(PS3-50) It is just too much to do at once: Understanding if Brief Parenting Programs Delivered via Telehealth to Meet the Needs of Parents with Executive Functioning Difficulties

Parenting interventions are the first step to helping up to 20% of children showing elevated externalizing concerns during early childhood. Generally, parenting interventions help parents practice more positive parenting and behavior management strategies. They reduce harsh parenting, parenting stress, and children’s externalizing concerns while also improving positive parenting. Group-based parenting programs delivered through telehealth are effective, scalable, accessible, and empower parents through supporting each other. Yet nearly 50% of families disengage from them and up to 60% of families show limited to no benefit. Parental executive functioning (EF) may be involved as difficulties in EF processes (e.g., inhibiting impulses, controlling attention, planning goals, being flexible) likely interfere with attending the intervention and applying parenting strategies in the real-world. Parents with EF difficulties are an important population to provide targeted support since they are at greater risk for using harsh parenting and perpetrating child physical abuse. It is crucial to adapt programs that are more accessible among this population. We will examine if adapting parenting programs to be delivered briefly and via telehealth improves the reach and effectiveness of parenting programs among parents with EF difficulties. This study employed an explanatory sequential mixed methods design. Parents completed the Behavior Rating Inventory of Executive Function (BRIEF) prior to receiving the adapted parenting program. We will recruit at least 15 parents experiencing EF difficulties, which was determined by an elevated Global Executive Composite (GEC) score on the BRIEF. We recruited parents from a large children’s hospital and a group of Head Start programs serving a diverse population of children ages 0-5, with 59% Hispanic/Latino, 28% Black/African American, and 16% Biracial or Multiracial, all meeting federal low-income eligibility guidelines. We will conduct semi-structured interviews with parents experiencing EF difficulties to identify adaptations necessary to improve intervention effects from the behavioral parenting group. Among our current sample (n=4), preliminary findings revealed several themes for barriers to effectiveness: Behavioral parenting group was hard to access on phones, missing support after group ends, experienced distractions related to telehealth delivery, and it was hard for parents to remember what to do between sessions. Facilitators to reach and effectiveness were also identified: Sessions were short, smaller groups helped with participation and engagement, it was accessible due to telehealth delivery, and reminders to join were helpful. We will conduct interviews with more parents experiencing EF difficulties to reach thematic saturation and conduct rapid qualitative analyses to understand implementation outcomes and parents’ experiences with the accessibility adaptations. These findings will also be presented in this poster.