Data_Sheet_2_Assessing the Satisfaction and Acceptability of an Online Parent Coaching Intervention: A Mixed-Methods Approach.PDF

BackgroundParent-mediated intervention (PMI) has been studied in promoting skill acquisition or behavior change in the children with autism spectrum disorder. Most studies emphasize on the improvement of child’s core symptoms or maladaptive behaviors, making parental perceived competence and self-efficacy secondary. Yet, the evaluations of intervention implementation are under-reported, especially when translating such interventions into a new population or context. This research investigated the intervention implementation of a 12-week parent coaching intervention which was delivered through telehealth and tailored to Chinese population. The intervention was based on the Parent-mediated Early Start Denver Model with culturally adapted lectures, manuals, and demonstration and commentary videos. This study aimed to evaluate the intervention implementation by assessing parents’ satisfaction, acceptability, appropriateness, and feasibility.
MethodA randomized controlled trial was conducted with two telehealth conditions: self-directed and web+group therapy. Parents in the self-directed condition received intervention individually through the online learning platform. The web+group therapy condition navigated the same program with weekly 1.5-h group coaching sessions via videoconferencing. This mixed-methods study used a concurrent convergent design to evaluate the intervention implementation at post-intervention. The quantitative data was collected from the Program Evaluation Survey and the qualitative data was collected from five focus groups.
ResultsParents in self-directed group reported significantly lower scores in total perceived competence than parents in web+group therapy condition, while there was no group difference on the total self-efficacy. Tailored feedback, demonstration and commentary videos, peer commenting, live coaching, and guided reflection were the top-five acceptable telehealth strategies that were strongly endorsed by parents. Family centered care, home-based intervention, strategies relative to daily activities, the remote learning platform, and the program-based community were elements that parents considered when evaluating the program’s appropriateness. Parent modeling, step-by-step instructions, and tailored feedback were key components in making intervention strategies feasible for parents to implement at home.
ConclusionFindings indicate the application of telehealth was acceptable, appropriate, and feasible for Chinese parents. Group-based parent coaching intervention via videoconferencing could be a promising home-based service model to increase parental perceived competence. A large-scale RCT is needed to investigate the effectiveness of group-based PMI via telehealth.

**背景**
家长介导干预（Parent-mediated intervention, PMI）在促进孤独症谱系障碍（autism spectrum disorder）儿童技能习得或行为改变领域已得到广泛研究。既往多数研究聚焦于改善患儿核心症状与适应不良行为，却将家长感知能力与自我效能感置于次要地位。此外，针对干预实施过程的评估报道相对匮乏，尤其当此类干预被迁移至新人群或新场景时，该问题更为突出。本研究针对一项面向中国人群、依托远程医疗（telehealth）开展的12周家长指导干预，对其实施过程进行了探究。该干预以家长介导早期丹佛模式（Parent-mediated Early Start Denver Model）为基础，配套经过文化适配的授课内容、手册、演示与解说视频。本研究旨在通过评估家长的满意度、可接受性、适宜性与可行性，对该干预的实施效果进行评价。
**方法**
本研究采用随机对照试验（randomized controlled trial）设计，设置两种远程医疗干预条件：自主学习组与网络+团体治疗组。自主学习组家长通过在线学习平台单独接受干预；网络+团体治疗组则在统一课程框架下，每周通过视频会议参与1.5小时的团体指导课程。本混合方法研究（mixed-methods study）采用并行收敛设计，在干预结束后对干预实施情况进行评估。定量数据来源于项目评估问卷（Program Evaluation Survey），定性数据则来自5场焦点小组（focus groups）访谈。
**结果**
自主学习组家长的总感知能力得分显著低于网络+团体治疗组家长，但两组家长的总自我效能感得分无显著组间差异。家长高度认可的前五类远程医疗干预策略依次为：定制化反馈、演示与解说视频、同伴互评、实时指导与引导式反思。家长在评估项目适宜性时，主要考量以下要素：以家庭为中心的照护、居家干预、贴合日常活动的策略、远程学习平台以及项目配套社群。而家长认为能让居家干预策略更具可行性的核心要素包括：家长示范、分步指南与定制化反馈。
**结论**
研究结果表明，远程医疗模式对于中国家长而言具备可接受性、适宜性与可行性。依托视频会议开展的团体家长指导干预，或可成为提升家长感知能力的极具潜力的居家服务模式。未来仍需开展大规模随机对照试验（large-scale RCT），以探究远程团体家长介导干预的实际效果。