibility, attrition rates were still high, with only 52% of participants completing all four sessions. Future programs should be designed with emerging insights from our work on the strengths and limitations of brief telehealth modalities.