A self‐help version of the New Forest Parenting Programme for parents of children with attention deficit hyperactivity disorder: a qualitative study of parent views and acceptability

Abstract

Background: Although parent interventions are recommended as a frontline treatment approach for children with attention deficit hyperactivity disorder (ADHD), a number of practical and situational barriers can impact accessibility and availability. Self-help parent interventions offer a potential alternative to therapist-led interventions when barriers prevent access to face-to-face treatment. This qualitative study aims to explore participant views and acceptability of self-help parent interventions. Method: Semi-structured interviews were conducted with parents/carers of 12 children (age 6-10 years) with ADHD who received the self-help version of the New Forest Parenting Programme (NFPP-SH) as part of a randomised controlled trial. Thematic analysis (as proposed by Braun and Clarke) was used to analyse the data. Results: Overall, participants had favourable views of the self-help intervention but also experienced some barriers to treatment adherence. Six key themes were identified in parent interviews related to parental desire to learn more; acquisition of new skills; the flexibility of the intervention; self-help intervention vs. traditional therapist-led formats; barriers to engagement in the home environment; and need for earlier access to help. Conclusions: NFPP-SH was an acceptable intervention for parents. However, some parents may need additional support to overcome barriers associated with completing an intervention at home. Implications for healthcare providers and researchers developing selfhelp parent interventions for ADHD and child behaviour are discussed. Key Practitioner Message• Self-help parent interventions are known to be effective for reducing parent-reported child behaviour problems; effect sizes for parent-reported outcomes may be comparable to therapist-led intervention.• To our knowledge, this is the first study to use qualitative methods to explore participant views and acceptability of self-help parent interventions for children with attention deficit hyperactivity disorder (ADHD).• Our findings suggest that parents had favourable views of the self-help version of the New Forest Parenting Programme (NFPP-SH).• Clinicians and service commissioners may wish to consider offering NFPP-SH to parents of children with ADHD, especially soon after diagnosis when parents may be seeking additional information, or where barriers to face-to-face treatment exist.

Acceptance and utilization of web-based self-help for caregivers of children with externalizing disorders

“…Previous analyses have likewise indicated a preference for online treatment for caregivers of children with anxiety and depression [17]. Flexibility in parent training, as a key element of acceptance, was also reported by Tarver and colleagues in qualitative analyses of an ADHD self-help program [53].…”

“…Some variables, however, were exclusively relevant for either frequency or intensity of use: The presence of siblings in the same household is one factor that may prevent caregivers from using web-based interventions [53]. Using CART, we were able to show that the number of persons per household did affect caregivers' frequency of use (but not the intensity).…”

“…A recent study by Tarver et al (2021) identi ed several factors that may act as barriers to the utilization of web-based PMT, such as the presence of siblings during the intervention [25]. Unfortunately, most research ndings do not allow for reliable inferences regarding the direct in uence of individual variables (e.g., socioeconomic status) on the utilization of web-based interventions [15].…”

“…DuPaul and colleagues recommend focusing on possible predictors in order to provide the optimal care tailored to the needs of individual families, as their research demonstrated similar effects of face-to-face and online PMT in terms of acceptability and engagement [19]. However, in addition to sociodemographic and socioeconomic factors that may affect the utilization of web-based interventions, telephone-based support by therapists has been found to improve adherence and motivation [25]. Indeed, our own investigations showed that low-frequency telephone-based support by specialists can even improve the outcome effects of an intervention [26].…”

First-line Behavioral Health Treatment Prior to Stimulant or Alpha-2 Agonist Use for Preschoolers on Kentucky Medicaid in 2017

“…Lastly, more research is needed to inform the development of family-centered interventions and strategies to engage families in behavioral parent training (Spencer et al, 2021). Much remains unknown about the timing, dose, duration, and delivery method (face-to-face, virtual, or combination) (DuPaul et al, 2018; Spencer et al, 2021; Tarver et al, 2022). Spencer et al (2021) developed a framework describing six stages of engagement in care for children with ADHD.…”