Examining the Impact of Intervention Quality on Mechanisms of Change in Digital Parent Training Programs

Therapeutic persuasiveness - the extent to which digital mental health interventions incorporate design features that encourage users to make positive behavior changes – may play a role in enhancing adherence and effectiveness in these interventions. This study focused on the underlying mechanisms of change and examined whether program quality, in terms of therapeutic persuasiveness, influences the way program participation translates into outcomes in digital parent training programs targeting child behavior problems. Data were obtained from a randomized controlled trial of two digital parent training programs with different levels of therapeutic persuasiveness quality. When parental self-efficacy and overreactivity were used as mediators of improvements in child behavior, mediation analysis revealed significant indirect effects among the enhanced therapeutic persuasiveness intervention users (n = 39), but not among the standard intervention users (n = 33; indirect effect medians = 18.30 and 2.29, respectively). These findings highlight the need to address an intervention’s quality in terms of its design features when examining the pathways through which it produces behavioral change.