Online-Delivered Over Staff-Delivered Parenting Intervention for Young Children With Disruptive Behavior Problems:...

Area of Science:

• Child and Adolescent Psychiatry
• Health Services Research
• Behavioral Science

Background:

• Childhood disruptive behavior problems (DBPs) are prevalent, necessitating scalable interventions.
• Evidence-based parenting interventions are effective but dissemination is limited by reliance on staff delivery.
• Online delivery offers potential for wider reach and cost reduction, but its cost-minimization for DBPs is unproven.

Purpose of the Study:

• To conduct a cost-minimization analysis (CMA) comparing online and staff-delivered parenting interventions for childhood DBPs.
• To evaluate cost differences using data from parents and service providers within a randomized trial.

Main Methods:

• A cost-minimization analysis (CMA) was performed comparing online and staff-delivered parenting interventions.
• 334 families with children aged 3-7 years with elevated DBPs were randomized.
• Data collected included family time/expenses, program delivery time, and non-personnel resources; intent-to-treat and per-protocol analyses were used.

Main Results:

• The online intervention showed significantly lower program, family, and total costs in intent-to-treat analyses (P<.001).
• Mean incremental cost savings per case for the online intervention were $1164 (total costs) in intent-to-treat and $1483 in per-protocol analyses.
• Cost savings were primarily driven by reduced personnel time, followed by facility and family travel costs.

Conclusions:

• Online-delivered parenting interventions offer substantial cost minimization compared to identical content delivered by staff.
• Cost savings are attributable to reduced personnel, facility, and family travel time.
• Unequivocal cost minimization was demonstrated under conditions of constant intervention content, randomization, and proven non-inferiority of the online intervention.