Understanding the impact of adaptations to a parent-mediated intervention on parents' ratings of perceived barriers, program attributes, and intent to use.
Let parents edit your parent-training slides—Medicaid families in this study felt fewer barriers and said they would use the strategies more.
01Research in Context
What this study did
Pickard et al. (2019) asked Medicaid families to help re-design Project ImPACT.
The team then ran a randomized trial. One group saw the new co-designed version. The other saw the original.
Parents rated how hard the program felt, how much they liked it, and if they would use it.
What they found
Parents who got the adapted version saw fewer roadblocks. They gave higher marks for program quality.
They also said they were more likely to use the strategies at home.
How this fits with other research
Ledbetter-Cho et al. (2023) later watched Early-Intervention providers use the same program. Fidelity rose with coaching, but staff still made lots of tweaks. The two papers together show: parents feel less burden when the program is co-designed, yet providers still adapt on the fly.
Dai et al. (2021) tested a fully online parent course. Parents liked it, but only two-thirds finished. The 2019 in-person co-design had stronger uptake, hinting that face-to-face joint planning may beat solo screen time.
Shepherd et al. (2018) surveyed 570 New Zealand parents. Cost and access were top reasons they skipped care. Pickard et al. (2019) cut those same barriers inside US Medicaid, showing the co-design move works where money is tight.
Why it matters
You can lift parent buy-in fast. Invite two or three families to preview your slides, time demands, and homework. Trim or swap any piece they call “too hard.” Try the lighter version in your next cycle and track how many parents actually run the strategies between visits.
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02At a glance
03Original abstract
Within the autism spectrum disorder field, rates of attrition in parent-mediated interventions have highlighted the need to engage families around improving the delivery of these services. The primary goal of this study was to approximate the impact of adaptations to an evidence-based, parent-mediated intervention, Project ImPACT (Improving Parents as Communication Teachers), that had been made in collaboration with families in a Medicaid system. A total of 103 parents of a child with autism spectrum disorder were randomized to watch a presentation of either the original or adapted Project ImPACT program. After watching the presentation, participants rated (1) demographic information, (2) perceived structural barriers, (3) Project ImPACT attributes, and (4) intent to use the program. Results from hierarchical linear regression models demonstrated that program type alone predicted parents' ratings of perceived structural barriers. Additionally, both program type and the interaction of program type and annual household income were unique predictors of parents' ratings of program attributes and intent to use. Qualitatively, although many parents reflected positively on both Project ImPACT programs, parents who viewed the adapted program appeared more likely to report positive program attributes. Results suggest the importance of engaging families in improving the fit of parent-mediated interventions for use within a variety of community settings.
Autism : the international journal of research and practice, 2019 · doi:10.1177/1362361317744078