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Stepping up to COVID-19: A Clinical Trial of a Telepsychology Positive Parenting Program Targeting Behavior Problems

Angela Deotto1,2, Giulia F Fabiano1, Beryl Y T Chung1,3

  • 1Division of Neurology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada.

Journal of Pediatric Psychology
|June 15, 2023
PubMed

Insights

This study shows a stepped-care parenting program effectively supported families of children with developmental disorders during COVID-19. The program improved child behavior and parenting skills, offering accessible mental health services.

Area of Science:

  • Child Psychology
  • Clinical Psychology
  • Telehealth Interventions

Background:

  • Behaviorally at-risk children with neurological or neurodevelopmental disorders often require specialized parenting support.
  • The COVID-19 pandemic created significant barriers to accessing traditional mental health services.
  • A stepped-care model offers a flexible approach to tailor psychological support to individual family needs.

Purpose of the Study:

  • To assess the feasibility, acceptability, and preliminary efficacy of a stepped-care parenting program (I-InTERACT-North) for families of children with developmental disorders during the COVID-19 pandemic.
  • To evaluate the program's ability to provide accessible and effective psychological support through a tiered system.
  • To determine if the stepped-care model could improve engagement and outcomes compared to traditional delivery methods.

Main Methods:

  • A pragmatic, prospective, pre-post mixed-method design was employed.
  • The stepped-care intervention involved three tiers: guided self-help (podcast), brief support, and longer-term parent support.
  • Recruitment occurred through hospital and research cohort referrals, with data collected over 15 months.

Main Results:

  • High enrollment (68 families) and completion rates (56 families) were achieved, with strong adherence across all intervention steps.
  • Parents reported high acceptability, citing accessibility, comprehension, effectiveness, and tailored care.
  • Significant improvements in positive parenting skills and child behavior problems were observed, particularly after Step 3 completion (p =.001, d = .390).

Conclusions:

  • The stepped-care telepsychology parenting program is a feasible and acceptable model for delivering mental health interventions to families of children with developmental disorders.
  • This model effectively addresses gaps in accessible mental health services and balances efficiency with targeted care.
  • Findings support the scalability of stepped-care interventions for mental health treatment delivery and monitoring, even beyond the pandemic context.
Abstract

Keywords:
COVID-19child behaviorearly brain injurymental healthneurodevelopmentalparentingstepped-caretelepsychology

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