Technology-enhanced program for child disruptive behavior disorders: development and pilot randomized control trial.
Early onset disruptive behavior disorders are overrepresented in low-income families; yet these families are less likely to engage in behavioral parent training (BPT) than other groups. This project aimed to develop and pilot test a technology-enhanced version of one evidence-based BPT program, Helping the Noncompliant Child (HNC). The aim was to increase engagement of low-income families and, in turn, child behavior outcomes, with potential cost-savings associated with greater treatment efficiency. Low-income families of 3- to 8-year-old children with clinically significant disruptive behaviors were randomized to and completed standard HNC (n = 8) or Technology-Enhanced HNC (TE-HNC; n = 7). On average, caregivers were 37 years old; 87% were female, and 80% worked at least part-time. More than half (53%) of the youth were boys; the average age of the sample was 5.67 years. All families received the standard HNC program; however, TE-HNC also included the following smartphone enhancements: (a) skills video series, (b) brief daily surveys, (c) text message reminders, (d) video recording home practice, and (e) midweek video calls. TE-HNC yielded larger effect sizes than HNC for all engagement outcomes. Both groups yielded clinically significant improvements in disruptive behavior; however, findings suggest that the greater program engagement associated with TE-HNC boosted child treatment outcome. Further evidence for the boost afforded by the technology is revealed in family responses to postassessment interviews. Finally, cost analysis suggests that TE-HNC families also required fewer sessions than HNC families to complete the program, an efficiency that did not compromise family satisfaction. TE-HNC shows promise as an innovative approach to engaging low-income families in BPT with potential cost-savings and, therefore, merits further investigation on a larger scale.
a Department of Psychology , University of North Carolina at Chapel Hill.
Deborah J
DJ
Jones
Rex
R
Forehand
Jessica
J
Cuellar
Justin
J
Parent
Amanda
A
Honeycutt
Olga
O
Khavjou
Michelle
M
Gonzalez
Margaret
M
Anton
Greg A
GA
Newey
D000328:Adult; D017668:Age of Onset; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000193:education*; D010865:Pilot Projects; D011203:Poverty; D016730:Program Development; D015397:Program Evaluation; D060145:Text Messaging; D014743:Videotape Recording