1 - (SYM 126) Patterns and Predictors of Engagement and Retention in “telegroup” Parent Behavior Management Training for Disruptive Behaviors

Background: PBMT programs have been found to be effective in modifying behaviors; however, research suggests that not all families benefit equally. For example, families from disadvantaged backgrounds have been shown to be less represented and benefit less from these programs than other families.

Objective: This study examined characteristics of families that benefit and those that do not engage or benefit in PBMT for childhood disruptive behaviors in a hospital outpatient clinic setting to inform strategies to improve access, acceptability, and benefits of PBMT.

Methods: The 9-week PBMT program is delivered via videoconference “telegroup” with weekly 1-hour sessions. Sessions are led by 2 group leaders along with 12-15 families of children with ADHD, disruptive behavior, developmental complexities, or adjustment problems. The program is the first tier in a stepped care model for behavior challenges. Enrolled families completed baseline demographics, goals, and standardized measures (DBDRS & IRS).

 

Results: Throughout 2022, a total of 22 groups were completed with 294 families enrolled. Of caregivers who completed measures, 89% were mothers, 8% fathers, and < 4% were grandparents, foster parents, or other caregivers. The telegroup format allowed families from 130 different zip codes across Washington to participate, with 56% and 18% residing in the host counties (King and Snohomish). Participant demographics included White (75%), Latino (10%), Asian (8%), Indigenous (4%), and Black (2%). Three attendance patterns were identified: 23% of families dropped-out (attended 0-2 visits), 12% were sporadic attenders (attended 3-6 visits), and 64% were completers (attended 6-9 visits). Attendance was not significantly associated with child age (F(2, 147) = 2.92, p = 0.06), baseline DBDRS oppositional factor (F(2, 151) = 0.10, p = 0.90), inattention factor (F(2, 151) = 0.10, p = 0.90), or impulsivity factor (F(2, 151) = 1.11, p = 0.33), nor baseline IRS (F(2, 146) = 2.20, p = 0.12). For completers, 93% reported improvement in child behavior, 62% denied needing additional services, and 91% were satisfied with their experience. Additional patterns associated with attendance are presented.

Conclusion: A 9-week course of parent training was sufficient treatment dose for the majority of families who participated. However, a significant portion of families did not complete the program.  Measurement-based care practices may assist with detecting which families are not benefiting from treatment that may be at risk of ending treatment prematurely.