Parent training for parents of toddlers born very premature: A factorial design to test web delivery and telephone coaching

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PROJECT SUMMARY/ABSTRACT Childhood behavior problems are a top mental and public health priority. Problem behavior such as aggression, defiance, and noncompliance emerge as early as 2 years of age and can persist through adolescence and adulthood leading to long term functional and psychological maladjustment. Children born very premature (VPT; gestational age at birth < 32 weeks) are twice as likely to demonstrate behavioral problems as their peers. Despite the risk and occurrence of behavior problems in the VPT population, early intervention tends to focus on treatment of developmental delays with very few resources for parents to manage behavior issues. Behavioral parent training (BPT) is an effective treatment for families of children with problem behaviors. However, little is known about the use of BPT programs for former VPT infants with their unique medical, developmental, and psychological risk profiles. In addition, system and individual barriers effect parent access and engagement in BPT. In an effort to address tailored needs of these families and service barriers, BPT delivery via digital applications and engagement strategies like telephone coaching calls can provide accessible and tailored approaches to support parents of young children. Currently, there is no effective, accessible BPT intervention for former VPT infants. The purpose of the study, “Parent training for parents of toddlers born very premature: A factorial design to test web delivery and telephone coaching” is to develop a new, accessible and effective form of BPT delivery to address the unmet and unique needs of parents of VPT children. The BPT program proposed in this study is an adaptation of the evidence-based based Chicago Parent Program (CPP) called the ezParent. The study design is a factorial design to test a hybrid approach of digital ezParent and telephone coaching calls. Coaching calls are meant to reinforce parent learning and support tailoring strategies to their child’s developmental level and needs. Parent and child (aged 20-30 months corrected) dyads will be recruited from two Midwest NICU follow up clinics within Chicago, IL and Columbus, OH. Parents (n=220) will be randomized to one of four conditions: (1) ezParent+coach, (2) ezParent, (3) Active Control+coach, or (4) Active Control. We will test the independent and combined effects of ezParent and coaching calls on parent and child outcomes. We will evaluate the differences in ezParent dose and engagement with and without coaching calls. Parent and child data will be assessed at baseline, and 3-, 6- and 12-months post baseline. Providing low intensity, digitally delivered interventions has the potential for influencing engagement and address challenges in service delivery for parents of VPT children at higher risk for behavioral problems and with elevated behavior problems.