An internet-based parent management training program (Net PAMA) improves parenting outcomes in a multicenter randomized controlled trial

Abstract

This study assessed the effectiveness of Net PAMA, a newly developed internet-based parent management training program. Parents of children aged 6-12 were randomly assigned to Net PAMA alone, Net PAMA with online group meetings (Net PAMA+), or a wait-list control. The six-chapter Net PAMA program involved weekly viewing of instructional video modules and daily homework. Effectiveness was measured at four time points-pre-study (T0), midpoint (T1), program completion (T2), and two months post-completion (T3)-using three scales. These included the Positive Parenting Scale (POPS), which covers relationship, respect for the child's individuality, and rule-setting; the Pediatric Symptom Checklist (PSC-17), which measures depressive and anxiety symptoms, hyperactive-inattentive behaviors, and conduct problems; and the Swanson, Nolan, and Pelham Rating Scale-IV (SNAP-IV), which assesses oppositional and defiant behaviors. Of 290 participants, 250 (86.2%) completed the study. Intention-to-treat analysis (using repeated-measures GLMs) revealed that both Net PAMA and Net PAMA+ significantly improved scores on all measures compared to the control group at both T2​ and T3​. For the POPS, both groups showed significant improvements compared to control at T2 (e.g. Net PAMA: parents' report p < .001, children's report p = .005) and T3. Similarly, both interventions significantly improved PSC-17 and SNAP-IV scores at T2​ and T3​, with most improvements significant across both parent and child reports (e.g. T2​ PSC-17 Net PAMA: parents' report: p = .007, children' report p < .001; T2 SNAP-IV Net PAMA: p = .005). Crucially, there were no significant differences in any measures between the Net PAMA and Net PAMA+ groups. To conclude, Net PAMA effectively improved positive parenting practices and reduced child behavior problems with small to medium effect sizes, with benefits persisting for at least two months. However, online group meetings did not show additional benefits beyond the Net PAMA program.Trial Registration: The study was registered with the Thai Clinical Trials Registry on April 9, 2021 (identification number TCTR20210409001). The trial registration record is publicly available at: https://trialsearch.who.int/Trial2.aspx?TrialID=TCTR20210409001 .