Feasibility and Preliminary Efficacy of an Online Parenting Skills Intervention: Gaining Real-Life Skills Over the Web (GROW)

ABSTRACT

Objective: Despite the high prevalence of pediatric traumatic brain injury (TBI) in children under 5 years of age, there has been limited research about early family support and interventions for this age group. Given that TBI can disrupt parent-child interactions and parent-child interactions are central for child development, we developed an online parenting skills intervention (Gaining Real Life Skills over the Web;GROW) to improve TBI recovery. The online parenting skills program aims to improve caregiver functioning and increase positive parenting behaviors. The purpose of this pilot study was to examine feasibility, acceptability, and preliminary efficacy of the program. Methods: Parents learned strategies for responsive parenting while integrating stress management and self-care techniques by reviewing online content and videos and practicing parenting skills with therapist feedback over 8 weeks. The online content consisted of 5 core modules with the option for 1 supplemental session. Primary study outcomes were feasibility, acceptability, and efficacy of the GROW program to improve caregiver functioning and positive parenting behaviors. Qualitative interviews and satisfaction questionnaires will be analyzed to identify common themes and suggestions across participants. Results: To date, of 63 potentially eligible parents 23 agreed to participate (36.5%), 19 declined (30.2%), and 21 are currently being recruited (33.3%). Of the 23 who agreed to participate 10 completed baseline visits (43.5%), 5 are scheduled (21.7%), and 8 are being rescheduled (34.7%). Four parents have completed the program thus far and rated the program as both helpful and enjoyable, finding the coaching to be particularly valuable. Preliminary findings also trend toward an increase in caregiver functioning and positive parenting behaviors. Suggestions for improving the program were oriented towards shortening the program length. Families acknowledged the difficulty in dedicating time to review web content, complete homework, and meet with the therapist weekly. Families with very young children are busy;a challenge made even more difficult amid the influence of COVID and its added stressors. Final pilot data will be presented at the time of the conference. Conclusion: Despite promising feedback about the value of the program, low rates of participation underscore the challenges of engaging parents of very young children. Disruptions due to the COVID-19 pandemic likely made uptake even lower. Assuming that preliminary evidence for acceptability and efficacy are confirmed, next steps include working with stakeholders to preserve key content while redesigning the program to minimize barriers (e.g., shorten modules) and increase engagement. Efforts to identify and target the unique stressors associated with parenting a very young child will be essential to promote uptake. Ultimately, a larger-scale randomized control trial is needed in order to examine the relative efficacy of the program in relation to a comparison group.