3 - (SYM 70) Treatment Satisfaction Is Associated with Clinical Outcomes for Internet-delivered Parent-child Interaction Therapy Among Racial/ethnic Minoritized Families of Children with Developmental Delay

Children with developmental delay (DD) are at increased risk for behavioral problems. Parenting interventions such as Parent-Child Interaction Therapy (PCIT) are effective in reducing behavior problems in this population. However, considering disparities in care based on race/ethnicity, socioeconomic status, and language, it is important to identify interventions that are accessible and adaptable to the needs of marginalized families. Internet-delivered PCIT (iPCIT) may reduce barriers related to transportation, childcare, stigma, etc. Additionally, services provided in Spanish can expand access. The current study assessed caregiver satisfaction with iPCIT for English- and Spanish-speaking families of children with DD. Furthermore, to examine which aspects of treatment are most related to satisfaction in this population, we assessed relations between clinical outcomes and caregiver satisfaction.

Participants (n = 65; 95% female; 66% Hispanic/Latinx, 18.5% Black or African American, 11% non-Latinx White, 1.5% Asian, 1.5% Latinx and Black, and 1.5% Latinx and Other race; 42% Spanish-speaking) were primary caregivers of children with DD (mean age = 36.3 months) who completed iPCIT and the Therapy Attitude Inventory (TAI), a measure of treatment satisfaction.

Caregivers reported high levels of satisfaction with iPCIT (TAI mean = 44.45 of 50). TAI scores did not vary significantly based on child or primary caregiver race/ethnicity, sex, or language. Higher TAI scores were associated with reductions in caregiver-reported scores of child behavior problems on the Eyberg Child Behavior Inventory Intensity (b = -.41, ΔR² = .36, p < .05) and Problem (b = -.47, ΔR² = .47, p < .05) scales from pre- to post-treatment. Higher TAI scores were also related to observed pre- to post-treatment reductions in the proportion of don’t skills (b = -.64, ΔR² = .54, p < .05) and increases in the proportion of do skills (b = .33, ΔR² = .34, p < .05) during child-led play. Finally, higher TAI scores were associated with reductions in caregiver-reported total scores on the Depression, Anxiety, Stress Scale (b = -.74, ΔR² = .37, p < .05), and caregivers’ negative feelings towards parenting on the Family Impact Questionnaire (b = -.22, ΔR² = .41, p < .01).

Results suggest acceptability of iPCIT for families of children with DD from racial and ethnic minority backgrounds, as well as Spanish-speaking families. Furthermore, results suggest caregivers who were more satisfied with treatment show greater improvements in child and parenting behavior, as well as caregiver stress.