Researchers: Amit Baumel¹, Idan Aderka¹, Fred Muench²

Background: The study examined a guided digital parent training program (DPT) for treating Oppositional Defiant Disorder (ODD), showcasing remote medicine's capacity to address health-system constraints. ODD was selected due to its prevalence and the critical need for early treatment.

Objectives: This study aimed to (1) evaluate the reach and usage of a fully remote, guided DPT, (2) determine the necessary human support for a fully automated program, and (3) assess its preliminary effectiveness. As the study was conducted before and during wartime in Israel we also sought to (4) examine the impact of wartime on intervention’s outcome by comparing two cohorts treated before and during wartime.

Method: Parents of children with ODD were given access to a human-supported DPT. Participants were divided into cohorts before (n=25) and during (n=30) wartime. Tools used for assessment included self-reported questionnaires, usage data, and clinician assessments.

Findings: Over 60% of families had never sought treatment for their child’s behavior issues before. Post-intervention improvements in child behavior (Cohen's ds ≥ 0.79) and parenting practices (0.39 ≤ Cohen's ds ≤ 0.87) were significant. Average engagement involved 138.6 minutes of usage and 31.4 logins, with about 39 minutes of human support per family. Wartime participants completed the onboarding faster (15.70 vs. 31.36 days) and had a higher completion rate in the critical phase (90% vs. 68%). However, the rate of recovery from ODD was lower during wartime (43.3% vs. 68%).

Conclusions: DPTs are an effective alternative for reaching untapped parental populations, showing high utility during crises but with potentially diminished outcomes.

Recommendations: Stakeholders should have an articulated plan for the deployment of digital interventions at the national level with nationwide screening procedures that could reach a high proportion of untreated population at low costs. Such strategic planning can also address immediate needs during a crisis.

Research end date: 11/2024