Creation and Refinement of a Technology-based Intervention for Parents of Children with Disruptive Behavior Problems

• In Event: 2-047 - Making an App for That: Initial program creation and evaluation of technology-based parent guidance programs

Integrative Statement

This investigation describes the initial creation and refinement of the Parenting Young Children Check-up (PYCC). The PYCC is a three-part, technology-based system for detecting and responding to disruptive behavior problems (DBPs) in young children (ages 2-5). First, parents complete a screener for DBPs while waiting at a pediatric visit. Second, if the screener is positive, parents go through a brief, tablet-based intervention. Third, parents’ receive tailored text messages. Fourth, text messages contain links to a parent training website that teaches parenting skills.

Development and evaluation of the PYCC is following the ORBIT model (Czajkowski et al., 2015); a NIH-recommended intervention development framework. This project focuses on the second step, Define and Refine, in which initial intervention materials are created and refined based on mixed methods feedback. A beta version of the tablet-based intervention was created through the Computerized Intervention Authoring System (CIAS). CIAS allows non-programmers to create interactive technology-based interventions and delivers text messages. Next, we created parent training videos to populate the website. Videos to teach parenting skills were created by blending animation with clips of actors depicting skills.

Feedback from physicians and parents is being sought through an iterative process. The first iteration of data collection is complete and includes 6 physicians (4 pediatricians and 2 family medicine doctors) and 5 parents. The parents are low-income, African-American mothers recruited from a University-based participant registry. All participants completed a survey, viewed PYCC beta materials (see Figure 1), completed a qualitative interview, and completed a feedback survey. Interviews were coded for positive, negative/critical, and skeptical comments about the intervention and specific suggestions for improvements.

On the survey, 5 physicians reported that DBPs were common topics of discussion during visits and all 6 physicians reported openness to the program. In the interview, physicians made more positive than negative comments. Physicians were most positive about the use of texts and the website. Five physicians expressed skepticism about the screening and brief intervention and gave suggestions about how to improve these parts of the intervention. Three physicians gave suggestions about how to improve the website content. The feedback survey was consistent with the interviews. All 5 parents reported elevated child behavior problems, but only 2 (of 5) felt the behavior was a problem for them. On the initial survey, only two said they would use a parent training website, but after seeing beta materials all parents expressed openness to using the PYCC and all 5 parents gave positive ratings to the program on the feedback survey. All 5 parents made positive comments about the program; parents were equally positive about the brief intervention, texts, and website. No parents were critical or skeptical about the text messages. Three parents gave specific suggestions to improve the program. Table 1 provide examples of quotes coded as positive and specific suggestions.

Based on the first iteration, program refinements were made. A second iteration of data collection is underway; a third will be complete if additional improvements are needed. Examples of final program content will be presented.

Authors

• Lucy (Kathleen) McGoron, Wayne State University
  Presenting Author

• Sharmi Purkayestha, Wayne State University
  Non-Presenting Author

• Elizabeth Towner, Wayne State University
  Non-Presenting Author

• Ronald Gallimore, University of California-Los Angeles
  Non-Presenting Author

• Steven J Ondersma, Wayne State University
  Non-Presenting Author