Study Protocol: Type 1 Hybrid Effectiveness-Implementation Trial of a Behavioral Parent Training Intervention for Parents of Young Children Who Are Deaf or Hard of Hearing
Christina R Studts1, Julie A Jacobs2, Matthew L Bush2
1Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora.
Insights
This study tests an adapted behavioral parent training intervention for young children who are deaf or hard of hearing (DHH). The goal is to improve child behavior and parent-child interactions, addressing a gap in evidence-based care for DHH children.
Area of Science:
- Pediatric audiology
- Developmental psychology
- Behavioral science
Background:
- Children who are deaf or hard of hearing (DHH) exhibit higher rates of behavioral problems compared to their hearing peers.
- Existing evidence-based behavioral interventions are underutilized in the DHH population, with a lack of rigorous trials.
- This study addresses the critical need for effective interventions tailored to DHH children's unique needs.
Purpose of the Study:
- To evaluate the effectiveness of an adapted behavioral parent training intervention for parents of young children who are DHH.
- To assess implementation outcomes, including acceptability, feasibility, fidelity, and cost.
- To explore contextual factors influencing intervention delivery and outcomes.
Main Methods:
- A Type 1 hybrid effectiveness-implementation trial using a stakeholder-engaged, mixed-methods approach.
- Participants: Parents of young children who are DHH.
- Assessments: Parenting behaviors, child behaviors, hearing aid/cochlear implant adherence, speech and language development, and implementation outcomes.
Main Results:
- The study aims to determine the intervention's impact on parenting and child behaviors.
- It will provide data on adherence to hearing assistive technology.
- Implementation outcomes will be assessed from multiple stakeholder perspectives.
Conclusions:
- Findings will inform the development and dissemination of effective interventions for behavioral problems in DHH children.
- Successful implementation could significantly improve outcomes for DHH children and their families.
- This research aims to bridge the gap in evidence-based care for this population.
Purpose:
Children who are deaf or hard of hearing (DHH) and who use hearing aids or cochlear implants are more likely than their peers with typical hearing to exhibit behavior problems. Although multiple evidence-based interventions for child behavior problems exist, they are rarely delivered to children who are DHH, and no rigorous randomized controlled trials have been conducted to determine their effects with this population. This protocol describes a study aiming to test the effectiveness of an evidence-based behavioral parent training intervention adapted for parents of young children who are DHH and simultaneously to assess key implementation outcomes and multilevel contextual factors influencing implementation.
Method:
The protocol for a Type 1 hybrid effectiveness-implementation trial of a behavioral parent training intervention for parents of young children who are DHH is presented, including details of the study design, participants, assessments, and analyses. Using a stakeholder-engaged, mixed-methods approach, we will test the effects of the intervention versus treatment as usual on parenting behaviors, child behaviors, and a range of secondary effectiveness outcomes, including adherence to using hearing aids and cochlear implants as well as measures of child speech and language. We will assess the acceptability, feasibility, fidelity, and costs of the intervention from the perspectives of peer coaches who deliver the intervention, hearing health care clinicians (including audiologists and speech-language pathologists), and administrators of programs serving young children who are DHH.
Conclusions:
Results of this trial will inform future efforts to close the gap between prevalence of behavioral problems in young children who are DHH and access to and use of evidence-based interventions to prevent and treat them. If effective, this intervention could be widely implemented using strategies informed by the findings of this study to benefit young children who are DHH and followed in hearing health care and their families.
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