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Currently accepted at: Journal of Medical Internet Research

Date Submitted: Jun 29, 2018
Open Peer Review Period: Jul 3, 2018 - Aug 16, 2018
Date Accepted: Dec 31, 2018
(closed for review but you can still tweet)

This paper has been accepted and is currently in production.

It will appear shortly on 10.2196/11446

The final accepted version (not copyedited yet) is in this tab.

The final, peer-reviewed published version of this preprint can be found here:

Implementation of Web-based Parent Training Intervention with Telephone Coaching for Disruptive Behavior in 4-Year-Old Children in Real World Practice

Ristkari T, Kurki M, Suominen A, Gilbert S, Sinokki A, Kinnunen M, Huttunen J, McGrath P, Sourander A

Implementation of Web-based Parent Training Intervention with Telephone Coaching for Disruptive Behavior in 4-Year-Old Children in Real World Practice

J Med Internet Res 2019;21(4):e11446

DOI: 10.2196/11446

PMID: 30973337

PMCID: 6482405

Implementation of Web-based Parent Training Intervention with Telephone Coaching for Disruptive Behavior in 4-Year-Old Children in Real World Practice

  • Terja Ristkari; 
  • Marjo Kurki; 
  • Auli Suominen; 
  • Sonja Gilbert; 
  • Atte Sinokki; 
  • Malin Kinnunen; 
  • Jukka Huttunen; 
  • Patrick McGrath; 
  • Andre Sourander

ABSTRACT

Background:

Parent training is the most effective approach to the psychosocial treatment of disruptive behavioral problems in childhood. However, no studies exist on how well web-based training programs work when they make the transition from the research setting to implementation in primary healthcare.

Objective:

To examine participants, duration, discontinuation, content and participants’ satisfaction rates when we compared a group of parents who participated in a randomized controlled trial (RCT) intervention study group with a group who took part in the implementation of the program in multiple primary healthcare settings in Finland.

Methods:

The study focused on 232 parents who had taken part in the Strongest Families Smart Website (SFSW) intervention, which formed part of a two-arm RCT study, and 882 families to participate in the subsequent SFSW implementation study group. Both groups comprised parents whose children displayed high levels of parent reported disruptive behavioral problems when they were screened in child health clinics at four years of age. Parents in both groups were provided with the SFSW intervention, which consisted of a web-based training program with 11 weekly themes and associated telephone sessions.

Results:

No statistical differences were found in family variables, sex distribution, child psychopathology measures using Strengths and Difficulties Questionnaire (SDQ) at population based screening phase or duration of problems when the two groups (RCT intervention group versus Implementation group) were compared. In the implementation group 42.0% (362/862) of children and in the RCT intervention group 35.4% (80/226) had suffered from behavioral difficulties more than one year before screening phase (p=.07). The mean duration of telephone coaching calls was very similar in the implementation and RCT intervention groups, i.e 38 and 37 minutes per call respectively (p=.79). The total time spent in the web site of the program was 451 minutes in the implementation group and 431 minutes in the RCT intervention group (p=.17). Of those 232 who were in RCT intervention group 52 (22.4%) discontinued the program before 10th week while the respective figure for those in implementation group was 109 of 882 (12.4%) (2.05, 95% CI 1.4-3.0, p<.001). Parents in both groups reported similar and high level of posttreatment satisfaction how program had improved their parenting skills, met their expectations and relieved their stress. Parents in both groups reported similar and high level of satisfaction in skills and professionalism of the telephone coaches.

Conclusions:

The findings indicate that the implementation of population based screening of web-based parent training intervention with telephone coaching resulted in good feasibility, fidelity, accessibility and similar satisfaction level posttreatment when compared with intervention in RCT research setting. The discontinuation of treatment in implementation was exceptionally low. The key elements of the successful implementation were the convenient and easy-to-use web-based format, providing telephone coaches who received intensive training on the protocol and ensuring sufficient training for stakeholders and primary health staff on the procedures, the importance of the psychosocial evaluation and the support that the program families would receive.


 Citation

Please cite as:

Ristkari T, Kurki M, Suominen A, Gilbert S, Sinokki A, Kinnunen M, Huttunen J, McGrath P, Sourander A

Implementation of Web-based Parent Training Intervention with Telephone Coaching for Disruptive Behavior in 4-Year-Old Children in Real World Practice

Journal of Medical Internet Research. (forthcoming/in press)

DOI: 10.2196/11446

URL: https://preprints.jmir.org/preprint/11446

PMID: 30973337

PMCID: 6482405

Download Accepted Manuscript PDF

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