Telegroup Parent Behavior Management Training for Disruptive Behavior: Mixed-Methods Comparison of Effectiveness and Engagement for White and BIPOC Caregivers

Background: Parent Behavior Management Training (PBMT) is the first-line psychosocial intervention for child disruptive behavior, though research documents disparities in PBMT engagement and effectiveness between Black, Indigenous, and People of Color (BIPOC) and White families. Objective: This study aimed to quantitatively compare clinical outcomes and satisfaction ratings of telegroup PBMT and qualitatively identify themes related to engagement and challenges among White and BIPOC caregivers. Method: Data from 177 caregivers (78% White; 22% BIPOC) of children aged 5 to 12 referred for treatment of disruptive behavior and/or ADHD were collected as part of measurement-based care (MBC) before and after participation in a nine-week one-hour PBMT telemedicine group. Data included caregiver report of their child’s inattention, hyperactivity and oppositional behavior, functional impairment and parenting behaviors. Post-treatment, caregivers provided satisfaction ratings and written open-ended suggestions to improve the group. Results: White caregivers attended significantly more sessions than BIPOC caregivers; thus, all analyses controlled for attendance. Both groups of caregivers reported significant reductions in children’s oppositional/defiant symptoms and functional impairment following group. Compared to BIPOC caregivers, White caregivers reported significant reductions in their child’s inattentive and hyperactive/impulsive symptoms and decreased use of inconsistent discipline. Overall satisfaction was high and did not differ across White and BIPOC caregivers. Qualitative feedback indicated that specific PBMT skills and group discussions/support were the most helpful aspects of the group. Themes related to specific PBMT content, timing (pace of group, scheduling), and other logistic barriers to participation were the most frequently reported unhelpful aspects or suggested improvements for group. Conclusion: This study highlights the importance of MBC and assessment of caregivers’ feedback to improve the programming of PBMT and access to equitable care. Our findings provide many realistic, scalable solutions to consider when implementing PBMT to better serve BIPOC families.