OBJECTIVE Despite effective treatment options, many families-especially those from marginalized backgrounds-lack access to quality care for their children's behavioral difficulties. Since the COVID-19 pandemic, telehealth has become a prominent format for the delivery of outpatient services, with potential to increase access to quality care. Although telehealth-delivered parenting interventions are associated with positive clinical outcomes, limited research has examined whether telehealth formats improve treatment engagement relative to office-based care. The present study is the first controlled comparison of engagement across office-based parent-child interaction therapy (PCIT) and internet-delivered PCIT (iPCIT). METHOD Children ages 3-5 years, and their caregiver(s) (N = 40) participated in a randomized trial comparing iPCIT to office-based PCIT in the treatment of behavioral problems. Analyses examined the effects of treatment format on engagement (i.e., missed sessions, premature treatment discontinuation, homework completion, therapeutic alliance, and treatment satisfaction). Logistic and linear regressions further explored whether treatment format moderated the effects of common predictors of treatment engagement (i.e., family economic means, racial/ethnic background, caregiver stress). RESULTS iPCIT improved attendance rates relative to office-based PCIT, especially for families from minoritized racial/ethnic backgrounds. At the same time, among families with relatively higher levels of caregiver stress, office-based PCIT was associated with lower dropout rates and improved treatment alliance and satisfaction, relative to iPCIT. CONCLUSIONS This study provides the first experimental support that telehealth formats can improve treatment attendance in behavioral parenting interventions. Findings highlight nuances in treatment engagement across treatment formats that reveal limits to the extent telehealth transcends engagement concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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家庭参与行为育儿干预：远程医疗与基于办公室的治疗形式的随机比较。


目的 尽管有有效的治疗方案，但许多家庭——尤其是那些来自边缘化背景的家庭——无法获得针对孩子行为困难的优质护理。自 COVID-19 大流行以来，远程医疗已成为提供门诊服务的一种重要形式，有可能增加获得优质护理的机会。尽管远程医疗提供的育儿干预与积极的临床结果相关，但有限的研究检查了远程医疗形式是否能相对于办公室护理提高治疗参与度。本研究是基于办公室的亲子互动疗法 （PCIT） 和互联网交付的 PCIT （iPCIT） 的参与度的首次对照比较。方法 3-5 岁的儿童及其照顾者 （N = 40） 参加了一项随机试验，将 iPCIT 与基于办公室的 PCIT 在行为问题治疗方面进行比较。分析检查了治疗形式对参与度 （即错过治疗、过早停止治疗、家庭作业完成、治疗联盟和治疗满意度） 的影响。Logistic 和线性回归进一步探讨了治疗形式是否调节了治疗参与的常见预测因素（即家庭经济收入、种族/民族背景、照顾者压力）的影响。结果 相对于基于办公室的 PCIT，iPCIT 提高了出勤率，尤其是对于来自少数种族/民族背景的家庭。同时，在照顾者压力水平相对较高的家庭中，相对于 iPCIT，基于办公室的 PCIT 与较低的退出率以及更好的治疗联盟和满意度相关。 结论 本研究提供了第一个实验支持，即远程医疗形式可以提高行为育儿干预的治疗出勤率。研究结果强调了不同治疗形式治疗参与度的细微差别，这些细微差别揭示了远程医疗超越参与问题的程度的局限性。（PsycInfo 数据库记录 （c） 2024 APA，保留所有权利）。