What Works Better? 1-Year Outcomes of an Effectiveness Trial Comparing Online, Telehealth, and Group-Based Formats of a Military Parenting Program.

Objective: The present study, conducted with a population of military families, examined the comparative effectiveness of three program formats of Adaptive Parenting Tools (ADAPT), a parenting program for families of school-aged children in which a National Guard or Reserve (NG/R) parent had returned from deployment to the post-9/11 conflicts. Despite well-documented need, parenting programs for NG/R families are scarce and often inaccessible. We predicted that both facilitator-delivered conditions (i.e., in-person group; individual telehealth) would result in stronger improvements in observed parenting than assignment to the online self-directed condition. We further proposed a noninferiority hypothesis wherein no significant difference would be detected between telehealth and group conditions. Method: Families (N = 244; 87% Caucasian) were recruited from NG/R units in two midwestern states. Families (with a 5–12-year-old child) were randomized to one of three conditions: in-person multifamily group, individual telehealth, or an online, self-directed condition. The intervention was delivered using the same content across conditions, over 14 weeks (group, telehealth conditions) or 12 modules (online condition); either or both parents could participate. Results: Intent-to-treat analyses supported both hypotheses: families in both in-person group and telehealth conditions showed significant improvements to observed parenting at 1-year postbaseline compared with those assigned to the self-directed online condition. Conclusions: This is the first study to demonstrate that in-person group and telehealth parenting programs are equally effective and that both are superior to a self-directed online program. Limitations include differences between the session lengths in each format, as well as greater attrition in the in-person format. What is the public health significance of this article?: Over the past decade or so, telehealth interventions (i.e., those offered by practitioners using a live video feed) have become common, but few studies have examined whether they are as effective as in-person parenting programs. This study compared telehealth, in-person group, and a self-directed online format of the same parenting program for military families. Families (N = 244) were randomly offered one of the three formats. Analyses of parenting practices at baseline and after 1 year showed that both the telehealth and the in-person group program led to significant improvements in parenting and were superior to the online self-directed program. Telehealth parenting programs appear to be a valuable and helpful way to support parents under stress. [ABSTRACT FROM AUTHOR]