Assessing the Satisfaction and Acceptability of an Online Parent Coaching Intervention: A Mixed-Methods Approach

Abstract

BackgroundParent-mediated intervention (PMI) has been studied in promoting skill acquisition or behavior change in the children with autism spectrum disorder. Most studies emphasize on the improvement of child’s core symptoms or maladaptive behaviors, making parental perceived competence and self-efficacy secondary. Yet, the evaluations of intervention implementation are under-reported, especially when translating such interventions into a new population or context. This research investigated the intervention implementation of a 12-week parent coaching intervention which was delivered through telehealth and tailored to Chinese population. The intervention was based on the Parent-mediated Early Start Denver Model with culturally adapted lectures, manuals, and demonstration and commentary videos. This study aimed to evaluate the intervention implementation by assessing parents’ satisfaction, acceptability, appropriateness, and feasibility.MethodA randomized controlled trial was conducted with two telehealth conditions: self-directed and web+group therapy. Parents in the self-directed condition received intervention individually through the online learning platform. The web+group therapy condition navigated the same program with weekly 1.5-h group coaching sessions via videoconferencing. This mixed-methods study used a concurrent convergent design to evaluate the intervention implementation at post-intervention. The quantitative data was collected from the Program Evaluation Survey and the qualitative data was collected from five focus groups.ResultsParents in self-directed group reported significantly lower scores in total perceived competence than parents in web+group therapy condition, while there was no group difference on the total self-efficacy. Tailored feedback, demonstration and commentary videos, peer commenting, live coaching, and guided reflection were the top-five acceptable telehealth strategies that were strongly endorsed by parents. Family centered care, home-based intervention, strategies relative to daily activities, the remote learning platform, and the program-based community were elements that parents considered when evaluating the program’s appropriateness. Parent modeling, step-by-step instructions, and tailored feedback were key components in making intervention strategies feasible for parents to implement at home.ConclusionFindings indicate the application of telehealth was acceptable, appropriate, and feasible for Chinese parents. Group-based parent coaching intervention via videoconferencing could be a promising home-based service model to increase parental perceived competence. A large-scale RCT is needed to investigate the effectiveness of group-based PMI via telehealth.

Comparison of the efficacy of parent-mediated NDBIs on developmental skills in children with ASD and fidelity in parents: a systematic review and network meta-analysis

“…During the randomization process, three studies were deemed high-risk due to the absence of randomization [ 32 , 37 , 36 ]. In terms of outcome measurement, three studies were considered high-risk: one due to parental completion of assessments [ 35 ], and the other for the use of self-made scale [ 34 ] and reliance on a single scale throughout the research [ 23 ]. The remaining studies were categorized as low risk or presented some concerns.…”

Evidence-Based Implementation of the Family-Centered Model and the Use of Tele-Intervention in Early Childhood Services: A Systematic Review

“…The findings suggested that the use of tele-intervention in that procedure was effective in achieving goals. A subsequent study published by Qu et al [ 45 ] in a population with Autism Spectrum Disorder (ASD) used the same intervention method and obtained positive results in terms of family perception variables.…”

“…Subsequent research continues this line of prevention and intervention in determining aspects of the health of infants aged 0 to 6 years, showing rates of effectiveness and acceptability, in which the figure of the family and its context are highlighted in the process [ 42 , 45 , 51 , 53 , 54 , 57 ].…”

“…The authors agree that the perception of the service is conditioned by the quality of the therapeutic relationship. When the practitioner takes into account the values, beliefs and needs of the family [ 43 ], as well as their demands and concerns [ 42 ] when agreeing on intervention goals, and provides a safe environment where support and guidance is offered [ 52 , 59 , 70 ], satisfaction, confidence, the sense of competence and empowerment increase [ 41 , 44 , 45 , 46 , 64 ]. These variables are related to the family quality of life, which is considered the ultimate goal of early intervention [ 59 ], being important predictors of service quality and social validity [ 42 ].…”

Parent-Implemented Interventions via Telepractice in Autism Research: A Review of Social Validity Assessments

“…It is also important to collect data on different dimensions of social validity, including goals, procedures, and outcomes, and across different times (e.g., before and after the intervention) when assessing social validity. Moreover, it is helpful to use the social validity data to understand other types of data and make adaptations to the intervention iteratively [37,38].…”