Remote versus face-to-face delivery of the Group Triple P parenting programme: a feasibility non-randomised trial

BACKGROUND: Many well-designed parenting interventions have demonstrated effectiveness in improving outcomes for parents and children. During the COVID pandemic, many group-based parenting interventions were rapidly transferred to remote delivery using online videoconferencing platforms. However, the evidence on the effectiveness of remotely delivered group-based parenting programmes, compared to face-to-face programmes, remains inconclusive. This trial aimed to assess the feasibility of delivering the Group Triple P intervention to parents/caregivers of young children to inform a potential, definitive trial of the effectiveness and cost-effectiveness of Group Triple P delivered remotely compared to face-to-face delivery. METHODS: This study was a feasibility non-randomised trial, with embedded process evaluation. Parents/caregivers of a child (up to 12 years old) were recruited by Local Authority or independent provider research sites and self-selected remote or face-to-face delivery of the Group Triple P intervention. Data were collected at baseline and 16 weeks follow-up. The following feasibility outcomes were assessed: site recruitment, participant recruitment rates and retention at the 16-week follow-up, intervention adherence, fidelity and reach, feasibility of trial processes and outcome measures (including resource use, cost and health-related quality of life) and Local Authority and independent service provider willingness to participate in a definitive trial. RESULTS: All sites utilised a multi-point participant recruitment strategy, relying on existing pathways to identify families. Only two sites reached participant recruitment targets. Participants' self-selected remote delivery (23 participants) or face-to-face delivery (19 participants) and baseline demographics, except for education level, were balanced across arms. A 66.7% retention rate was observed at 16 weeks. Most trial processes were acceptable to participants and site staff. However, randomisation was not considered acceptable to site staff or 37.5% of participants, due to the removal of participant choice. The intervention was delivered to high fidelity, except for some intervention adaptations. Participant engagement in the remote arm was hampered by inconsistent use of cameras and little interaction between parents and facilitators. CONCLUSIONS: A number of barriers to using a randomised trial design were identified. Ongoing research should consider a potential non-randomised definitive trial to assess the use of remotely delivered group-based parenting interventions and to overcome these barriers. TRIAL REGISTRATION: ISRCTN81494090, 19/09/2023.