Factor Structure of the Obstacles to Engagement Scale: Problems, Solutions, and Hypotheses.

Behavioral parent training is an efficacious treatment for children with externalizing behavior problems, but many parents refuse to attend treatment and/or terminate prematurely. The Obstacles to Engagement Scale (OES) assesses the impact of personal and intervention-based obstacles on attending parent training. The published factor structure of the OES has an unstable, two-item subscale and has not been confirmed. We ran exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) and, consistent with literature, hypothesized that factors would differ across different demographic groups. An EFA was conducted on 192 parents of 2-8 year old children presenting to primary care pediatric clinics, with a CFA on a similar sample. CFA failed to support a stable factor structure for the full sample. An EFA on 129 parents with at least a college degree revealed a 3-factor solution: Health and legal barriers, Belief in utility and effectiveness, and Personal barriers. This structure was confirmed with a CFA on 53 parents. Consistent with our hypothesis, this model did not fit for parents with less than a college education. Findings of differences based on amount of education of parents supports the need for additional research on the factor structure and predictive validity of the OES for parents with more or less education. Research should continue to examine educational differences in willingness to attend and belief in efficacy of psychological treatments. Interventions to improve attendance at empirically supported treatments need to be customized based on education of parents. Larger samples will be needed to assess the factor structure for other relevant groups. [ABSTRACT FROM AUTHOR]