Hybrid Psycho-educational Intervention for Caregivers of Children with Developmental Delay: Random Control Trial

Research Objectives: To investigate the impact of hybrid mode psycho-educational intervention on stress of caregivers with developmental delay children. We used the "Atomic Habits" as a psycho-educational intervention foundation to establish positive caregiver thinking and behavioral patterns to increase self-identity and reduce stress. Past literature supports the use of digital media providing continuous intervention for families with difficult children(Marino et al., 2020). Changing parental behavior patterns can improve caregiver self-efficacy stress and relationship(Leadbitter et al., 2018; Neece et al., 2019; Salisbury et al., 2022).

Design: Pre-experimental design.

Setting: A medical center's outpatient service for special-needs children

Participants: Totally 40 patients were recruited and randomly assigned to the hybrid (n = 20) and self-reading group (n = 20) between March 20, 2023, and December 20, 2023. During the study, three patients in the self-reading group dropped out. Before treatment commenced, there were no significant differences in demographic characteristics between the groups.

Interventions: Our study adopted the theoretical foundation from “Atomic Habits” aiding parents and integrated the “Four Laws of Behavior Change” into daily routines, reducing parental stress and improving parent-child relationships. The 'Hybrid Group' engaged 8-week online curriculum includes audiobook with frequent reminders tailored to caregivers and two personalized guidance by therapist. Progress was tracked through a 'Homework Record Sheet’ and personalized support. The 'Self-Reading Group’ received an initial overview and read at their own pace over 8 weeks, with one face-to-face consultation after the post-test.

Main Outcome Measures: The main evaluations include the Parenting Stress Index: Short Form (PSI/SF), Parental Distress (PD), Parent-Child Dysfunctional Interaction (PCDI), difficult child (DC).

Results: There were no significant differences between the two groups. The hybrid and the self-reading group demonstrated significant improvements including the PSI/SF (p = 0.01, p = 0.04), PD (p = 0.00, p = 0.00) and PCDI (p = 0.04, p = 0.03). However, no significant differences were observed in DC.

Conclusions: This study investigated the effects of the psycho-education from "Atomic Habits" through hybrid for enhancing parental roles and reducing parental stress. They demonstrated improvements in PSI/SF, PD and PCDI with no significant differences between the groups.

Author(s) Disclosures: Chieh-Yu Pan and Fen-Ling Kuo contributed to the conception, design, execution, and manuscript preparation of this study. Chieh-Yu Pan developed the programs of audiobooks and Fen-Ling Kuo facilitated the measurements and overseeing the project's findings. All authors have read and approved the final manuscript.