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ezParent Implementation Bundle

ezParent Implementation Bundle

Positive parenting practices help support optimal child social and emotional development. Parent training is considered a gold standard for supporting and strengthening parenting practices and for treating and preventing child behavior problems. A new research grant awarded to Klein Buendel will develop and test a comprehensive implementation package (the ezParent Bundle) to support the hybrid delivery of the ezParent Program.

Klein Buendel Research Investigator, Ms. Julia Berteletti, and the Klein Buendel Creative Team are collaborating with Dr. Susan Breitenstein from Ohio State University (Principal Investigator) on the project. ezParent is the web-based delivery mechanism of the Chicago Parent Program. ezParent integrates empirically supported parenting strategies and includes video vignettes, interactive activities, and in-home practice. The new bundle will include asynchronous web-based facilitator training and the ezParent dashboard, which allows facilitators to track parent program use and offer support.

Young children’s behavioral health is declining with current estimates of up to one-third of preschool children exhibiting behavior problems (such as tantrums, defiance, and aggression). Behavior problems have been more pronounced in minoritized and low-income populations and because of the COVID-19 pandemic. Positive and supportive parenting can buffer the negative effects of early adverse experiences and childhood trauma.

The primary method of delivering parent training involves face-to-face, in-person sessions. Although effective, there are multiple limitations with in-person parent training delivery affecting access and reach (such as time; schedule conflicts; access to childcare, transportation, trained facilitators; and stigma). These barriers result in many referred parents not receiving parent training. Parent completion access issues are more pronounced in underserved communities. An overall goal of this research is to expand parent training access in community organizations dedicated to serving low-income families [such as Head Start and Early Head Start (HS/EHS)].

Many web-based parent training programs are self-administered, yet there is evidence suggesting web-based programs are more effective when paired with human support, known as hybrid delivery. Trained facilitators can foster parent completion of web-based programs and tailoring of strategies. However, parent training programs lack a proven method for systematically integrating facilitator training in an accessible manner. In addition, for hybrid models to be effective, facilitators require methods to monitor and track parent use of the program. Real-time access to training can increase program sustainability and user tracking allows support to be tailored based on parent program use and individual needs.

The ezParent bundle will be evaluated in a cluster randomized trial in 16 HS/EHS sites with personnel facilitators and 516 parents of children aged 2-5 years old. The investigators hypothesize that relative to the control group, parents in the ezParent bundle group will report greater improvements in parenting skills and self-efficacy, parent-child relationship, and reductions in child behavior problems.

This STTR Fast Track grant was awarded to Klein Buendel by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD116627; Dr. Susan Breitenstein, Principal Investigator from Ohio State University). Research collaborators include Ms. Julia Berteletti from Klein Buendel, and Dr. Amie Bettencourt and Dr. Deborah Gross from Johns Hopkins University. The ezParent technology will be designed and programmed by the Creative Team at Klein Buendel.

Usability Evaluation of the ezParent Administrative Dashboard

Usability Evaluation of the ezParent Administrative Dashboard

A team from Ohio State University and Klein Buendel has published results from the usability testing of the ezParent administrative dashboard in JMIR Formative Research. ezParent is a web-based training program for parents of children ages 2-6 years. It provides behavioral training through brief videos, interactivity, reflection questions, and assessments to parents of young children. 

Web-based parent training programs can strengthen parent-child relationships. They can help equip caregivers with knowledge and evidence-based strategies to manage behavior. They also can help surmount some logistical and personal barriers of in-person parent training. Web-based administrative dashboards provide administrators, facilitators, researchers, and others with detailed information about their participants’ usage, which can strengthen delivery of the intervention. Despite the utility of administrative dashboards, the authors know of no other research studies that have explored the perspectives and insights of dashboard users.

The study described in JMIR Formative Research used a descriptive, single-group survey design with four administrators who were overseeing implementation of the ezParent program and 19 trained facilitators for hybrid ezParent delivery. Participants were instructed to spend 30 minutes reviewing and assessing the ezParent dashboard and then prompted to complete a survey of their interaction with it. The survey included the validated 10-item System Usability Scale (SUS) and some open-ended questions.

Fifteen respondents indicated high usability of the ezParent dashboard, with a total mean SUS score of 83.5. Most participants (87%) rated the user-friendliness of the dashboard as good (20%), excellent (60%), or best imaginable (7%). Open-ended questions revealed the dashboard would be useful to monitor parent progress (40%), communicate with parents (13%), to review topics for discussion (20%), and to identify trends in parent participation (13%). ezParent administrators identified real-time data for ezParent users helps overall management of program uptake. Suggestions for features to add to the dashboard included the ability to track partial progress of program modules (29%), total time spent per module (14%), and exportable reports (7%). Other ideas for improvement included direct messaging capabilities, video-conferencing platform integration, and the ability to modify participant account and contact information.

Results indicate that the dashboard is easy to use and provides functional information to facilitators and administrators in delivering ezParent. Providing resources to aid in facilitation of the hybrid intervention may foster improved parent uptake and outcomes. Integrating suggested features into the dashboard may help provide a smoother experience for facilitators, administrators, and parents using the program.

This research was sponsored by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD104072; Dr. Susan Breitenstein, Principal Investigator, Ohio State University). Collaborating authors include Ms. Julia Berteletti and Mr. Charlie Barger from Klein Buendel; and Shea Smoske, Kyrie Tipps, and Nathan P. Helsabeck from The Ohio State University. The ezParent web-based program and administrative dashboard were programmed by the Creative Team at Klein Buendel.